J Korean Soc Spine Surg.  2018 Jun;25(2):54-59. 10.4184/jkss.2018.25.2.54.

The Effect of Cervical Lordosis on Cervical Disc Degeneration in Patients with a High T1 Slope

• Hong SH
• Lee SH
• Park BM
• Song KS
• Lim ST

• KMID: 2421611
• DOI: http://doi.org/10.4184/jkss.2018.25.2.54

Abstract

STUDY DESIGN: Retrospective evaluation.
OBJECTIVES
To analyze the effect of cervical lordosis on cervical disc degeneration in patients with a high T1 slope. SUMMARY OF LITERATURE REVIEW: The T1 slope is known to be a parameter that may be very useful in evaluating sagittal balance. We previously reported that a low T1 slope was a potential risk factor for cervical spondylosis, especially in the C6-7 cervical segment. However, no study has analyzed the effect of cervical lordosis in patients with a high T1 slope (>25) on cervical disc degeneration.
MATERIALS AND METHODS
Seventy-seven patients with a high T1 slope who underwent cervical spine MRI in our orthopedic clinic were enrolled. Patients were divided into 2 groups according to cervical compensation. The radiologic parameters obtained from radiography and cervical spine MRI were compared between the uncompensated group (cervical lordosis <25) and the compensated group (cervical lordosis ≥25).
RESULTS
In the uncompensated group, the average degeneration grade of each segment was 2.72 (±0.70) in C2-3, 3.00 (±0.76) in C3-4, 3.02 (±0.91) in C4-5, 3.37 (±0.95) in C5-6, and 2.95 (±0.98) in C6-7. The average degeneration grade of each segment in the compensated group was 2.38 (±0.78) in C2-3, 2.38 (±0.60) in C3-4, 2.62 (±0.60) in C4-5, 2.82 (±0.72) in C5-6, and 2.41 (±0.74) in C6-7. The degeneration grade was significantly higher in the uncompensated group than in the compensated group for all cervical segments. The risk of high-grade degeneration of C3-4 was significantly higher in the uncompensated group (odds ratio = 6.268; 95% CI, 2.232-17.601; p<.001).
CONCLUSIONS
Patients with a high T1 slope without compensation of cervical lordosis had a higher grade of degeneration in all cervical segments.

Keyword

Cervical disc degeneration; T1 slope; Cervical lordosis

MeSH Terms

Animals
Compensation and Redress
Humans
Intervertebral Disc Degeneration*
Lordosis*
Magnetic Resonance Imaging
Orthopedics
Radiography
Retrospective Studies
Risk Factors
Spine
Spondylosis

Figure

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  Fig 1. Radiographic example of a 55-year-old female patient without cervical compensation. (A) Upright lateral X-ray. (B) T2-weighted sagittal image on cervical magnetic resonance imaging.

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  Fig 2. Radiographic example of a 51-year-old female patient with cervical compensation. (A) Upright lateral X-ray. (B) T2-weighted sagittal image on cervical magnetic resonance imaging.

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