C7
Complement component C7 precursor
Publications[править]
In the older population, tortuosity of the vertebral artery (VA), uncovertebral joint (UVJ) osteoarthritis, and abnormal vertebral alignment may alter the normal anatomy. We aimed to determine the anatomical variations and relationships between the cervical segment of the VA and the cervical spine with regard to ageing. In this retrospective cross-sectional study, the computed tomography angiography scans of 110 subjects were reviewed. Any variations in the VA, UVJ degeneration were identified. The distance between the VA and uncinate process (UP) was measured electronically. The distance between the VA and UP were compared according to the age group (group A < 45, group B = 45-65, and group C > 65 years-old). With regard to the transverse foramen, 7.2% of the cases had entering abnormalities of the VA, while in one case (0.83%), the right VA had an exiting abnormality (exiting from the C2 instead of the C1). UVJ degeneration was found to be significantly higher in the older age group (p < 0.05). Furthermore, at the C4-C7 levels, the distances between the VA and UP were significantly smaller in the older age group (p < 0.01). The VA-UP distance has been shown to decrease due to increasing UVJ osteoarthritis in the elderly. The convergence of the VA toward the spine occurs at the most mobile segment of the cervical spine, and this anatomical alteration may predispose temporary and/or permanent vertebral artery occlusion clinically, and be dangerous during cervical spine surgery.
MeSH Terms
- Aged
- Aged, 80 and over
- Aging
- Cervical Vertebrae
- Computed Tomography Angiography
- Cross-Sectional Studies
- Female
- Humans
- Male
- Middle Aged
- Retrospective Studies
- Vertebral Artery
Keywords
- angiography
- computed tomography
- osteoarthritis
- spine
- vertebral artery
- aging
Retrospective cohort study. To identify age-related changes in cervical sagittal parameters using standard radiographs. Cervical sagittal balance is important for the maintenance of neutral head posture and horizontal gaze. Degenerative changes in the cervical spine that occur with aging may alter cervical sagittal balance, which can lead to chronic neck pain and predispose to various cervical spine pathologies. We performed a retrospective cohort study of 151 patients with lateral cervical spine radiographs taken at our institution between December 2017 and June 2018. Cervical sagittal parameters were measured, including C1 inclination, C2 slope, C2-C7 Cobb angle, cervical sagittal vertical axis (cSVA), cervical tilt, upper and lower C7 slopes, T1 slope, and T1 slope minus cervical lordosis (TS-CL). The association between age and cervical sagittal parameters was assessed using the Pearson correlation coefficient and a linear regression analysis. An analysis of variance (ANOVA) with Tukey adjustments was then performed to identify differences in cervical sagittal parameters among patients aged 18 to 39 years, 40 to 64 years, and >64 years of age. There were positive correlations between age and C2-C7 Cobb angle (r = 0.231, P = 0.004), upper C7 slope (r = 0.280, P < 0.001), lower C7 slope (r = 0.283, P < 0.001), and T1 slope (r = 0.189, P = 0.020). Upper C7 slope (R = 0.079) and lower C7 slope (R = 0.074) had the strongest correlation with age in the linear regression analysis. The ANOVA found significant differences among the age subgroups in terms of C2-C7 Cobb angle (P = 0.002), upper C7 slope (P < 0.001), lower C7 slope (P < 0.001), and T1 slope (P = 0.031). Patients >64 years old had significantly higher C2-C7 Cobb angle, upper C7 slope, lower C7 slope, and T1 slope. Changes in cervical sagittal alignment with age are characterized by increased cervical lordosis and increased thoracic kyphosis. 3.
