Effect of thoracic and pelvic anteroposterior diameters on spinal sagittal alignment

Purpose: This study aimed to analyze the effect of the thoracic anteroposterior diameter (TAPD) and pelvic anteroposterior diameter (PAPD) on global sagittal alignment in asymptomatic patients with normal sagittal alignment. Patient sample: The study investigated 2042 adult patients who initially presented at our hospital with a hip and knee problem without history of symptoms related to the entire spine. Only 57 patients with normal global sagittal alignment (C2–7 sagittal vertical axis (SVA) and C7–S1 SVA of <10 mm) were considered. Methods: The whole-spine standing lateral radiographs were obtained to analyze the following parameters: pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), lumbar lordosis (LL), thoracic inlet angle (TIA), T1 slope, cervical spinal parameters (angle of C0–2, C2–7, and C0–7), TAPD, and PAPD. Statistical analysis was performed using Pearson correlation coefficients and multiple regression analyses. Results: All the parameters showed a normal distribution. TAPD had a significant relationship with thoracic kyphosis (TK; r = 0.458), TIA ( r = 0.677), and C0–2 angle ( r = 0.294) but no significant relationship with T1 slope and other cervical parameters. PAPD had a significant relationship with PI ( r = 0.309) and PT ( r = 0.463) but no significant relationship with LL, SS, and TK. The multiple regression analysis showed that TIA = 21.974 + 0.405 (TK) + 0.188 (TAPD) ( p < 0.0001). Conclusions: TAPD and PAPD are associated with TIA, TK, C0–2 angle, PI, and PT, all of which act as key factors in spinal sagittal alignment. Although they did not directly correlate with other cervical parameters, T1 slope, and LL, TAPD and PAPD might have indirect effects on cervical and lumbar spinal sagittal alignment through their relationships with TIA, TK, and PI.

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Relationship of T1 Slope with sagittal alignment parameters of the upper and subaxial cervical spine in patients with cervical lordotic and kyphotic curvature

10.21203/rs.3.rs-26626/v2 ◽

2020 ◽

Author(s):

Dong Sun ◽

Peng Liu ◽

Zhaolin Wang ◽

Jie Cheng ◽

Jianhui Mou ◽

...

Keyword(s):

Cervical Spine ◽

Sagittal Alignment ◽

Pearson Correlation ◽

Linear Regression Analysis ◽

Observer Agreement ◽

Group Differences ◽

Cervical Lordosis ◽

Cervical Alignment ◽

T1 Slope ◽

Subaxial Cervical Spine

Abstract Background: To identify the relationship between T1 slope and the sagittal alignment parameters of the upper and subaxial cervical spine in patients with cervical lordosis and kyphosis.Methods: Relevant sagittal radiographic parameters pertaining to patients with non-specific neck pain but with no associated neurogenic symptoms were retrospectively analyzed. Patients were categorized into lordotic alignment and kyphotic alignment groups based on the C2-C7 Cobb. Correlation among radiographic variables was assessed with the Pearson correlation coefficient and linear regression analysis. Between-group differences with respect to cervical alignment parameters were assessed with One-way Analysis of Variance.Results: Intra-observer and inter-observer agreement (two independent observers) was rated as excellent (kappa: 0.91 - 0.93). Inter-observer agreement for the two independent observers was rated as and substantial (kappa: 0.79 - 0.80), respectively. Significant between-group differences were observed with respect to C0-C1 angle, C1-C2 angle, C0-C2 angle, C2-C7 SVA (sagittal vertical axis) and TS-CL (T1 slope minus cervical lordosis) (P<0.01 for all), but not with respect to T1S (T1 slope) (P=0.367). In both groups, C2-C7 SVA showed a significant linear correlation with T1S (r2=0.712 vs. r2=0.467) and TS-CL (r2=0.810 vs. r2=0.248).Conclusion: This study showed that the two cervical alignment types (lordosis and kyphosis) have different angular variation in upper and subaxial cervical spine. With the increase in T1 slope, the upper cervical C0-C2 Cobb angle and the C2-7 SVA in the lordotic group were significantly higher than that of the kyphotic group. TS-CL mismatch may significantly impact lordotic cervical alignment in patients with lordosis.

