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- 저자 : Varun Khanna (검색결과 2 건)
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Shankar Acharya,Varun Khanna,Manoj Kumar 대한척추외과학회 2022 대한척추외과학회지 Vol.29 No.4
Study Design: Cross-sectional, record-based. Objectives: To analyze the cervical sagittal (CS) and thoracic inlet (TI) parameters in asymptomatic adults and form predictive equations for cervical lordosis (CL) and T1 slope (T1S). Summary of Literature Review: Normative values of CS parameters, including physiological CL, and their relationship with TI parameters among healthy Indian adults have been scarcely documented in the literature. Methodology: We analyzed cervical radiographs of 171 healthy adult volunteers and estimated normative values of CS and TI parameters. The thoracic inlet angle (TIA), neck tilt (NT) and T1S were the TI parameters, while the cervical parameters included C2- C7 CL (Cobb’s method), the cervical sagittal vertical axis (cSVA), and C7 slope (C7S). T1S-CL was also calculated. The correlations were estimated and predictive equations were established using simple linear and stepwise multiple regression. The paired-sample t-test was used to evaluate the statistical significance of differences between the estimated and measured values. Results: The mean age of participants was 30±7.76 years. The mean TIA, T1S, NT, CL, cSVA, C7S, and T1S-CL were 79.6°±9.08°, 29.5°±8.6°, 49.3°±8.7°, 21.4°±16.5°,18.8±12.4 mm, 25.7°±7.9°, 8.7°±13.8° respectively. We established the following predictive equations: CL= 0.66 T1S+0.57 TIA - 0.68 SVA - 30.9 (r=0.72; R2 =0.53; p<0.01); CL=0.68 TIA - 30.4 (r=0.41, R2 =0.34; p=0.04) and T1S= 4.45+ 0.72 C7S (r=0.77; R2 =0.62; p<0.01). There was no statistically significant difference between the predicted and the measured values of CL (t=0.09, p=0.973) or T1S (t=0.14; p=0.84). Conclusions: This analysis of sagittal parameters in an asymptomatic adult population provides valuable reference points for the management of various cervical alignment disorders.
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Acharya Shankar,Khanna Varun,Chahal Rupinder Singh,Kalra Kashmiri Lal,Vishwakarma Gayatri 대한척추외과학회 2023 Asian Spine Journal Vol.17 No.5
Study Design: This is a retrospective cohort study.Purpose: This study aimed to identify the clinicoradiological risk factors associated with the inability to achieve minimum clinically important difference (MCID) on the modified Japanese Orthopaedic Association (mJOA) Scale in operated cases of cervical spondylotic myelopathy (CSM).Overview of Literature: Only a few studies have evaluated the outcomes of surgery performed for CSM using MCID on the mJOA scale.Methods: We analyzed 124 operated CSM cases from March 2019 to April 2021 for preoperative clinical features, cervical sagittal radiographic parameters, and magnetic resonance imaging (MRI) signal intensities (SI). The risk factors associated with missing the MCID (poor outcome) on mJOA at the final follow-up were identified using binary logistic regression. Multivariate analysis was used to find significant risk factors, and odds ratios (OR) were computed.Results: A total of 110 men (89.2%) and 14 women (10.8%) with an average age of 53.5±13.2 years were included in the analysis. During the last follow-up, 89 cases (72.1%) achieved MCID (meaningful gains following surgery) while 35 (27.9%) could not. The final model identified the following parameters as significant risk factors for poor outcome: increased duration of symptoms (OR, 6.77; <i>p</i>=0.001), lower preoperative mJOA scale (OR, 0.75; <i>p</i>=0.029), the presence of multilevel T2-weighted (T2W) MRI SI (OR, 4.79; <i>p</i>=0.004), and larger change in cervical sagittal vertical axis (ΔcSVA) (OR, 1.06; <i>p</i>=0.013). Also, an increase in cSVA postoperatively correlated with a reduced functional recovery rate (<i>r</i>=−0.4, <i>p</i><0.001).Conclusions: Surgery for CSM leads to significant functional benefits. However, poorer outcomes are observed in cases of greater duration of symptoms, higher preoperative severity with multilevel T2W MRI SI, and a larger increase in the postoperative cSVA (sagittal imbalance).
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