Cervical Vertebrae ; Humans ; Neck/diagnostic imaging* ; Neck Pain/etiology*

Cervical Vertebrae/diagnostic imaging* ; Humans ; Magnetic Resonance Imaging ; Nitrous Oxide/adverse effects* ; Spinal Cord Diseases/diagnostic imaging* ; Substance-Related Disorders

OBJECTIVE: To investigate the correlation between the changes of cervical curvature and atlantoaxial instability. METHODS: The correlation between the changes of cervical curvature and atlantoaxial instability was retrospectively studied in 50 outpatients with abnormal cervical curvature (abnormal cervical curvature group) from January 2018 to December 2019. There were 24 males and 26 females in abnormal cervical curvature group, aged from 18 to 42 years old with an average of(30.62±5.83) years. And 53 patients with normal cervical curvature (normal cervical curvature group) during the same period were matched, including 23 males and 30 females, aged from 21 to 44 years with an average of(31.98±6.11) years. Cervical spine X-ray films of 103 patients were taken in lateral position and open mouth position. Cervical curvature and variance of bilateral lateral atlanto-dental space(VBLADS) were measured and recorded, Pearson correlation coefficient analysis was used to study the correlation between the changes of cervical curvature and atlantoaxial instability. RESULTS: Atlantoaxial joint instability accounted for 39.6%(21/53) in normal cervical curvature group and 84.0%(42/50) in abnormal cervical curvature group. There was significant difference between two groups(P<0.01). VBLADS in abnormal cervical curvature group was (1.79±1.01) mm, which was significantly higher than that in normal cervical curvature group(0.55±0.75) mm(P<0.01). Pearson correlation coefficient analysis showed that the size of cervical curvature was negatively correlated with VBLADS. CONCLUSION Cervical curvature straightening and inverse arch are the cause of atlantoaxial instability, the smaller the cervical curvature, the more serious the atlantoaxial instability.
Adolescent ; Adult ; Atlanto-Axial Joint/diagnostic imaging* ; Cervical Vertebrae/diagnostic imaging* ; Female ; Humans ; Joint Instability/diagnostic imaging* ; Kyphosis ; Male ; Radiography ; Retrospective Studies ; Young Adult

OBJECTIVE: To explore clinical symptoms and X-ray imaging features of cervical instability in young adult represented by postgraduates with a master's degree in medicine. METHODS: Totally 91 postgraduates with a master's degree in medicine were investigated from September to December 2021, including 45 males and 46 females;aged from 22 to 30 years old with an average of (25.30±2.18) years old. The cervical spondylosis-related discomfort symptoms of the subjects were collected and examined by the examiner for neck and shoulder tenderness point examination and cervical vertebra positive and lateral and functional X-ray radiography. According to the results of X-ray examination, the subjects were divided into stable cervical group and unstable cervical group. RESULTS: Among 91 subjects, there were 50 patients with cervical instability, accounting for 54.90% of total number of subjects. The cervical curvature was abnormal in 78 patients, accounting for 85.70% of total number of subjects. Among 50 patients with cervical instability, 50 patients were diagnosed as cervical instability on the basis of angular displaxement(AD)≥ 11 °, including 13 cases of C_3,4 instability, 30 cases of C_4,5 instability and 7 cases of C_5,6 instability;and 5 cases were diagnosed as cervical instability based on horizontal displacement(HD)≥ 3.5 mm, including 1 case of C_3,4 instability and 4 cases of C_4,5 instability. Compared with stable cervical group, the number of discomfort symptoms of neck pain, headache and shoulder pain in instability group was significantly higher than that of in stable cervical group(P<0.05);and the number of tenderness in spinous process space of C_4,5 and C_5,6, 2 cm adjacent to the spinous process of C₂-C₅ and the superior angle of the scapula (the stop point of levator scapulae) in the instability group was significantly higher than that in the stable cervical group (P<0.05);and the cervical curvature in the instability group was significantly lower than that in stable cervical group(P<0.05). CONCLUSION The incidence of cervical instability in young adult represented by postgraduates with a master's degree in medicine is high, they are mainly diagnosed as cervical instability on the basis of vertebral angular displacement ≥ 11°, and the instability segments are concentrated on C_3,4, C_4,5 and C_5,6 segments, the occurrence of cervical instability is often accompanied by abnormalities of cervical curvature. Most of clinical manifestations are head, neck and shoulder pain, especially neck pain in unstable segment.
Male ; Female ; Humans ; Young Adult ; Adult ; Neck Pain/etiology* ; Shoulder Pain ; Spinal Diseases ; Radiography ; Spondylosis/diagnostic imaging* ; Joint Instability/diagnostic imaging* ; Cervical Vertebrae/diagnostic imaging*