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Spinopelvic Sagittal Alignment after Microendoscopic Laminotomy in Patients with Lumbar Degenerative Spondylolisthesis

Journal of Neurological Surgery Part A Central European Neurosurgery ◽

10.1055/s-0038-1666847 ◽

2018 ◽

Vol 79 (06) ◽

pp. 479-485

Author(s):

Sho Dohzono ◽

Yusuke Hori ◽

Shinji Takahashi ◽

Akinobu Suzuki ◽

Hidetomi Terai ◽

...

Keyword(s):

Sagittal Alignment ◽

Degenerative Spondylolisthesis ◽

Group Versus ◽

Leg Pain ◽

Sacral Slope ◽

Sagittal Imbalance ◽

Low Grade ◽

Spinopelvic Parameters ◽

Spinal Sagittal Alignment ◽

Global Sagittal Alignment

Background and Study Aims Spinopelvic sagittal balance is important in managing lumbar diseases. We evaluated the change in spinal sagittal alignment after microendoscopic laminotomy in patients with low-grade degenerative spondylolisthesis (DS). Material and Methods We retrospectively reviewed the records of 87 patients who underwent microendoscopic laminotomy. We enrolled 35 patients with DS and 52 patients without DS. Spinopelvic parameters were evaluated, including the sagittal vertical axis (SVA), lumbar lordosis (LL), sacral slope, pelvic tilt, and pelvic incidence (PI). Primary outcome was a change in spinopelvic alignment between the baseline and latest follow-up values (DS group versus non-DS group). Secondary outcomes were the relationships between improved global sagittal alignment and preoperative spinopelvic parameters. Results Both groups showed significantly alleviated low back pain (LBP), leg pain, and leg numbness. Preoperative SVA and PI were significantly higher in the DS group than in the non-DS group (p < 0.05). SVA significantly decreased and LL significantly increased in the DS group (p < 0.05), whereas those parameters did not differ significantly from before versus after surgery in the non-DS group. In both groups, SVA improvement correlated significantly with preoperative SVA (DS: r = 0.702; non-DS: r = 0.397). There was also a significant intergroup difference in the correlation coefficient (z = 1.98; r = 0.048). Conclusions SVA and LL significantly improved after microscopic laminotomy in patients with low-grade DS and neurologic symptoms. SVA improvement in the DS group was correlated with preoperative spinopelvic sagittal imbalance. The strength of those correlations was greater in the DS group than in the non-DS group.

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Predictive formula of cervical lordosis in asymptomatic young population

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-019-1526-x ◽

2020 ◽

Vol 15 (1) ◽

Cited By ~ 2

Author(s):

Yuchen Zhu ◽

Zhongcheng An ◽

Yingjian Zhang ◽

Hao Wei ◽

Liqiang Dong

Keyword(s):

Multiple Regression ◽

Pearson Correlation ◽

Reference Value ◽

Vertical Axis ◽

Stepwise Multiple Regression ◽

Cervical Lordosis ◽

Sagittal Vertical Axis ◽

Thoracic Inlet ◽

Sagittal Parameters ◽

The Mean

Abstract Background Not a large number of previous studies have reported the normal sagittal balance of the cervical spine and physiological cervical lordosis (CL) has not been clearly defined yet. Methods This was a prospective radiological analysis of asymptomatic subjects. The following cervical sagittal parameters were measured: CL, thoracic inlet angle (TIA), T1 slope (T1S), neck tilt (NT), and C2–7 sagittal vertical axis (C2–7 SVA). The Pearson correlation test was calculated, and the stepwise multiple regression analysis was conducted by using the CL (dependent variable) and the other cervical sagittal parameters (independent variables) to determine the best sets of predictors. A paired sample t test was conducted between the predicted and measured values. Results The mean age of 307 participants was 24.54 + 3.07. The mean CL, TIA, T1S, NT, and C2–C7 SVA was 17.11° ± 6.31°, 67.87° ± 7.78°, 25.84° ± 5.36°, 42.53° ± 6.68°, and 14.60 ± 8.20 mm, respectively. The formula was established as follows: CL = 0.762 × T1S − 0.392 × C2–C7 SVA + 0.25 × TIA − 13.795 (R = 0.812, R2 = 0.660) (stepwise multiple regression) and CL = 0.417 × TIA − 11.193 (R = 0.514, R2 = 0.264) (simple linear regression). There was no statistical difference between the predicted CL and the measured CL (t = 0.034, P = 0.973). Conclusions There was a significant correlation between CL and other cervical sagittal parameters, including TIA, T1S, NT, and C2–C7 SVA in asymptomatic Chinese population. The results of this study may serve as a normal reference value for the study of asymptomatic population.

