Relationship between Cervical Sagittal Parameters and Health Related Quality of Life in Cervical Degenerative Disc Diseases

Abstract

Introduction: The evaluation of the differences in radiological cervical sagittal parameters between symptomatic and asymptomatic individuals with radiologically- confirmed (CDDD) is fundamental for understanding the normal variation in sagittal plane parameter between individuals, to determine the age-related changes, to know the predictive sagittal parameters for unfavorable clinical symptoms and to determine the factors that participate in economic sagittal balance (compensation) in asymptomatic subjects. This will provide radiographic guidelines for the assessment and management of cervical spine patients. Objectives: This study aimed to evaluate the relation between the radiological cervical sagittal parameter changes with the presence and severity of symptoms as well as quality of life in CDDD individuals, and provided radiographic guidelines for the assessment and management of cervical spine patients. Methodology: The first 100 subjects who have visited the Outpatient clinic of Orthopedic Department in Tanta University Hospitals with radiologically-confirmed CDDD with or without clinical symptoms were reviewed. The individuals were divided into 2 groups for analysis and comparison. Group1 included the first 50 patients with symptomatic CDDD. Group2 included another 50 individuals with asymptomatic CDDD in their radiographs who visited the outpatient clinic as a relative to other patients or complained from other transient musclo-skeletal symptoms not affecting their quality of life. Results: In the Analysis of the relationships between the data of the 2 groups: There were no statistically significant differences between each of the age, sex, occupations, and BMI in comparison between the 2 groups. The T1S angle was the only significant parameter in correlation between 2 groups. In the Analysis of the relationships between the data in the symptomatic group: There was a statistically significant increase in each of the T1S, C2-C7 lordosis, C2-C7 SVA with increasing the age. T1S was significantly lower in farmers and manual workers than in housewives and office workers. There was a significantly inverse correlation between each of the CL, T1S, T1S-CL and VAS. There was a significantly positive correlation between each of the CL, T1S, T1S-CL and modified EQ-5D-3L score. In the Analysis of the relationships between the data in the asymptomatic group: There was a significant increase in each of the TIA, T1S and NT with increase age, with an insignificant increase CL and with a significant decrease in C2-C7 SVA. There were insignificantly inverse correlations with each of the CL, TIA and T1S. Conclusions: There is no difference in the C2–C7 lordosis curvature between the symptomatic patients and the asymptomatic individuals. The T1S is significantly lower in the symptomatic patients than in the asymptomatic individuals. So, Low T1S is a risk for the occurrence and development of cervical disc degeneration.