Cervical lordosis: the effect of age and gender
Cervical lordosis: the effect of age and gender
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DOI：
10.1016/j.spinee.2017.02.007
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发表时间：
2017-06-01
期刊：
影响因子：
4.5
通讯作者：
Soudack, Michalle
中科院分区：
文献类型：
--
作者：
Been, Ella;Shefi, Sara;Soudack, Michalle
背景：颈椎前凸对姿势和功能有重要意义。颈部疼痛和残疾通常与颈椎前凸对线不良有关。涉及颈椎前凸稳定或恢复的外科手术必须考虑到颈椎前凸结构的年龄和性别差异，以避免进一步的并发症。目的：因此，本研究的目的是评估男性和女性从儿童到成年的颈椎前凸差异。研究设计：这是一项回顾性描述性研究。患者样本：共检查了197例6-50岁患者的颈椎侧位X线片。这些人分为两个年龄组：年轻组（76名6至19岁的儿童; 48名男孩和28名女孩）和成年组（121名20至50岁的成年人; 61名男性和60名女性）。回顾性审查的X线片是由institutional review board.METHODS批准的：在每张X线片上，测量6个前凸角，包括总颈椎前凸角（FM-C7），上（FM-C3; C1-C3）和下（C3-C7）颈椎前凸角，C1-C7前凸角，以及枕骨大孔和寰椎之间的角度（FM-C1）。还测量了每个椎体（C3-C7）和椎间盘（C2-C3至C6-C7）的楔角。椎体楔入和椎间盘楔入分别定义为C3至C7椎体或椎间盘楔入的总和。每个颈椎X线片根据四种姿势分类：A-前凸，B-直，C-双曲线，D-后凸。男性的上颈椎前凸（FM-C3）小于女性，下颈椎前凸（C3-C7）大于女性。男性和女性的椎体楔形总和为后凸（前部高度小于后部高度）。男性比女性有更多的前凸椎间盘。一半的成年人（51%）有颈椎前凸，41%有直脊柱，不到10%有双弯或后凸脊柱。儿童的总颈椎前凸（FM-C7）与成人相似。儿童椎体楔入的总和比成人更后凸7度，而儿童椎间盘楔入的总和比成人更前凸11度。71%的儿童颈椎前凸，23%的儿童颈椎直，少于6%的儿童颈椎双曲。性别差异在儿童中已经很明显，女孩有较高的上颈椎前凸（FM-C3; C1-C3）比boys do.CONCLUSIONS：虽然总颈椎前凸（FM-C7）没有改变年龄组之间，男性和女性之间，颈椎前凸的内部结构发生了显着变化。因此，在进行颈部稳定手术或矫正和恢复之前，医生应考虑到颈椎前凸的性别和年龄差异。(C)2017爱思唯尔公司All rights reserved.
BACKGROUND CONTEXT: Cervical lordosis is of great importance to posture and function. Neck pain and disability is often associated with cervical lordosis malalignment. Surgical procedures involving cervical lordosis stabilization or restoration must take into account age and gender differences in cervical lordosis architecture to avoid further complications.PURPOSE: Therefore, the purpose of the present study was to evaluate differences in cervical lordosis between males and females from childhood to adulthood.STUDY DESIGN: This is a retrospective descriptive study.PATIENT SAMPLE: A total of 197 lateral cervical radiographs of patients aged 6-50 years were examined. These were divided into two age groups: the younger group (76 children aged 6-19; 48 boys and 28 girls) and the adult group (121 adults aged 20-50; 61 males and 60 females). The retrospective review of the radiographs was approved by the institutional review board.METHODS: On each radiograph, six lordosis angles were measured including total cervical lordosis (FM-C7), upper (FM-C3; C1-C3) and lower (C3-C7) cervical lordosis, C1-C7 lordosis, and the angle between foramen magnum and the atlas (FM-C1). Wedging angles of each vertebral body (C3-C7) and intervertebral discs (C2-C3 to C6-C7) were also measured. Vertebral body wedging and intervertebral disc wedging were defined as the sum of the individual body or disc wedging of C3 to C7, respectively. Each cervical radiograph was classified according to four postural categories: A-lordotic, B-straight, C-double curve, and D-kyphotic.RESULTS: The total cervical lordosis of males and females was similar. Males had smaller upper cervical lordosis (FM-C3) and higher lower cervical lordosis (C3-C7) than females. The sum of vertebral body wedging of males and females is kyphotic (anterior height smaller than posterior height). Males had more lordotic intervertebral discs than females. Half of the adults (51%) had lordotic cervical spine, 41% had straight spine, and less than 10% had double curve or kyphotic spine. Children had similar total cervical lordosis (FM-C7) to adults. The sum of vertebral body wedging for children was more kyphotic-by 7 degrees-than that of adults, whereas the sum of intervertebral disc wedging in children was more lordotic-by 11 degrees-than that of adults. Seventy-one percent of the children had lordotic cervical spine, 23% had straight spine, and less than 6% had double curve spine. Gender differences are already apparent in children as girls had higher upper cervical lordosis (FM-C3; C1-C3) than boys do.CONCLUSIONS: Although the total cervical lordosis (FM-C7) did not change between age groups, and between males and females, the internal architecture of the cervical lordosis changed significantly. Practitioners before neck stabilization procedures or correction and restoration should therefore take into account the gender and age differences in cervical lordosis. (C) 2017 Elsevier Inc. All rights reserved.