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European Spine Journal
Published in: European Spine Journal 1/2015

01-01-2015 | Original Article

Sagittal parameters of global cervical balance using EOS imaging: normative values from a prospective cohort of asymptomatic volunteers

Authors: J. C. Le Huec, H. Demezon, S. Aunoble

Published in: European Spine Journal | Issue 1/2015

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Abstract

Objective

To define reference parameters for analyzing sagittal balance of the cervical spine in asymptomatic volunteers.

Methods

Prospective study after Bioethics Committee approval. Imaging performed using a low-dose radiographic system (EOS Imaging, Paris, France). The absence of pain was assessed using the Oswestry Questionnaire and VAS. 106 subjects were included of whom 55.66 % were men. The parameters measured were: pelvic incidence, pelvic tilt, sacral slope, thoracic and lumbar curvature, C7 plumb line position and the spino-sacral angle. The C7 slope and new parameters were measured: cranial incidence, defined in relation to the McGregor line and the sella turcica allowing to define cranial slope and tilt, and the spino-cranial angle (SCA).

Results

This study demonstrated a close correlation between the C7 slope and the cranio-cervical system. Economic sagittal balance in the asymptomatic population was defined by a constant SCA angle of 83° ± 9°. To maintain this balance, a spine with a marked C7 slope will present lordosis and vice versa. Cranial incidence is an anatomical parameter characteristic of the cranio-cervical system which makes it possible to analyze the spatial positioning of the head and to predict the desired value of cervical lordosis which is closely correlated to cranial slope.

Conclusion

The C7 slope has a predictive value of the shape of the cervical spine in the sagittal plane. One-third of the asymptomatic population had cervical kyphosis. Our results could be used to study sagittal balance before and after arthrodesis, or cervical prosthesis.
Literature
1.
2.
3.
Akcam MO, Koklu A (2004) Investigation of natural head posture in different head types. J Oral Sci 46:15–18PubMedCrossRef
4.
Berthonnaud E, Dimnet J, Roussouly P, Labelle H (2005) Analysis of the sagittal balance of the spine and pelvis using shape and orientation parameters. J Spinal Disord Tech 18:40–47PubMedCrossRef
5.
Hellsing E, Reigo T, Mcwilliam J, Spangfort E (1987) Cervical and lumbar lordosis and thoracic kyphosis in 8, 11 and 15-year-old children. Eur J Orthod 9:129–138PubMedCrossRef
6.
Zepa I, Hurmerinta K, Kovero O, Nissinen M, Kononen M, Huggare J (2000) Associations between thoracic kyphosis, head posture, and craniofacial morphology in young adults. Acta Odontol Scand 58:237–242PubMedCrossRef
7.
Hellsing E, Mcwilliam J, Reigo T, Spangfort E (1987) The relationship between craniofacial morphology, head posture and spinal curvature in 8, 11 and 15-year-old children. Eur J Orthod 9:254–264PubMedCrossRef
8.
9.
Roussouly P, Berthonnaud E, Dimnet J (2003) Geometrical and mechanical analysis of lumbar lordosis in an asymptomatic population: proposed classification. Rev Chir Orthop Reparatrice Appar Mot 89:632–639PubMed
10.
Roussouly P, Gollogly S, Berthonnaud E et al (2005) Classification of the normal variation in the sagittal alignment of the human lumbar spine and pelvis in the standing position. Spine 30:346–353PubMedCrossRef
11.
Legaye J, Duval-Beaupère G, Hecquet J et al (1998) Pelvic incidence: a fundamental pelvic parameter for three-dimensional regulation of spinal sagittal curves. Eur Spine J 7:9–103CrossRef
12.
Glassman S, Gornet MF, Branch C, Polly D Jr, Peloza J, Schwender JD, Carreon L (2006) MOS short form 36 and oswestry disability index outcomes in lumbar fusion: a multicenter experience. Spine J 6:21–26PubMedCrossRef
13.
14.
Gheno R, Nectoux E, Herbaux B, Baldisserotto M, Glock L, Cotten A, Boutry N (2012) Three-dimensional measurements of the lower extremity in children and adolescents using a low-dose biplanar X-ray device. Eur Radiol 22:765–771. doi:10.​1007/​s00330-011-2308-y PubMedCrossRef
15.
Gille O, Champain N, Benchikh-El-Fegoun A, Vital JM, Skalli W (2007) Reliability of 3D reconstruction of the spine of mild scoliotic patients. Spine 32:568–573PubMedCrossRef
16.
Roussouly P, Gollogly S, Noseda O, Berthonnaud E, Dimnet J (2006) The vertical projection of the sum of the ground reactive forces of a standing patient is not the same as the C7 plumb line: a radiographic study of the sagittal alignment of 153 asymptomatic volunteers. Spine 31:320–325CrossRef
17.
Vital JM, Senegas J (1986) Anatomical bases of the study of the constraints to which the cervical spine is subject in the sagittal plane. A study of the center of gravity of the head. Surg Radiol Anatom 8:169–173CrossRef
18.
Moussellard H (2009) Ostéosynthèse du rachis cervical supérieur. In: Masson (ed) Conférence d’enseignement, pp 364–383
19.
Kuntz C, Shaffrey CI, Ondra SL, Durrani AA, Mummaneni PV, Levin LS, Pettigrew DB (2008) Spinal deformity: a new classification derived from neutral upright spinal alignment measurements in asymptomatic juvenile, adolescent, adult, and geriatric individuals. Neurosurgery 63:25–39PubMed
20.
Cobb JR (1948) Outlines for the study of scoliosis. In: Edwards (ed) Instructional course lecture of American academy of orthopedic surgeons, pp 261–275
21.
22.
23.
Fineman S, Borrelli FJ, Rtubinstein BM, Epstein H, Jacobson HC (1963) The cervical spine: transformation of the normal lordotic pattern into a linear pattern in the neutral posture. A roentgenographic demonstration. J Bone Joint Surg 45:1179–1183PubMed
24.
Gum JL, Glassman SD, Douglas LR, Carreon LY (2012) Correlation between cervical spine sagittal alignment and clinical outcome after anterior cervical discectomy and fusion. Am J Orthop 41:81–84
Metadata
Title
Sagittal parameters of global cervical balance using EOS imaging: normative values from a prospective cohort of asymptomatic volunteers
Authors
J. C. Le Huec
H. Demezon
S. Aunoble
Publication date
01-01-2015
Publisher
Springer Berlin Heidelberg
Published in
European Spine Journal / Issue 1/2015
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-014-3632-0

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