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Relationship of T1 Slope with Sagittal Alignment Parameters of the Upper and Subaxial Cervical Spine in Patients with Cervical Lordotic and Kyphotic Curvature

10.21203/rs.3.rs-26626/v1 ◽

2020 ◽

Author(s):

Dong Sun ◽

Peng Liu ◽

Zhaolin Wang ◽

Jie Cheng ◽

Jianhui Mou ◽

...

Keyword(s):

Cervical Spine ◽

Sagittal Alignment ◽

Pearson Correlation ◽

Linear Regression Analysis ◽

Observer Agreement ◽

Group Differences ◽

Cervical Lordosis ◽

Cervical Alignment ◽

T1 Slope ◽

Subaxial Cervical Spine

Abstract Background To identify the relationship between T1 slope and the sagittal alignment parameters of the upper and subaxial cervical spine in patients with cervical lordosis and kyphosis.Methods Relevant sagittal radiographic parameters pertaining to patients with non-specific neck pain but with no associated neurogenic symptoms were retrospectively analyzed. Patients were categorized into lordotic alignment and kyphotic alignment groups based on the C2-C7 Cobb. Correlation among radiographic variables was assessed with the Pearson correlation coefficient and linear regression analysis. Between-group differences with respect to cervical alignment parameters were assessed with One-way Analysis of Variance.Results Intra-observer and inter-observer agreement (two independent observers) was rated as excellent (kappa: 0.91–0.93). Inter-observer agreement for the two independent observers was rated as and substantial (kappa: 0.79–0.80), respectively. Significant between-group differences were observed with respect to C0-C1 angle, C1-C2 angle, C0-C2 angle, C2-C7 SVA (sagittal vertical axis) and TS-CL (T1 slope minus cervical lordosis) (P < 0.01 for all), but not with respect to T1S (T1 slope) (P = 0.367). In both groups, C2-C7 SVA showed a significant linear correlation with T1S (r2 = 0.712 vs. r2 = 0.467) and TS-CL (r2 = 0.810 vs. r2 = 0.248).Conclusion This study showed that the two cervical alignment types (lordosis and kyphosis) have different angular variation in upper and subaxial cervical spine. With the increase in T1 slope, the upper cervical C0-C2 Cobb angle and the C2-7 SVA in the lordotic group were significantly higher than that of the kyphotic group. TS-CL mismatch may significantly impact lordotic cervical alignment in patients with lordosis.

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Analysis of global spine sagittal parameters in cervical spondylotic patients and asymptomatic subjects

10.21203/rs.2.21726/v1 ◽

2020 ◽

Author(s):

Liang Zhu ◽

Xiaojun Ma ◽

Qiang Shen ◽

Bao Sun ◽

Qiang Fu

Keyword(s):

