Study On Sequence Changes Of Cervical Spine Sagittal Balance In Patients With Hirayama Disease

Background and ObjectivesSome studies have pointed out that cervical curvature and mobility of patients with Hirayama disease are different from those of normal people,and cervical sagittal balance index is closely related to quality of life and patient satisfaction.To study the changes of cervical sagittal balance parameters in patients with hirayama disease is helpful to clarify the cervical sagittal balance of patients with hirayama disease and achieve the purpose of better understanding and diagnosis and treatment of the disease.MethodsFrom 2008 to 2017,43 patients with Hirayama disease(HD),39 males and 4 females,aged 14-28 years,with an average age of 19.95±3.72 years,were diagnosed and excluded from our hospital through clinical manifestations,physical examination,electromyography,cervical spine anteroposterior radiography and magnetic resonance imaging.Forty-two asymptomatic healthy persons who had no abnormality in the physical examination of our hospital and the cervical spine X-ray examination of the outpatient department,and whose terminal plate on the lateral X-ray T1 showed clearly,were selected as control group(NC),including 33 males and 9 females,aged 13-29 years,with an average age of 21.50±4.25 years.The cervical sagittal balance parameters of the two groups were measured respectively,including c2-7cobb angle,c2-7SVA,globa cervical angle,T1-slop,neck nihing NT,thoracic inlet angle(TIA),T1S-CL,K-line tilt;Paired sample T test was used to compare the difference between the two groups of measurement data,Pearson correlation test was used to analyze the correlation between the two groups of measurement results,and linear regression was used to establish a linear model for each parameter of the two measurement methods.ResultThe c2-7Cobb angle,global cervical angle,T1 S,NT,T1S-CL and NC group of Pingshan disease group were significantly different(P<0.05),and there was no significant difference between c2-7SVA,TIA and K-line tilt.P>0.05).The measurement parameters of the two groups were analyzed by Pearson correlation test.The NC group c2-7Cobb angle and c2-7SVA(r=-0.38),T1S(r=0.34),global cervical angle(r=0.75),NT(r =-0.31),there is a significant correlation between T1S-CL(r=-0.86)and K-line tilt(r=-0.36),c2-7SVA and global cervical angle(r=-0.34)and K-line tilt There was a correlation between(r = 0.93),global cervical angle and T1S-CL(-0.61);T1S and global cervical angle(r = 0.32),NT(r =-0.31),TIA(r = 0.41)There is a significant correlation between NT and TIA(r = 0.75);HD group c2-7Cobb angle and T1S(r = 0.45),global cervical angle(r = 0.84),T1S-CL(There was a significant correlation between r=-0.81),there was a correlation between global cervical angle and T1S-CL(-0.60);there was a significant correlation between T1 S and global cervical angle(r=0.50)and TIA(r=0.69).There was a significant correlation between NT and TIA(r=0.71);there was a significant correlation between c2-7SVA and K-line tilt(r=0.86).ConclusionThe sagittal balance parameters(c2-7Cobb angle,global cervical angle,T1 S,NT,T1S-CL)of patients with Hirayama disease are significantly different from those of asymptomatic healthy people,suggesting that patients with Hirayama disease may have changes in cervical sagittal sequence imbalance,which is related to cervical flexion and abnormal mobility.Therefore,effective maintenance of cervical stability and reconstruction of cervical sagittal balance are the key to the treatment of hirayama disease.