Page 38 - JCTR-9-5

Journal of Clinical and Translational Research 2023; 9(5): 340-346

Journal of Clinical and Translational Research

Journal homepage: http://www.jctres.com/en/home

ORIGINAL ARTICLE

Changes in correlations between cervical and distal spinal sagittal

alignments in asymptomatic population with aging

Jiang Xu , Junlong Zhong , Zongmiao Wan , Jiachao Xiong , Zhenhai Zhou , Honggui Yu , Kai Cao *
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1 Nanchang University Spine and Spinal Cord Institute, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, China, Department
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of Orthopedics, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, China
ARTICLE INFO ABSTRACT
Article history: Background: In recent years, the correlations between spinal sequences and aging have been
Received: April 14, 2023 identified. However, the trends in correlations between cervical and distal spinal alignments with
Revised: June 05, 2023 aging in asymptomatic populations remain underexplored.
Accepted: July 31, 2023 Aim: This study aimed to compare the correlations between cervical and distal spinal sagittal
Published: October 02, 2023 alignments in different age groups as well as investigate their trends during the aging process in an
asymptomatic population.
Keywords: Methods: A total of 128 asymptomatic healthy volunteers were enrolled and stratified into four groups
Cervical alignment according to age (Group A: ≤20 years; Group B: 21 – 40 years; Group C: 41 – 60 years; Group D:
Spine >61 years), with 32 subjects in each group. Then, sagittal spinal parameters including C0-1 Cobb
Aging angle (C0-1 CA), C1-2 Cobb angle (C1-2 CA), C0-2 Cobb angle (C0-2 CA), C2-7 Cobb angle (C2-
Asymptomatic population 7 CA), C2-7 sagittal vertical axis (C2-7 SVA), neck tilt, thoracic inlet angle (TIA), T1 slope (TS),
thoracic kyphosis (TK), lumbar lordosis, pelvic tilt, sacral slope, pelvic incidence, and C7-S1 sagittal
*Corresponding author: vertical axis (C7-S1 SVA) were measured, and differences in parameters among the four groups were
Kai Cao analyzed. Finally, the trends in correlations between the cervical and distal spinal sagittal parameters
The Orthopedic Hospital, The First Affiliated were investigated in the different age groups.
Hospital of Nanchang University, Nanchang, Results: No significant correlations were detected between upper cervical sagittal parameters (C0-1
Jiangxi Province, 330209, China. CA, C1-2 CA, and C0-2 CA) and distal spinal sagittal parameters in the four groups. An increasing
E-mail: kaichaw@126.com trend with aging was discovered in the correlations between subaxial cervical sagittal parameters and
distal spinal sagittal parameters. Finally, significant correlations were observed between TS and TK,
© 2023 Author(s). This is an Open-Access as well as between TIA and TK in the four groups.
article distributed under the terms of the Conclusions: Subaxial cervical alignments exhibit a close correlation with distal spinal alignments
Creative Commons Attribution-Noncommercial during the aging process in the asymptomatic population. An increasing trend was observed with age
License, permitting all non-commercial use,
distribution, and reproduction in any medium, in the correlations between C2-7 CA, C2-7 SVA, and distal spinal sagittal parameters.
provided the original work is properly cited. Relevance for Patients: Given the correlations between the cervical and distal spinal alignments,
which tend to increase with age, it is crucial to pay special attention to the influence of C2-7 CA and
C2-7 SVA on distal spinal alignments before spinal surgery for patients.

1. Introduction

The sagittal balance of the spine has recently garnered increasing attention from spinal
surgeons [1,2]. Indeed, sagittal alignment of the spine provides key information about spinal
function and largely influences spinal biomechanics. Thus, maintaining the sagittal balance
of the spine plays a vital role in maintaining the normal posture of the body [3].
As is well documented, the spine is composed of cervical and distal segments. As an essential
component of the spine, the cervical spine plays an instrumental role in maintaining the

DOI: http://dx.doi.org/10.18053/jctres.09.202305.23-00059