Postural Consequences of Cervical Sagittal Imbalance: A Novel Laboratory Model

Spine
Avinash G PatwardhanWilliam Sears

Abstract

A biomechanical study using human spine specimens. To study postural compensations in lordosis angles that are necessary to maintain horizontal gaze in the presence of forward head posture and increasing T1 sagittal tilt. Forward head posture relative to the shoulders, assessed radiographically using the horizontal offset distance between the C2 and C7 vertebral bodies (C2-C7 [sagittal vertical alignment] SVA), is a measure of global cervical imbalance. This may result from kyphotic alignment of cervical segments, muscle imbalance, as well as malalignment of thoracolumbar spine. Ten cadaveric cervical spines (occiput-T1) were tested. The T1 vertebra was anchored to a tilting and translating base. The occiput was free to move vertically but its angular orientation was constrained to ensure horizontal gaze regardless of sagittal imbalance. A 5-kg mass was attached to the occiput to mimic head weight. Forward head posture magnitude and T1 tilt were varied and motions of individual vertebrae were measured to calculate C2-C7 SVA and lordosis across C0-C2 and C2-C7. Increasing C2-C7 SVA caused flexion of lower cervical (C2-C7) segments and hyperextension of suboccipital (C0-C1-C2) segments to maintain horizontal gaze. Increasing kyph...Continue Reading

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Citations

Feb 3, 2016·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Zachary A SmithAvinash G Patwardhan
Apr 12, 2016·The Spine Journal : Official Journal of the North American Spine Society·Hwee Weng Dennis HeyHee-Kit Wong
Jul 31, 2016·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Kenichiro SakaiAtsushi Okawa
Feb 6, 2018·Clinical Spine Surgery : a Spine Publication·Koji TamaiHiroaki Nakamura
Nov 7, 2019·Clinical Spine Surgery : a Spine Publication·Taotao LinWenge Liu
Nov 30, 2018·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·H KollerYohan Robinson
May 16, 2017·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Donald J BlaskiewiczGregory M Mundis
Jan 1, 2018·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Heiko KollerWolfgang Hitzl
Nov 8, 2017·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Avinash G PatwardhanWilliam Sears
Jan 27, 2019·European Journal of Orthopaedic Surgery & Traumatology : Orthopédie Traumatologie·Han Jo KimVirginie Lafage
Aug 10, 2020·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Permsak PaholpakZorica Buser
Mar 25, 2018·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Masahito OshinaK Daniel Riew
Jan 26, 2021·Clinical Biomechanics·Filipe PagaimoÓscar L Alves
Apr 27, 2021·Journal of Taibah University Medical Sciences·Zaenab Alowa, Walaa Elsayed

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