• Spine · Jul 2022

    Increased Cervical Spinal Instability is Associated with the Development of Proximal Type Cervical Spondylotic Amyotrophy.

    • Sho Ishiwata, Yoichi Lizuka, Eiji Takasawa, Tokue Mieda, Yohei Kakuta, Yusuke Tomomatsu, Akira Honda, Shunsuke Ito, Kazuhiro Inomata, and Hirotaka Chikuda.
    • Department of Orthopedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma Japan.
    • Spine. 2022 Jul 1; 47 (13): 938943938-943.

    Study DesignRetrospective cohort study.ObjectivesWe aimed to clarify the clinical relationship between the etiology of proximal-type cervical spondylotic amyotrophy (CSA) and cervical sagittal alignment and instability.Summary Of Background DataAlthough several researchers have discussed hypotheses regarding the etiology of CSA, the trigger and mechanism underlying the onset remain unclear.MethodsWe retrospectively analyzed 52 proximal-type CSA patients (CSA group) and 60 control patients (Control group). The following data were collected: age; sex; cervical lordosis (CL); T1 slope (TS); TS-CL; C2-7 sagittal vertical axis (SVA) on x-ray in the neutral position; flexion angle; extension angle and range of motion (ROM) of C3/4, C4/5 and C5/6; and C3/4, C4/5 and C5/6 instability (translation of >3 mm for adjacent segmental segments) on dynamic x-ray.ResultsCompared with the Control group, the CSA group was associated with an older age (mean age, 67.6 vs. 61.1 years' old, P= 0.029) and male sex (78.8% vs. 50.0%, P= 0.002). In the CSA group, the radiographic parameters showed smaller C4/5 and C5/6 extension angles and C5/6 ROM values and a greater C3/4 flexion angle than the Control group. Furthermore, compared with the Control group, the CSA group was associated with C3/4 instability (13.5% vs. 3.3%, P= 0.049) and C4/5 (21.2% vs. 3.3%, P = 0.003). A logistic regression analysis, with adjusting for the age and sex, showed that the C3/4 flexion angle (odds ratio [OR], 1.2; 95% confidence interval [CI], 1.08- 1.40, P =0.002), C3/4 instability (OR, 7.3; 95% CI 1.25-42.96, P =0.027) and C4/5 instability (OR, 8.1; 95% CI, 1.56-42.19, P = 0.012) were independent risk factors of CSA.ConclusionThis study suggested that a wide C3/4 flexion angle and high C3/4 or C4/5 spinal instability were closely associated with the etiology of proximal-type CSA.Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…