The effect of cervical spine flexion-extension motion on odontoid parameters
Abstract Objective To assess the stability of odontoid parameters on flexion-extension motion and to validate the accuracy of the physiological cervical lordosis (CL) predictive formula across different cervical positions. Methods Standard cervical spine lateral radiographs in neutral, flexion, and...
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BMC
2025-01-01
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Online Access: | https://doi.org/10.1186/s13018-025-05488-7 |
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author | Longao Huang Dun Liu Hongyuan Xu Junfei Feng Tao Kang Shengwang Wei Hua Jiang |
author_facet | Longao Huang Dun Liu Hongyuan Xu Junfei Feng Tao Kang Shengwang Wei Hua Jiang |
author_sort | Longao Huang |
collection | DOAJ |
description | Abstract Objective To assess the stability of odontoid parameters on flexion-extension motion and to validate the accuracy of the physiological cervical lordosis (CL) predictive formula across different cervical positions. Methods Standard cervical spine lateral radiographs in neutral, flexion, and extension positions were collected to measure odontoid incidence (OI), odontoid tilt (OT), C2 slope (C2S), CL, T1 slope (T1S), and T1S minus CL (T1S-CL). Friedman’s test was used to assess the differences in parameters among the three cervical spine positions. The predictive performance of the formula CL = 0.36× OI − 0.67 × OT − 0.69 × T1S was assessed and validated using the Pearson correlation coefficient (r), coefficient of determination (R²), mean squared error (MSE), and mean absolute error (MAE). Results No significant differences were found for OI and T1S among the three different cervical spine positions (p = 0.162 and p = 0.186, respectively). There was a strong, significant positive correlation between the predicted value and actual value of physiological CL at three cervical positions (neutral, flexion, and extension). The predictions for the neutral position were the most accurate, with statistical measures of r = 0.85 (p < 0.01), R²=0.82, MAE = 4.28, and MSE = 27.77. Conclusion OI is a stable and reliable anatomic parameter, not affected by cervical spine flexion-extension motion. OI can serve as a supplementary parameter for evaluating cervical sagittal balance and compensatory ability. The formula CL = 0.36×OI − 0.67×OT − 0.69×T1S provides the best predictions for physiological CL in the neutral position. |
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institution | Kabale University |
issn | 1749-799X |
language | English |
publishDate | 2025-01-01 |
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series | Journal of Orthopaedic Surgery and Research |
spelling | doaj-art-1f3bb839344840688fa805dc0ce2d4d02025-01-19T12:32:44ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2025-01-0120111010.1186/s13018-025-05488-7The effect of cervical spine flexion-extension motion on odontoid parametersLongao Huang0Dun Liu1Hongyuan Xu2Junfei Feng3Tao Kang4Shengwang Wei5Hua Jiang6Department of Spine Surgery, The First Affiliated Hospital of Guangxi Medical UniversityDepartment of Spine Surgery, The First Affiliated Hospital of Guangxi Medical UniversityDepartment of Spine Surgery, The First Affiliated Hospital of Guangxi Medical UniversityDepartment of Spine Surgery, The First Affiliated Hospital of Guangxi Medical UniversityDepartment of Spine Surgery, The First Affiliated Hospital of Guangxi Medical UniversityDepartment of Orthopedics, The Fourth Affiliated Hospital of Guangxi Medical University, Guangxi Zhuang Autonomous RegionDepartment of Spine Surgery, The First Affiliated Hospital of Guangxi Medical UniversityAbstract Objective To assess the stability of odontoid parameters on flexion-extension motion and to validate the accuracy of the physiological cervical lordosis (CL) predictive formula across different cervical positions. Methods Standard cervical spine lateral radiographs in neutral, flexion, and extension positions were collected to measure odontoid incidence (OI), odontoid tilt (OT), C2 slope (C2S), CL, T1 slope (T1S), and T1S minus CL (T1S-CL). Friedman’s test was used to assess the differences in parameters among the three cervical spine positions. The predictive performance of the formula CL = 0.36× OI − 0.67 × OT − 0.69 × T1S was assessed and validated using the Pearson correlation coefficient (r), coefficient of determination (R²), mean squared error (MSE), and mean absolute error (MAE). Results No significant differences were found for OI and T1S among the three different cervical spine positions (p = 0.162 and p = 0.186, respectively). There was a strong, significant positive correlation between the predicted value and actual value of physiological CL at three cervical positions (neutral, flexion, and extension). The predictions for the neutral position were the most accurate, with statistical measures of r = 0.85 (p < 0.01), R²=0.82, MAE = 4.28, and MSE = 27.77. Conclusion OI is a stable and reliable anatomic parameter, not affected by cervical spine flexion-extension motion. OI can serve as a supplementary parameter for evaluating cervical sagittal balance and compensatory ability. The formula CL = 0.36×OI − 0.67×OT − 0.69×T1S provides the best predictions for physiological CL in the neutral position.https://doi.org/10.1186/s13018-025-05488-7Cervical flexion and extensionCervical spine motionCL predictionOdontoid incidence |
spellingShingle | Longao Huang Dun Liu Hongyuan Xu Junfei Feng Tao Kang Shengwang Wei Hua Jiang The effect of cervical spine flexion-extension motion on odontoid parameters Journal of Orthopaedic Surgery and Research Cervical flexion and extension Cervical spine motion CL prediction Odontoid incidence |
title | The effect of cervical spine flexion-extension motion on odontoid parameters |
title_full | The effect of cervical spine flexion-extension motion on odontoid parameters |
title_fullStr | The effect of cervical spine flexion-extension motion on odontoid parameters |
title_full_unstemmed | The effect of cervical spine flexion-extension motion on odontoid parameters |
title_short | The effect of cervical spine flexion-extension motion on odontoid parameters |
title_sort | effect of cervical spine flexion extension motion on odontoid parameters |
topic | Cervical flexion and extension Cervical spine motion CL prediction Odontoid incidence |
url | https://doi.org/10.1186/s13018-025-05488-7 |
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