Cervical Spondylosis ◽

Lumbar Lordosis ◽

Sagittal Alignment ◽

Vertical Axis ◽

Normal Group ◽

Sacral Slope ◽

Sagittal Vertical Axis ◽

Thoracic Inlet ◽

Global Sagittal Alignment ◽

Sagittal Parameters

Abstract Background: Degenerative changes associated with cervical spondylotic can result in a change of normal sagittal alignment, and this may be the initial change of kyphosis and sagittal imbalance. Few studies have analyzed the correlations between the cervical spine lordosis and global spine balance in patients with cervical spondylotic. This study is applied to investigate the characteristics and relationships of cervical and global sagittal parameters in normal adults and cervical spondylotic patients. Methods: We reviewed 46 asymptomatic control subjects (normal group, NG) and 48 cervical spondylotic patients (cervical spondylotic group, CSG), who had both cervical MRI and global radiographs obtained together, between January 2016 and September 2018. Data includes C1-2 angle, C2–7 lordosis (CL), T1 slope (T1S), thoracic inlet angle (TIA), C2–7 sagittal vertical axis (CSVA), sagittal vertical axis(SVA), thoracic-kyphosis(TK), thoracic-lumbar lordosis(TL), lumbar lordosis (LL), pelvic incidence (PI), pelvic tilt (PT) and sacral slope (SS). The values were presented as the mean ± standard deviation. Student t-test and Pearson’s correlation coefﬁcient were used for statistical analysis. Probability values less than 0.05 were considered statistically signiﬁcant. Results: 1.Comparison of global sagittal parameters between the normal group and cervical spondylosis group. A total of 48 cervical spondylotic patients with an average age of 57.91±9.58 and 46 healthy people with an average age of 28.00±8.09 were recruited in our study. CL in the NG was significantly lower than CSG (P<0.05), while TK and TL were significantly lower than in the CSG(P< 0.01). However, a comparison of the NG and CSG yielded no significant differences in C1-2, TIA, TIS, LL, PT, PI, SS, CSVA, and SVA. 2.The relationship between cervical and global sagittal alignment. CL positively correlated with T1S (r=0.433) and TK (r=0.335) while negatively correlated with CSVA (r=-0.309) in cervical spondylosis group. TIA has positively correlated with T1S (r=0.376 in NG and r=0.416 in CSG) and no correlated with other parameters in both groups. Conclusions Cervical spondylosis causes changes in sagittal parameters of the cervical and thoracic spine but does not affect on lumbar and pelvic parameters. TIA is a relative constant parameter, not affected by cervical spondylotic.

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The Sagittal Balance of the Cervical Spine: Radiographic Analysis of Interdependence between the Occipitocervical and Spinopelvic Alignment

Asian Spine Journal ◽

10.31616/asj.2019.0165 ◽

2020 ◽

Vol 14 (3) ◽

pp. 287-297 ◽

Cited By ~ 1

Author(s):

Babak Alijani ◽

Javid Rasoulian

Keyword(s):

Cobb Angle ◽

Sagittal Balance ◽

Sagittal Alignment ◽

Surgical Reconstruction ◽

Sagittal Imbalance ◽

Sagittal Vertical Axis ◽

Asymptomatic Patients ◽

Significant Difference ◽

Cervical Sagittal Alignment ◽

Global Sagittal Alignment

Study Design: This was a prospective clinical study.Purpose: Previous studies have indicated that cervical lordosis is a parameter influenced by segmental and global spinal sagittal balance parameters. However, this correlation still remains unclear. Therefore, a better understanding of the normal values and interdependencies between inter-segmental alignment parameters is needed. This is a preliminary analysis that helps to understand these factors.Overview of Literature: Change in global sagittal alignment is associated with poor health-related quality of life. Questions regarding which parameters play the primary roles in the progression of spinal sagittal imbalance and which might be compensatory factors remain unanswered.Methods: Prospectively, 420 adults (105 asymptomatic, 105 cervical symptomatic, 105 lumbar symptomatic, and 105 post-surgical) were selected. Whole-spine standing lateral radiographs were taken, and spinopelvic, thoracic, and cervical parameters were measured. Then, the data were analyzed using correlation coefficient test and multiple regression analysis.Results: All the parameters showed a normal distribution. The mean values of the cervical parameters are as follows: C1C2 Cobb angle, −27.07°±4.3°; C2C7 Cobb angle, −16.4°±5.6°; OCC2 Cobb angle, −14.5°±3.8°; OCC7 Cobb angle, −29.8°±5.6°; C2C7 Harrison angle, 20.4°±4.3°; and C7 slope, −25.4°±5.6°. The analysis of these parameters revealed no statistically significant difference between asymptomatic, symptomatic, and post-surgical patients. C7 sagittal vertical axis (SVA) correlated with the C2C7 Cobb angle (r =0.7) in all groups. No significant correlation was noted between cervical and spinopelvic parameters in asymptomatic patients. However, C1C2 Cobb angle correlated significantly with pelvic incidence (PI, r =−0.2), lumbar lordosis (LL, r =0.2), and pelvic tilt (PT, r =−0.2) in cervical symptomatic patients. Irrespective of the patient symptom sub-group (n=420), C1C2 Cobb angle correlated with LL (r =0.1) and C2C7 Harrison angle correlated with PI and PT (r =0.1).Conclusions: Our results indicate significant interdependence between the spinopelvic and cervical alignment, especially in cervical symptomatic patients. In addition, strong correlation was found between the C7 SVA and C2C7 Cobb angle. Overall, the results of this study could help to better understand the cervical sagittal alignment and serve as preliminary data for planning surgical reconstruction procedures.

