The Study: Influence of the Occipital Orientation on Cervical Sagittal Alignment: A Prospective Radiographic Study on 335 Normal Subjects.
a. The authors note that sagittal alignment is thought “to have a special role in the pathogenesis” of cervical disease.
b. Cervical sagittal alignment correlates with the sagittal alignment of thoracic and pelvic areas, but the relationship of occipital alignment to cervical alignment has not been reported.
c. The present study used radiographs of 335 subjects on which the “occipital incidence (OI), occipital slope (OS), occipital tilt (OT), C0-C2 angle, C2-C7 angle, C0-C7 angle, T1 slope and thoracic kyphosis were measured in every individual.”
d. The authors found that the occipital incidence had a significant correlation to the occipital slope and the C0-C2, C2-C7 and the C0-C7 angles.
e. The occipital slope was significantly correlated to the occipital tilt and the C0-C2, C2-C7 and the C0-C7 angles.
f. Occipital tilt was meaningfully correlated to the C0-C2, C2-C7 and C0-C7 angles.
g. The T1 slope and the thoracic kyphosis were correlated to the C2-C7 and C0-C7 angles respectively.
h. “However, no significant correlation was noted between the thoracic parameters and the C0-C2 angle and the occipital parameters.”
i. “The upper cervical sagittal alignment is mainly compensated by the occipital orientation, while a lower cervical sagittal alignment is mainly compensated by the occipital and thoracic alignments.”
j. The authors noted that this study could help surgeons better plan “an optimum fusion angle in the cervical spine.”
There is an interplay between the alignment of the occiput and the alignment of the cervical spine and the study might help surgeons better plan the best angle for fusions.
We have been saying over and over again that as the chiropractic profession moves away from using imaging to evaluate spines and placing great importance on spinal alignment, others will move into that void. Surgeons understand that structure is important and once again we have another article that points out the importance structural alignment has to other professions
Reviewer: Roger Coleman DC
Editor: Mark R. Payne DC
Reference: Zhu W, Sha S, Liu Z, Li Y, Xu L, Zhang W, Qiu, Zhu Z. Influence of the Occipital Orientation on Cervical Sagittal Alignment: A Prospective Radiographic Study on 335 Normal Subjects. Sci Rep. 2018 Oct 18;8(1):15336. doi: 10.1038/s41598-018-33287-0.
Link to Abstract: https://www.ncbi.nlm.nih.gov/pubmed/30337710