Abstract：Objective This study aimed to compare the differences and correlation of cervical sagittal alignment between healthy adults and patients with C5/6 single-level degenerative cervical myelopathy (DCM) based on gender. Methods In this retrospective study, 143 patients with C5/6 single-level DCM (DCM group) and 144 normal adults (control group) in the spinal surgery department of the Affiliated Hospital of Xuzhou Medical University from January to November 2021 were included. In the DCM group, 72 were males and 71 were females, aged between 30 and 70 (56.7±11.0) years. In the control group, 72 were males and 72 were females, aged between 30 and 70 (55.8±9.4) years. The following parameters were measured and recorded on sagittal MRI of the cervical spine: C2 slope (C2S), cervical lordosis (CL), C2-7 sagittal vertical axis (cSVA), T1 slope (T1S), neck tilt (NT), thoracic inlet angle (TIA), spinocranial angle (SCA), cervical tilt (CeT), cranial tilt (CrT), and range of compressed spinal cord of patients with DCM. The differences in imaging parameters between males and females were analyzed in both groups, and the parameters of both genders were separately compared between the two groups. The correlation between spinal cord compression range and all imaging parameters was compared in male and female DCM group. Results In the control group, C2S was higher in females (11.25°±6.51°) than in males (7.63°±7.82°), whereas CL(8.12°±8.45°), T1S(20.89°±6.50°), TIA(71.72°±11.88°), SCA(86.44°±8.54°) and CeT(16.20°±6.59°) were all lower in females than in males (14.69°±9.77°, 23.27°±7.65°, 75.50°±10.92°, 95.89°±10.56°, and 19.23°±8.34°), and the difference was statistically significant (all P values <0.05). No significant difference was found in the cSVA, NT, and CrT between males and females (all P values >0.05). In the DCM group, SCA (88.19°±11.78°) and CeT (15.11°±8.46°) were lower in females than in males (95.88°±11.84° and 18.10°±9.21°), while the CrT (5.09°±4.22°) in females was higher than that in males (3.82°±3.20°), and the difference was statistically significant (all P values <0.05). Other imaging parameters showed no significant difference between the two genders (all P values <0.05). In females, the NT (50.83°±12.66°) and TIA(71.72°±11.88°) in the control group were lower than those in the DCM group (55.81°±13.15° and 76.02°±13.45°), and the difference was statistically significant (all P values <0.05). In males, the CL in the control group (14.68°±9.67°) was higher than that in the DCM group (10.37°±13.78°), while the NT and TIA in the control group (52.24°±8.89°, 75.50°±10.92°) was lower than that in the DCM group (57.33°±11.18°, 79.27°±9.40°), and the difference was statistically significant (all P values <0.05). The C5/6 single-level DCM attack was correlated with CL and NT, and no significant difference was observed between females and males (r=-0.26, 0.28 in female DCM group, r=-0.22, 0.25 in male DCM group; all P values <0.05). Conclusions Loss of CL is associated with single-level DCM attack, and cervical spine morphology changes more significantly in the cervical spine degeneration towards DCM in healthy males than in females. The difference in MRI sagittal cervical morphology between the two genders in patients with DCM is mainly due to the differences in the position of the head barycenter, the degree of cervical lordosis and cervical prolapse.
蔡大钊, 王子豪, 马一鸣, 鹿麒, 吴东迎, 袁峰, 陈宏亮. 健康成人与颈5/6单节段脊髓型颈椎病患者颈椎MRI矢状面形态的比较[J]. 中华解剖与临床杂志, 2022, 27(11): 763-768.
Cai Dazhao, Wang Zihao, Ma Yiming, Lu Qi, Wu Dongying, Yuan Feng, Chen Hongliang. Analysis of cervical sagittal alignments in MRIs between normal adults and patients with C5/6 single-level degenerative cervical myelopathy. Chinese Journal of Anatomy and Clinics, 2022, 27(11): 763-768.
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2022, Vol. 27 