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Analisis Pemahaman Wajib Pajak dan Iklan Pajak Terhadap Tingkat Kepatuhan Wajib Pajak Dalam Pajak Bumi dan Bangunan di KPP Tangerang Timur

Jurnal ULTIMA Accounting ◽

10.31937/akuntansi.v4i1.137 ◽

2012 ◽

Vol 4 (1) ◽

pp. 66-85

Author(s):

Nico Darmawan

Keyword(s):

Mass Media ◽

Hypothesis Testing ◽

Multiple Regression ◽

Sampling Method ◽

Pearson Correlation ◽

Electronic Media ◽

Reliability Testing ◽

Test Hypothesis ◽

Validity Test ◽

Convenience Sampling

This research was conducted to analyze relationship between the understanding of the taxpayer and the tax advertising towards compliance of taxpayer to pay Land and Building Tax (PBB) in the Tax Office (KPP) East Tangerang especially in sub-district Ciledug. Objects of this research are taxpayers who pay PBB in KPP East Tangerang especially in sub-district Ciledug and had seen tax advertising in both mass media and electronic media. The samples were taken by non-probability sampling method by using convenience sampling. The total samples used in analysis are 100 respondents. In the technique of data analysts, this research do the validity test by pearson correlation, reliability testing with coefficient Cronbach’s alpha, the classical assumption test, hypothesis testing multiple regression, t test, and F test. The result showed that the understanding of taxpayer have a significant effect on compliance of taxpayer and the tax advertising have insignificant effect on compliance of taxpayer, meanwhile the understanding of taxpayer and tax advertising simultaneously had a significant effect on compliance of taxpayer. Keywords: Tax Advertising, Compliance of Taypayer, The Understanding of Taxpayer

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Lumbar Level Significantly Influences Postoperative Global Sagittal Balance Following Pedicle Subtraction Osteotomy

Global Spine Journal ◽

10.1177/21925682211032563 ◽

2021 ◽

pp. 219256822110325

Author(s):

Athan G. Zavras ◽

T. Barrett Sullivan ◽

Navya Dandu ◽

Howard S. An ◽

Christopher J. DeWald ◽

...

Keyword(s):

Sagittal Balance ◽

Sagittal Alignment ◽

Adult Spinal Deformity ◽

Vertical Axis ◽

Pedicle Subtraction Osteotomy ◽

Current Evidence ◽

Sacral Slope ◽

Sagittal Vertical Axis ◽

Lumbar Level ◽

Global Sagittal Alignment

Study Design: Retrospective cohort study. Objectives: The current evidence regarding how level of lumbar pedicle subtraction osteotomy (PSO) influences correction of sagittal alignment is limited. This study sought to investigate the relationship of lumbar level and segmental angular change (SAC) of PSO with the magnitude of global sagittal alignment correction. Methods: This study retrospectively evaluated 53 consecutive patients with adult spinal deformity who underwent lumbar PSO at a single institution. Radiographs were evaluated to quantify the effect of PSO on lumbar lordosis (LL), thoracic kyphosis (TK), sacral slope (SS), pelvic tilt (PT), pelvic incidence (PI), T1-spinopelvic inclination (T1SPI), T1-pelvic alignment (TPA), and sagittal vertical axis (SVA). Results: Significant correlations were found between PSO SAC and the postoperative increase in LL ( r = 0.316, P = .021) and PT ( r = 0.352, P = .010), and a decrease in TPA ( r = −0.324, P = .018). PSO level significantly correlated with change in T1SPI ( r = −0.305, P = .026) and SVA ( r = −0.406, P = .002), with more caudal PSO corresponding to a greater correction in sagittal balance. On multivariate analysis, more caudal PSO level independently predicted a greater reduction in T1SPI (β = −3.138, P = .009) and SVA (β = −29.030, P = .001), while larger PSO SAC (β = −0.375, P = .045) and a greater number of fusion levels (β = −1.427, P = .036) predicted a greater reduction in TPA. Conclusion: This study identified a gain of approximately 3 degrees and 3 cm of correction for each level of PSO more caudal to L1. Additionally, a larger PSO SAC predicted greater improvement in TPA. While further investigation of these relationships is warranted, these findings may help guide preoperative PSO level selection.

