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07.09.2018 | Original Article | Ausgabe 11/2018

European Spine Journal 11/2018

Cervical and postural strategies for maintaining horizontal gaze in asymptomatic adults

Zeitschrift:
European Spine Journal > Ausgabe 11/2018
Autoren:
Nour Khalil, Aren Joe Bizdikian, Ziad Bakouny, Michel Salameh, Naji Bou Zeid, Fares Yared, Joeffroy Otayek, Khalil Kharrat, Gaby Kreichati, Ismat Ghanem, Renaud Lafage, Virginie Lafage, Ibrahim Obeid, Ayman Assi
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s00586-018-5753-3) contains supplementary material, which is available to authorized users.

Abstract

Purpose

To investigate the different cervical strategies for maintaining horizontal gaze in asymptomatic subjects.

Methods

One hundred and forty-four asymptomatic adults filled the SF-36 quality of life questionnaire and underwent full-body biplanar radiographs. Chin brow vertical angle (CBVA) and postural and cervical parameters were measured. Subjects were grouped according to cervical spine curvature (C2–C7 angle): kyphotic (< − 5°), straight [− 5°, 5°], lordotic (> 5°). Demographics, SF-36 component scores and CBVA were compared between groups. All other parameters were compared between groups, while controlling for confounding factors (ANCOVA). A correlation test was conducted between all cervical parameters.

Results

32% of subjects had kyphotic (− 12° ± 7°), 27% straight (0° ± 3°) and 41% lordotic (12° ± 7°) cervical spines. While demographic and SF-36 data did not differ between groups, CBVA differed between lordotic and kyphotic groups (2° vs. 6.5°, p = 0.002). Sagittal vertical axis (SVA) and thoracic kyphosis (TK) were lower in the kyphotic group (SVA: K = − 26 ± 20 mm vs. L = − 2 ± 21 mm, p < 0.001; TK: K = 40° ± 6° vs. L = 51° ± 8°, p < 0.001). C2 slope (K = 29° ± 6° vs. L = 18° ± 6°, p < 0.001), C0–C2 (K = 42° ± 8° vs. L = 30° ± 8°, p < 0.001) and C1–C2 (K = 33° ± 6° vs. L = 28° ± 6°, p = 0.004) were higher in the kyphotic group. Significant correlations were found between almost all cervical parameters and C2–C7 angle.

Conclusions

Subjects with cervical kyphosis presented with more posterior global alignment and lower TK than subjects with lordosis. In order to maintain horizontal gaze, subjects with cervical kyphosis presented with a more lordotic upper cervical spine than subjects with cervical lordosis. Subjects with straight cervical curvature presented with an intermediate sagittal alignment.

Graphical abstract

These slides can be retrieved under Electronic Supplementary Material.

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