Correlation Analysis Between Cervical Curvature And Sagittal Plane Parameters In Cervical Spondylotic Myelopathy

Objective:To investigate the correlation analysis of cervical curvature C2-C7 Cobb Angle with cervical sagittal plane parameters,responsible intervertebral space height and intervertebral Angle in patients with cervical spondylotic myelopathy.Methods:The clinical data of 75 patients with cervical Spondylotic myelopathy were collected for retrospective study.There were 38 cases in group A(male 20,female 18)and 37 cases in group B(male 18,female 19);aged from 56 to 72 years,with an average of(64.2±2.1)years.According to the number of C2-C7 Cobb angles from small to large,they were divided into groups An and B: group An included the first 38 patients with small C2-C7 Cobb angle,and group B included the remaining 37 patients with larger C2-C7 Cobb angle.The imaging results were evaluated,and the physiological curvature of cervical vertebra,NT,T1 S,TIA,C2-7 SVA,C7 S,ROM,height and angle of responsible intervertebral space were measured.The geometric Sketchpad 5.06 is used to measure and record the straight line and angle,and Photoshop 6 is used to edit the picture.These data were analyzed and calculated by SPSS 25.0 statistical software.For the single factor independent sample test,the data that did not accord with the normal distribution,using the rank sum test,the difference was statistically significant(P < 0.05).Pearson correlation coefficient was used to analyze the correlation between C2-C7 Cobb angle and each cervical vertebra parameter variable.P < 0.05.It showed that there was a correlation between variables,and the correlation coefficient(r value)indicated that the correlation was stronger.Multiple linear regression analysis showed that there was significant difference between C2-C7 Cobb angle and intervertebral space height and intervertebral disc angular factors.Through the ROC curve and using Graph Pad Prism 7.00 to draw Bland-Altman diagram for diagnostic analysis to study the accuracy and consistency.All imaging data were obtained with the patient’s head in the appropriate position under the guidance of the physician.The determination of the data is done independently by two researchers,and when there is a disagreement,it is determined by the third researcher.Results:In these 75 patients with cervical Spondylotic myelopathy,only TIA had no significant relationship with C2-C7 Cobb angle.The changes of other sagittal parameters of cervical spine,such as physiological curvature of cervical vertebra,NT,T1 S,C2～7 SVA,C7 S and ROM,increased with the increase of C2-C7 Cobb angle.The height of intervertebral space increased with the increase of C2-C7 Cobb angle,but in the intervertebral angle formation,it was found that the intervertebral space of C3/4,C4/5,C5/6 and C6/7 increased with the increase of C2-C7 Cobb angle,and there was no statistical significance between the height of intervertebral space,intervertebral angle and C2-C7 Cobb angle in the responsible intervertebral space of C2/C3,but there was no statistical significance between the height of intervertebral space,the angle of intervertebral body and the angle of C2-C7 Cobb.The change of intervertebral height and Angle in the lower cervical spine of patients with responsibility space was more significant than that in the upper cervical spine,as well as the change of C2-C7 Cobb Angle and the patient’s condition.There was a strong correlation between T1 S and C2-C7 Cobb angle,followed by a strong correlation between NT and C2-C7 Cobb angle.The correlation between cervical physiological curvature,ROM and C2-C7 Cobb angle was weak.There was a moderate correlation between C2～7 SVA,C7 S and C2-C7 Cobb angle,while there was no correlation between TIA and C2-C7 Cobb angle.The fitting degree of the height of intervertebral space and the model of angulation and C2-C7 Cobb angle is more than 85%,the fitting effect is good,and the model is stable,the height of intervertebral space and the model of angulation and C2-C7 Cobb angle are all more than 85%,and the fitting effect is good,and the model is stable.In the C3/C4 segment,only the intervertebral angle model has a fitting degree of more than96.9% for the data,the fitting effect is excellent,and the model is stable.In the ROC curve,the asymptotic significance of TIA was 0.217,P > 0.05,and this method had no the same effect;the physiological curvature of cervical vertebra,the area under ROC curve of NT and T1 S were all greater than 0.9,which indicated that the diagnostic value of these three items was higher;the areas under ROC curve of C2～7 SVA,C7 S and ROM were all 0.5-0.7,indicating that the diagnostic value of these three items was low.There is a limit of less than 95% consistency between C2-C7 Cobb angle and TIA in the Bland-Altman map of consistency analysis of cervical Spondylotic myelopathy,so the measurement results are not consistent,and the conclusions of other sagittal plane parameters are consistent to a certain extent.Conclusion:The parameters of cervical sagittal plane are important reference factors to measure the degenerative changes of cervical intervertebral disc.Cervical intervertebral height and intervertebral angle affect the changes of cervical curvature.In patients with cervical Spondylotic myelopathy,there was no correlation between TIA and C2-C7 Cobb angle,other parameters such as cervical physiological curvature,NT,T1 S,C2～7 SVA,C7 S,ROM parameters and C2-C7 Cobb angle had a certain correlation,increases with the increase of C2-C7 Cobb Angle,among which the correlation between T1 S and C2-C7 Cobb angle was the strongest.In the aspect of intervertebral height and intervertebral angle,the intervertebral space height and angle of C5/C6、C6/C7 segments will increase with the increase of C2-C7 Cobb angle.Only the intervertebral angle increased with the increase of C2-C7 Cobb’s angle for the responsibility space of C3/4 、 C4/C5 Intervertebral space height,intervertebral angulation and C2-C7 Cobb Angle were not significant in the C2/3 segment.It shows that the intervertebral height and intervertebral angle of the lower cervical vertebra affect the change of cervical curvature,and it is also meaningful to improve the intervertebral angle to restore the cervical curvature.Synthetical use of cervical sagittal plane parameters,responsible intervertebral space height and intervertebral angulation is conducive to the prevention,diagnosis and treatment of cervical spondylotic myelopathy patients,evaluation of the prognosis of the disease,increase the cure rate of patients,and improve social satisfaction.