Establishing a method for quantifying spinal curvature during videofluoroscopic swallow studies: Applying the modified Cobb angle to healthy young and older adults.
Establishing a method for quantifying spinal curvature during videofluoroscopic swallow studies: Applying the modified Cobb angle to healthy young and older adults.
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DOI：
10.21926/obm.geriatr.2003129
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发表时间：
2020-10
期刊：
影响因子：
--
通讯作者：
Molfenter SM
中科院分区：
文献类型：
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作者：
Namasivayam-MacDonald AM;Riquelme LF;Molfenter SM
Cobb角传统上用于通过评估整个脊髓来量化脊柱弯曲程度。在进行视频透视吞咽研究（VFSS）测量时，Cobb角可以测量颈椎弯曲程度，这可能对吞咽有影响。考虑到该测量方法可能在吞咽困难研究中具有实用性，从C2-C4中获取的该测量方法的可靠性以及确定随年龄变化的存在是当前原理验证研究的重点。回顾性分析了19名健康青年人和39名健康老年人的VFSS。在喉前庭闭合（LVC）和吞咽后休息的框架上测量颈椎2和4之间的C2-C4 Cobb角。结果显示，吞咽后静息帧的评定者间和评定者内可靠性水平极佳（ICC = 0.788和0.793），LVC帧的一致性水平一般至良好（ICC = 0.667和0.621）。健康青年组与老年组C2-C4 Cobb角有显著性差异（p <0.01）。健康的年轻成人在LVC时的平均角度为5.8 ± 9.0度，在吞咽休息时为7.7 ± 4.5度，而健康的老年成人在LVC时的平均角度为12.5 ± 9.0度，在休息时为12.4 ± 9.7度。与现有的脊柱文献一致，颈椎的弯曲似乎随着年龄的增长而增加。在确定可靠性的基础上，我们建议C2-C4 Cobb角可用于确定各种患者人群的脊柱弯曲程度，以确定对吞咽功能的影响。
The Cobb angle is traditionally used for quantifying the degree of spinal curvature through evaluation of the full spinal cord. When conducting measurements on videofluoroscopy swallowing studies (VFSS), the Cobb angle can measure degree of cervical vertebrae curvature, which may have implications for swallowing. Given that this measure may have utility in dysphagia research, the reliability of this measure taken from C2-C4 and establishing the presence of changes with age were the focus of the current, proof-of-principle study. VFSS from 19 healthy young adults and 39 healthy older adults were retrospectively analyzed. The C2-C4 Cobb angle was measured between cervical vertebrae two and four on frames of laryngeal vestibule closure (LVC) and post-swallow rest. Results revealed excellent levels of inter- and intra-rater reliability for frame of post-swallow rest (ICCs = 0.788 and 0.793), and fair to good levels of agreement for frame of LVC (ICCs = 0.667 and 0.621). Significant differences in the C2-C4 Cobb angle were found between the healthy young and old data (p < 0.01). Healthy younger adults had a mean angle of 5.8±9.0 degrees at LVC and 7.7±4.5 degrees at swallow rest, whereas healthy older adults had a mean angle of 12.5±9.0 degrees at LVC and 12.4±9.7 degrees at rest. Consistent with the existing spine literature, the curvature of cervical vertebrae appears to increase with age. With established reliability, we propose that the C2-C4 Cobb angle may be used to determine the degree of spinal curvature in a variety of patient populations in order to determine impacts on swallowing function.