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논문 기본 정보

자료유형
학술저널
저자정보
Go Yoshida (Hamamatsu Medical Center) Kenta Kurosu (Hamamatsu Medical Center) Yu Yamato (Hamamatsu Medical University) Tomohiko Hasegawa (Hamamatsu Medical University) Tatsuya Yasuda (Hamamatsu Medical University) Daisuke Togawa (Hamamatsu Medical University) Yukihiro Matsuyama (Hamamatsu Medical University)
저널정보
대한척추외과학회 Asian Spine Journal Asian Spine Journal Vol.11 No.2
발행연도
2017.1
수록면
190 - 197 (8page)

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Study Design: Prospective physical measurement of the sagittal vertical axis (SVA). Purpose: To evaluate a simple method for measuring SVA by analyzing its relationship with radiographic measurements and clinical appearance. Overview of Literature: No studies have examined physical measurements using the cranial center of gravity (CCG) in a relaxed standing position. Methods: The physical measurement of the horizontal distance between CCG and spina iliaca posterior superior (CCG-SIPS) was measured using a straight ruler in 252 healthy volunteers and 56 patients with adult spinal deformity. Health-related quality of life (HRQOL) was evaluated using the Oswestry disability index (ODI), and clinical symptoms were assessed according to standing status and the presence of gastroesophageal reflux disease (GERD). Results: CCG-SIPS increased with age in the volunteer group and strongly correlated with radiographic SVA in the patient group (r =0.984). Differences increased between CCG-SIPS in patients in the relaxed position and radiographic SVA with an increase in sagittal malalignment (r =0.692, p <0.001). ODI with high sagittal malalignment (CCG-SIPS >120 mm) was significantly larger in the patient group than in the group with low sagittal malalignment (59.9±18.8 vs. 45.1±17.0; p =0.004); these patients (CCG-SIPS >120 mm) needed crutches or walkers for standing. The patient group with GERD had significantly larger sagittal malalignment than the group without GERD (160.3 mm vs. 81.0 mm). Conclusions: The CCG-SIPS correlated with age and strongly reflected radiographic SVA and HRQOL in the patients. Moreover, it reflects a relaxed posture without a backward shift in the radiographic position even in patients with severe sagittal malalignment. The critical limit of CCG-SIPS can be relevant to clinical appearance, including standing assistance (>120 mm) and the existence of GERD (>150 mm). Thus, it will be a useful predictor of true SVA in clinical practice before radiographic evaluation.

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