SERVİKAL SPİNAL DENGE PARAMETRELERİNİN KISA DERLEMESİ

Servikal omurga sadece kafanın yükünü taşımakla kalmaz, omurganın kalanından daha fazla hareket kabiliyetine sahiptir ve pelvik tilt kadar horizontal dengenin sağlanmasında daönemlidir. Kompleks servikal patolojilerin yönetilmesinde servikal biyomekaniğinin anlaşılması ve normal değerlerine hâkim olunması büyük önem taşımaktadır. Servikal omurga denge parametrelerinde en sık kullanılan parametreler Cobb açısı, Jackson stres çizgileri, Harrison posterior tanjant çizgileri, yerçekimi merkezi veya sagital verteks aksı için C-2 şakül hattı ve kaş-çene hattının vertikal açısıdır. Torasik giriş açısı, servikal tilt, boyun tilti ve kranial tilt ise servikal denge için literatürde tartışılan yeni parametrelerdir.

BRIEF REVIEW ON FUNDAMENTALS OF CERVICAL SPINE ALIGNMENT

The cervical spine where not only loads the mass of the head but also makes the widest range of motion relative to the rest of the spine, plays an important role in influencing subjacent global spinal alignment and pelvic tilt as compensatory changes occur to maintain horizontal gaze. The management of complex cervical pathologies could be handled with understanding of cervical biomechanics as well as the normative data for cervical alignment.The major parameters used to assess cervical spine alignment include Cobb angles, Jackson stress lines, and Harrison posterior tangent lines for sagittal curvature; gravity line or C-2 plumb line for sagittal vertical axis; and the Chin-Brow to vertical angle for horizontal gaze. Thoracic inlet angle, cervical tilt, neck tilt, and cranial tilt are new parameters that being discussed in the literature for cervical alignment.

Kaynakça

1. Ames CP, Smith JS, Scheer JK, Bess S, Bederman SS, Deviren V. Impact of spinopelvic alignment on decision making in deformity surgery in adults. A review. J Neurosurg Spine 2012; 16: 547-564.

2. Cobb JR. Outlines for the Study of Scoliosis: Instructional Course Lecture. In: ed. Edwards JW Vol 5. American Academy of Orthopedic Surgeons, Ann Arbor 1948; pp: 261-275.

3. Deviren V, Scheer JK, Ames CP. Technique of cervicothoracic junction pedicle subtraction osteotomy for cervical sagittal imbalance: report of 11 cases. Clinical article. J Neurosurg Spine 2011; 15: 174-181.

4. Gay RE. The curve of the cervical spine: variations and significance. J Manipulative Physiol Ther 1993; 16: 591- 594.

5. Gore DR: Roentgenographic findings in the cervical spine in asymptomatic persons: a ten-year follow-up. Spine 2001; 26: 2463-2466.

6. Gore DR, Sepic SB, Gardner GM. Roentgenographic findings of the cervical spine in asymptomatic people. Spine 1986; 11: 521-524.

7. Gwinn DE, Iannotti C, Benzel EC. Effective lordosis: analysis of sagittal spinal canal alignment in cervical spondylotic myelopathy. J Neurosurg Spine 2009; 11: 667- 672.

8. Hardacker JW, Shuford RF, Capicotto PN, Pryor PW. Radiographic standing cervical segmental alignment in adult volunteers without neck symptoms. Spine 1997; 22: 1472-1480.

9. Harrison DE, Harrison DD, Cailliet R, Troyanovich SJ, Janik TJ, Holland B. Cobb method or Harrison posterior tangent method: which to choose for lateral cervical radiographic analysis. Spine 2000; 25: 2072-2078.

10. Jackson RP, McManus AC. Radiographic analysis of sagittal plane alignment and balance in standing volunteers and patients with low back pain matched for age, sex, and size. A prospective controlled clinical study. Spine 1994; 19: 1611-1618.

11. Jackson R. The Cervical Syndrome, ed 2. Charles C. Thomas, Springfield 1958.

12. Kim KT, Lee SH, Son ES, Kwack YH, Chun YS, Lee JH. Surgical treatment of "chin-on-pubis" deformity in a patient with ankylosing spondylitis: a case report of consecutive cervical, thoracic, and lumbar corrective osteotomies. Spine 2012; 37: E1017-E1021.

13. Lafage V, Schwab F, Skalli W, Hawkinson N, Gagey PM, Ondra S. Standing balance and sagittal plane spinal deformity: analysis of spinopelvic and gravity line parameters. Spine 2008; 33: 1572-1578.

14. Lee SH, Kim KT, Seo EM, Suk KS, Kwack YH, Son ES. The influence of thoracic inlet alignment on the craniocervical sagittal balance in asymptomatic adults. J Spinal Disord Tech 2012; 25: E41-E47.

15. Legaye J, Duval-Beaupere G, Hecquet J. Pelvic incidence: a fundamental pelvic parameter for three dimensional regulation of spinal sagittal curves. Eur Spine J 1998; 7: 99-103.

16. Louis R. Spinal stability as defined by the three-column spine concept. Anat Clin 1985; 7: 33-42.

17. McAviney J, Schulz D, Bock R, Harrison DE, Holland B. Determining the relationship between cervical lordosis and neck complaints. J Manipulative Physiol Ther 2005; 28: 187-193.

18. Pal GP, Sherk HH. The vertical stability of the cervical spine. Spine 1988; 13:447-449.

19. Pigge RR, Scheerder FJ, Smit TH, Mullender MG, van Royen BJ. Effectiveness of preoperative planning in the restoration of balance and view in ankylosing spondylitis. Neurosurg Focus 2008; 24(1): E7.

20. Scheer JK, Tang JA, Smith JS, Acosta FL Jr, Protopsaltis TS, Blondel B, Bess S, Shaffrey CI, Deviren V, Lafage V, Schwab F, Ames CP; International Spine Study Group. Cervical spine alignment, sagittal deformity, and clinical implications. J Neurosurg Spine 2013; 19(2): 141-159.

21. Suk KS, Kim KT, Lee SH, Kim JM. Significance of chinbrow vertical angle in correction of kyphotic deformity of ankylosing spondylitis patients. Spine 2003; 28: 2001-2005.

22. Tang JA, Scheer JK, Smith JS, Deviren V, Bess S, Hart RA. The impact of standing regional cervical sagittal alignment on outcomes in posterior cervical fusion surgery. Neurosurgery 2012; 71: 662-669.

23. Wang Y, Zhang Y, Mao K, Zhang X, Wang Z, Zheng G. Transpedicular bivertebrae wedge osteotomy and discectomy in lumbar spine for severe ankylosing spondylitis. J Spinal Disord Tech 2010; 23: 186-191.

Kaynak Göster

  • ISSN: 2147-5903
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 1989
  • Yayıncı: Galenos Yayınevi

2.9b 2.2b

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