Abstract：
The impact of cervical sagittal alignment on cervical facet joint degeneration (CFD) and the risk factors for CFD in patients with degenerative cervical myelopathy (DCM) were investigated in the current study.
A total of 250 surgical patients with DCM were recruited. The clinical data and radiographical characteristics, including CFD, cervical sagittal balance parameters, Hounsfield unit (HU) values, disc degeneration (DD), and modic change, were collected. The detailed correlation between these characteristics and CFD was analyzed. Characteristics, including CFD, were compared among the various cervical alignment types and different CFD groups. Finally, the risk factors for CFD were revealed via logistic regression.
CFD was prevalent in DCM patients. Age, cervical sagittal vertical axis (cSVA), range of motion, T1 slope, thoracic inlet angle, DD, HU value, and modic change correlated with CFD segmentally and globally (P < 0.05). The lordosis and sigmoid types had a significantly higher CFD prevalence (P < 0.05). Furthermore, the average CFD threshold for the severe CFD group was 1.625 (area under the curve, 0.958). Additionally, 167 patients with average CFD <1.625 and 83 patients with CFD of ≥1.625 were classified into the mild CFD group and severe CFD group, respectively. Finally, multivariate analysis was performed, and age, cSVA, HU value, modic change, and DD were determined to be independent risk factors for CFD.
The load distribution tends to shift to a more shear-like pattern in the sigmoid and kyphosis types and in those with a higher cSVA, thereby promoting CFD. Aging, cervical malalignment, low bone mineral density, DD, and modic change were revealed to result in high risks of CFD.
A total of 250 surgical patients with DCM were recruited. The clinical data and radiographical characteristics, including CFD, cervical sagittal balance parameters, Hounsfield unit (HU) values, disc degeneration (DD), and modic change, were collected. The detailed correlation between these characteristics and CFD was analyzed. Characteristics, including CFD, were compared among the various cervical alignment types and different CFD groups. Finally, the risk factors for CFD were revealed via logistic regression.
CFD was prevalent in DCM patients. Age, cervical sagittal vertical axis (cSVA), range of motion, T1 slope, thoracic inlet angle, DD, HU value, and modic change correlated with CFD segmentally and globally (P < 0.05). The lordosis and sigmoid types had a significantly higher CFD prevalence (P < 0.05). Furthermore, the average CFD threshold for the severe CFD group was 1.625 (area under the curve, 0.958). Additionally, 167 patients with average CFD <1.625 and 83 patients with CFD of ≥1.625 were classified into the mild CFD group and severe CFD group, respectively. Finally, multivariate analysis was performed, and age, cSVA, HU value, modic change, and DD were determined to be independent risk factors for CFD.
The load distribution tends to shift to a more shear-like pattern in the sigmoid and kyphosis types and in those with a higher cSVA, thereby promoting CFD. Aging, cervical malalignment, low bone mineral density, DD, and modic change were revealed to result in high risks of CFD.
摘要：
目的：本研究探讨颈椎矢状位对退行性脊髓型颈椎病（DCM）患者颈椎小关节退变（CFD）的影响及其危险因素。
方法：共招募250例DCM手术患者。临床数据和影像学特征，包括CFD，颈椎矢状面平衡参数,Hounsfield单位(Hu)值，椎间盘退变（DD），收集了修改更改。分析了这些特征与CFD之间的详细相关性。比较了各种宫颈排列类型和不同CFD组的特征，包括CFD。最后,CFD的危险因素通过logistic回归分析.
结果：CFD在DCM患者中普遍存在。年龄,颈椎矢状面垂直轴(cSVA),运动范围（ROM），T1斜率(T1S),胸廓入口角(TIA),DD,胡值，和modic变化与CFD节段性和全局性相关(p<0.05)。前凸和乙状结肠的CFD患病率明显较高（p<0.05）。Further,重度CFD组的平均CFD阈值确定为1.625（AUC，0.958)。此外,将平均CFD（<1.625）的167例患者和FD≥1.625的83例患者分别分为轻度CFD组和重度CFD组。最后,进行多变量分析，年龄，cSVA,胡值，改变和DD被确定为CFD的独立危险因素。
结论：在乙状结肠和后凸类型或具有较高cSVA的个体中，负荷分布倾向于向更像剪切的模式转移。从而促进CFD。衰老,子宫颈排列不良,骨密度低，椎间盘退变,和modic变化被发现对CFD有很高的风险。
方法：共招募250例DCM手术患者。临床数据和影像学特征，包括CFD，颈椎矢状面平衡参数,Hounsfield单位(Hu)值，椎间盘退变（DD），收集了修改更改。分析了这些特征与CFD之间的详细相关性。比较了各种宫颈排列类型和不同CFD组的特征，包括CFD。最后,CFD的危险因素通过logistic回归分析.
结果：CFD在DCM患者中普遍存在。年龄,颈椎矢状面垂直轴(cSVA),运动范围（ROM），T1斜率(T1S),胸廓入口角(TIA),DD,胡值，和modic变化与CFD节段性和全局性相关(p<0.05)。前凸和乙状结肠的CFD患病率明显较高（p<0.05）。Further,重度CFD组的平均CFD阈值确定为1.625（AUC，0.958)。此外,将平均CFD（<1.625）的167例患者和FD≥1.625的83例患者分别分为轻度CFD组和重度CFD组。最后,进行多变量分析，年龄，cSVA,胡值，改变和DD被确定为CFD的独立危险因素。
结论：在乙状结肠和后凸类型或具有较高cSVA的个体中，负荷分布倾向于向更像剪切的模式转移。从而促进CFD。衰老,子宫颈排列不良,骨密度低，椎间盘退变,和modic变化被发现对CFD有很高的风险。