OBJECTIVE: To explore the normal distribution of cervical sagittal alignment and the relationship between cervical alignment and global spine balance in asymptomatic young adults. METHODS: A cohort of 272 asymptomatic Chinese adults (including 161 males and 111 females, with an average age of (23.2±4.4) years, ranging from 18 to 45 years) were prospectively recruited from November 2011 to December 2014. The C₀-C₂ angle, disk angles from C₂-C₃ to C₆-C₇, vertebral angles from C₃ to C₇, T₁ slope, thoracic kyphosis (TK), lumbar lordosis (LL), pelvic incidence (PI), sacral slope (SS), C₂-C₇ sagittal vertical axis (C₂-C₇SVA), center of gravity of head to C₇SVA (CGH-C₇SVA), C₇-S₁SVA were measured and statistically analyzed. All the subjects were categorized with the Roussouly classification and the cervical morphologies were evaluated as lordotic, straight, sigmoid or kyphotic. Spinal sagittal alignment parameters were compared between different sexes and Roussouly classifications with independent student t test, analysis of variance (ANOVA) or Chi-square test. Correlations between cervical sagittal alignment and global spine sagittal alignment were calculated using the Pearson and Spearman correlation coefficient. Linear regression analysis was performed. RESULTS: Sixty-seven males and 59 females aged from 18 to 30 years old were included in the study. The mean value of C₀-C₇ was 26.0°±12.8°, composed of 15.2°±6.7° for C₀-C₂, 9.1°±12.1° for sum of disk angles from C₂-C₃ to C₆-C₇, and 1.4°±10.2° for sum of vertebral angles from C₃ to C₇. C₂-C₇SVA [(18.6±7.9) mm] and CGH-C₇SVA [(22.9±12.3) mm]were offset ideally by C₇-S₁SVA [(-21.6±31.0) mm]. Males had a larger T₁ slope (P < 0.05) and accordingly, a larger cervical lordosis C₂-C₇ (P < 0.01) and C₀-C₇ angle (P < 0.01) than females. Males had a smaller C₇-S₁SVA (P < 0.01) and accordingly, a smaller CGH-C₇SVA (P=0.165) than females. Significant difference was found between cervical alignment of different Roussouly types (P < 0.01). In general, a larger LL was consistent with a set of larger TK, C₂-C₇angle, C₀-C₇ angle, and vice versa. There was no significant correlation between cervical morphology and the Roussouly classification (Chi-square=10.548, P=0.308). There was significant correlation between cervical alignment and T₁ slope (P < 0.01), TK (P < 0.01). There was significant correlation between adjacent segmental angles from T₁ slope up to C₀-C₂ angle (P < 0.05). CONCLUSION Normative values of each vertebral angle and disk angle were established. The cervical lordosis occurred mainly at C₀-C₂ and disk levels, which was influenced by parameters of other parts of the spine, such as T₁ slope, TK and the Roussouly classification. There was significant correlation between adjacent disk angles.
Adolescent ; Adult ; Cervical Vertebrae/diagnostic imaging* ; China ; Female ; Humans ; Kyphosis ; Lordosis/diagnostic imaging* ; Male ; Thoracic Vertebrae ; Young Adult

OBJECTIVE: To explore the correlation between the curvature of the cervical spine and the degree of cervical disc bulging in young patients with cervical pain. METHODS: The clinical data of 539 young patients with neck pain from January 2015 to December 2018 were retrospectively analyzed. There were 251 males and 288 females, aged 18 to 40 (32.2±6.3) years old. The cervical curvature and cervical disc bulging were measured by cervical X-ray and MRI. According to cervical curvature, the patients were divided into 175 cases of cervical lordosis group (cervical curvature > 7 mm), 163 cases of cervical erection group (0 <cervical curvature ≤ 7 mm), and 201 cases of cervical kyphosis group (cervical curvature ≤ 0 mm). The degreeof cervical intervertebral disc bulging was compared among three groups, and the correlation between cervical curvature and cervical disc bulging was analyzed by Pearson correlation coefficient. RESULTS: The cervical disc bulging of cervical lordosis group, cervical erection group, and cervical kyphosis group were(0.83±0.24), (1.47±0.58), (2.96±1.11) mm, respectively. The degree of cervical disc bulging in cervical lordosis group was less than cervical erection group and cervical kyphosis group( CONCLUSION The degree of cervical disc bulging in young patients with neck pain is closely related to the reduction of cervical curvature.
Adolescent ; Adult ; Cervical Vertebrae/diagnostic imaging* ; Female ; Humans ; Kyphosis ; Lordosis ; Male ; Neck Pain/diagnostic imaging* ; Retrospective Studies ; Young Adult

