Cervical Spinal Alignment Change Accompanying Spondylosis Exposes Harmonization Failure with Total Spinal Balance: A Japanese Cohort Survey Randomly Sampled from a Basic Resident Registry

Shota Ikegami; Masashi Uehara; Ryosuke Tokida; Hikaru Nishimura; Noriko Sakai; Hiroshi Horiuchi; Hiroyuki Kato; Jun Takahashi

doi:10.3390/jcm10245737

Cervical Spinal Alignment Change Accompanying Spondylosis Exposes Harmonization Failure with Total Spinal Balance: A Japanese Cohort Survey Randomly Sampled from a Basic Resident Registry

J Clin Med. 2021 Dec 8;10(24):5737. doi: 10.3390/jcm10245737.

Authors

Shota Ikegami^{1

2}, Masashi Uehara¹, Ryosuke Tokida², Hikaru Nishimura², Noriko Sakai³, Hiroshi Horiuchi^{1

2}, Hiroyuki Kato¹, Jun Takahashi¹

Affiliations

¹ Department of Orthopaedic Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto 390-8621, Nagano, Japan.
² Rehabilitation Center, Shinshu University Hospital, 3-1-1 Asahi, Matsumoto 390-8621, Nagano, Japan.
³ Department of Orthopaedic Surgery, New Life Hospital, Obuse, Nagano 381-0295, Kamitakai-gun, Japan.

Abstract

The relationship between spinal posture and quality of life has garnered considerable attention with the increase in older community-dwelling residents. However, details of this association remain insufficient. A recent Japanese population cohort epidemiological locomotion survey (the Obuse study) revealed that the C2-C7 cervical sagittal vertical axis (CSVA) began to increase in males from their 60s, but not in females. This study aimed to clarify the pathology of these cervical spondylotic changes. A total of 411 participants (202 male and 209 female) aged between 50 and 89 years were selected by random sampling from a cooperating town's resident registry. All participants underwent lateral X-ray photography in a standing position for the measurement of several sagittal spinal alignment parameters, including CSVA, C2-C7 cervical lordosis (CL), T1 slope (T1S), and sagittal vertical axis (SVA). The presence of cervical spondylotic changes was also recorded. Associations of cervical sagittal spinal alignment with cervical spondylosis and between cervical and total sagittal spinal alignment were examined. The prevalence of cervical spondylosis was significantly higher in males (81%) than in females (70%) (p = 0.01). CL was significantly smaller in cervical spondylosis subjects when adjusted by age (3.4 degrees less; p = 0.01). T1S minus CL displayed a moderate positive correlation with CSVA in both males and females (r = 0.49 and 0.48, respectively, both p < 0.01). In males only, CSVA and CL showed weak positive correlations with SVA (r = 0.31 and 0.22, respectively, both p < 0.01) independently of age. Cervical spinal misalignment was more clearly associated with diminished SF-8^TM scores in females than in males. In community-dwelling elderly residents, cervical sagittal spinal alignment change accompanying cervical spondylosis manifested as hypofunction to compensate for whole-spine imbalance.

Keywords: adult spine; aging; cervical spine; epidemiological study; gender; resident cohort; resident registry; spinal alignment; spinal balance.

Abstract

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