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The Studying the Components of Social Capital and its Relationship with the Social Happiness in Iranian Students

International Journal of Engineering & Technology ◽

10.14419/ijet.v7i4.7.20371 ◽

2018 ◽

Vol 7 (4.7) ◽

pp. 19

Author(s):

Zadeh Foroughinia ◽

Hakimeh Mohammadzadeh ◽

Reza Pourmirza Kalhori ◽

Neda Kianipour

Keyword(s):

Social Capital ◽

Significant Relationship ◽

Social Inclusion ◽

Pearson Correlation ◽

Cluster Sampling ◽

Medical Sciences ◽

The Social ◽

Research Population ◽

Iranian Students ◽

Almost All

The concept of social capital, due to its nature and content, is associated with almost all the issues in the human, social and health fields. On the other hand, the role of happiness and joy in mental health, physical health, and social inclusion are very important in the field of health. The purpose of this study was to investigate the components of social capital and its relation with social happiness of students in Kermanshah University of Medical Sciences in 2017. This study is descriptive-correlational. The research population consisted of 450 students in Kermanshah University of Medical Sciences in 2017who were selected by cluster sampling. Bullen& Onyx Standard Social Capital Questionnaire and Oxford Happiness Questionnaire (OHQ) were used to collect data. Data were analyzed using descriptive and inferential statistics (Pearson correlation coefficient). Data analysis was performed using SPSS-23 software. In this research, social capital score was 3.17 ± 0.45 according to the students' score and the mean score of the social happiness was 3.68 ± 0.14. There was a positive and significant relationship between two variables of social capital and social happiness of students (r=0.423). Among the social capital fields, the variables of the value of life, trust, and security had the most and the least relationship with the overall social happiness. Social capital and its aspects have a direct and significant relationship with the social happiness; therefore, with increasing the social capital, the level of social happiness increases.

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The Relationship Between Leisure Management and Exam Anxiety Levels of University Students

10.53350/pjmhs2115102915 ◽

2021 ◽

Vol 15 (10) ◽

pp. 2915-2921

Author(s):

Fatih Yaşartürk ◽

Buğra Akay ◽

Betül Ayhan

Keyword(s):

University Students ◽

Test Anxiety ◽

Goal Setting ◽

Significant Relationship ◽

Family Income ◽

Pearson Correlation ◽

Significant Difference ◽

Anxiety Levels ◽

Exam Anxiety ◽

The Relationship

Aim: The aim of the study is to examine the relationship between leisure management and test anxiety levels of university students and their differentiation status in terms of some demographic variables. Methods: The relational survey model was used in the study, and there were 284 (147 male and 137 female) university students selected from the universe by convenient sampling method. Personal information form prepared by the researchers, “Leisure Management Scale (LMS)” and “Test Anxiety Inventory (TAI)” were used as data collection tools. In the analysis of the data, descriptive statistics, t-Test and Pearson Correlation analyzes were used by using SPSS 26.0 program. Results: There was no significant difference in the sub-dimensions of the leisure management scale and the total score averages according to the gender variable, while a significant difference was found in the TAI "delusional", "affective" sub-dimensions and total score averages. According to the family income variable of university students, a low-level and negative significant relationship was found in the "leisure attitude" sub-dimension of LMS, and in the total TAI and "delusional sub-dimension". A significant relationship was found between the age variable and the "goal setting and method" sub-dimension of LMS. A low and negative significant relationship was found between leisure and "goal setting and method", "leisure attitude" and total LMS score averages. In addition, while there was no significant relationship between LMS and TAI, it was found that there was a low and negative significant relationship between the "leisure attitude" sub-dimension and the test anxiety inventory and its sub-dimensions. Conclusion: It can be said that as the level of attitude towards leisure activities of university students’ increases, the feeling of exam anxiety may decrease, and the increase in free time will adversely affect the level of leisure management and attitude. Keywords: University students, Leisure management, Exam anxiety level. *It was presented as an oral presentation at the 5th Academic Sports Research Congress

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