To establish an intelligent cervical vertebra maturity assessment system, and to evaluate the reliability and clinical value of the system. Sixty children aged were recruited in the study. Lateral cephalometric radiograph and cone beam CT (CBCT) were taken at the same period. Based on the CBCT data, the system automatically extracted the patient's facial area through Otsu's method, intercepted the sagittal plane by three-dimensional least squares method, captured the second to fourth cervical vertebrae by superpixel segmentation. And then selected points were marked automatically through morphological algorithm and manual method. Consistency test was performed on the two sets of data to compare the reliability of automated cervical morphology capture. According to the parameters of morphological identification, positioning and staging algorithms were designed to form the intelligent cervical vertebra maturity assessment system. The cervical vertebra maturity was also judged manually on the lateral cephalometric radiograph. The weighted Kappa test and the Gamma correlation coefficient were subsequently applied to evaluate the consistency and correlation. The results showed that the cervical vertebra features automatically captured based on CBCT data had a high accuracy on the overall morphological recognition. In the prediction of 8 inflection points out of 13 points, there was no significant difference between automatic and manual method on both X and Y axes (all >0.05). The assessment results of the cervical vertebra maturity of the intelligent system had strong consistency and correlation with the manual recognition results (weighted Kappa value=0.877, Gamma value=0.991, both <0.05). The intelligent cervical vertebrae maturity assessment system based on CBCT data established in this study presents reliable outcome and high degree of automation, indicating that the system may be used clinically.
Cephalometry ; Cervical Vertebrae/diagnostic imaging* ; Child ; Cone-Beam Computed Tomography ; Humans ; Radiography ; Reproducibility of Results

Brucella ; Brucellosis/diagnosis* ; Cervical Vertebrae/diagnostic imaging* ; Epidural Abscess ; Humans ; Magnetic Resonance Imaging ; Quadriplegia ; Spondylitis/diagnostic imaging*

Cervical Vertebrae/diagnostic imaging* ; Humans ; Range of Motion, Articular ; Spondylosis/diagnostic imaging* ; Treatment Outcome

OBJECTIVE: To investigate the population distribution of cervical spine instability in rheumatoid arthritis (RA) patients, and to analyze the clinical characteristics in RA patients with cervical spine instability. METHODS: A total of 439 RA patients who had completed cervical spine X-ray examination from Department of Rheumatology and Immunology of Peking University Shenzhen Hospital and Peking University Third Hospital from August 2015 to March 2019 were enrolled. The clinical data, laboratory data and cervical radiographic data were collected and analyzed by t-test, rank sum test and Chi-square test to clarify the clinical characteristics in the RA patients with cervical spine instability. RESULTS: Of the 439 RA patients, 80.9% (355/439) were female, with an average age of (52.9±13.9) years, a median duration of the disease was 60 months, the shortest history was 2 weeks, and the longest history was up to 46 years. 29.6% (130/439) of the RA patients showed cervical spine instability. Among them, 20 RA patients were complicated with two different types of cervical instability, the atlantoaxial subluxation (AAS) accounted for 24.6% (108/439), the vertical subluxation (VS) accounted for 7.3% (32/439) and the subluxial subluxations (SAS) accounted for 2.3% (10/439). The patients with cervical spine instability had a longer duration of disease [120 (36, 240) months vs. 48 (12, 120) months], a higher proportion of peripheral joint deformity (56.9% vs. 29.9%), and a higher visual analog scale (VAS) measuring general health score (4.89±2.49 vs. 3.93±2.38), a lower hemoglobin [(111.31±19.44) g/L vs. (115.56±16.60) g/L] and a higher positive rate of anti-cyclic citrullina-ted peptide (CCP) antibody (90.8% vs. 76.6%). There were no significant differences in gender, age, number of swollen joints, number of tenderness joints, erythrocyte sedimentation rate, rheumatoid factor level, 28-joint disease activity score, positive rate of anti keratin antibody, duration of glucocorticoid use and duration of disease modifying anti-rheumatic drugs use between the two groups. CONCLUSION In the study, 29.6% of the RA patients showed cervical spine instability. RA patients with cervical spine instability had a long-term disease, a higher proportion of peripheral joint deformity, a higher VAS measuring general health score, a lower hemoglobin and a higher positive rate of anti-CCP antibody.
Adult ; Aged ; Arthritis, Rheumatoid/epidemiology* ; Autoantibodies ; Cervical Vertebrae/diagnostic imaging* ; Demography ; Female ; Humans ; Joint Instability/epidemiology* ; Middle Aged