MeSH Terms
- Adolescent
- Adult
- Aged
- Aging
- Cervical Vertebrae
- Humans
- Kyphosis
- Lordosis
- Middle Aged
- Retrospective Studies
- Young Adult
Localized vascular disruption after traumatic spinal cord injury (SCI) triggers a cascade of secondary events, including inflammation, gliosis, and scarring, that can further impact recovery. In addition to immunomodulatory and neurotrophic properties, mesenchymal stromal cells (MSCs) possess pericytic characteristics. These features make MSCs an ideal candidate for acute cell therapy targeting vascular disruption, which could reduce the severity of secondary injury, enhance tissue preservation and repair, and ultimately promote functional recovery. A moderately severe cervical clip compression/contusion injury was induced at C7-T1 in adult female rats, followed by an intravenous tail vein infusion 1 hour post-SCI of (a) term-birth human umbilical cord perivascular cells (HUCPVCs); (b) first-trimester human umbilical cord perivascular cells (FTM HUCPVCs); (c) adult bone marrow mesenchymal stem cells; or (d) vehicle control. Weekly behavioral testing was performed. Rats were sacrificed at 24 hours or 10 weeks post-SCI and immunohistochemistry and ultrasound imaging were performed. Both term and FTM HUCPVC-infused rats displayed improved (p < .05) grip strength compared with vehicle controls. However, only FTM HUCPVC-infusion led to significant weight gain. All cell infusion treatments resulted in reduced glial scarring (p < .05). Cell infusion also led to increased axonal, myelin, and vascular densities (p < .05). Although post-traumatic cavity volume was reduced with cell infusion, this did not reach significance. Taken together, we demonstrate selective long-term functional recovery alongside histological improvements with HUCPVC infusion in a clinically relevant model of cervical SCI. Our findings highlight the potential of these cells for acute therapeutic intervention after SCI.
MeSH Terms
- Aging
- Animals
- Behavior, Animal
- Benzylidene Compounds
- Disease Models, Animal
- Female
- Heterografts
- Infusions, Intravenous
- Mesenchymal Stem Cell Transplantation
- Mesenchymal Stem Cells
- Rats
- Rats, Wistar
- Recovery of Function
- Spinal Cord Injuries
Keywords
- Cervical spinal cord injury
- Mesenchymal stromal cells
- Vascular disruption
The complement system is essential for an adequate immune response. Much attention has been given to the role of complement in disease. However, to better understand complement in pathology, it is crucial to first analyze this system under different physiological conditions. The aim of the present study was therefore to investigate the inter-individual variation in complement activity and the influences of age and sex. Complement levels and functional activity were determined in 120 healthy volunteers, 60 women, 60 men, age range 20-69 year. Serum functional activity of the classical pathway (CP), lectin pathway activated by mannan (MBL-LP) and alternative pathway (AP) was measured in sera, using deposition of C5b-9 as readout. In addition, levels of C1q, MBL, MASP-1, MASP-2, ficolin-2, ficolin-3, C2, C4, C3, C5, C6, C7, C8, C9, factor B, factor D, properdin, C1-inhibitor and C4b-binding protein, were determined. Age- and sex-related differences were evaluated. Significantly lower AP activity was found in females compared to males. Further analysis of the AP revealed lower C3 and properdin levels in females, while factor D concentrations were higher. MBL-LP activity was not influenced by sex, but MBL and ficolin-3 levels were significantly lower in females compared to males. There were no significant differences in CP activity or CP components between females and males, nevertheless females had significantly lower levels of the terminal components. The CP and AP activity was significantly higher in the elderly, in contrast to MBL-LP activity. Moreover, C1-inhibitor, C5, C8, and C9 increased with age in contrast to a decrease of factor D and C3 levels. In-depth analysis of the functional activity assays revealed that MBL-LP activity was predominantly dependent on MBL and MASP-2 concentration, whereas CP activity relied on C2, C1-inhibitor and C5 levels. AP activity was strongly and directly associated with levels of C3, factor B and C5. This study demonstrated significant sex and age-related differences in complement levels and functionality in the healthy population. Therefore, age and sex analysis should be taken into consideration when discussing complement-related pathologies and subsequent complement-targeted therapies.
MeSH Terms
- Adult
- Aged
- Aging
- Complement Activation
- Complement System Proteins
- European Continental Ancestry Group
- Female
- Humans
- Male
- Middle Aged
- Sex Characteristics
Keywords
- complement
- gender
- health
- innate imunity
- sex and age
A 20-year longitudinal study. To evaluate the long-term effect of sagittal alignment of the cervical spine on intervertebral disk degeneration in healthy asymptomatic subjects. This study continues a previous 10-year longitudinal study to determine whether sagittal alignment affects disk degeneration during normal aging. We assessed 90 healthy subjects (30 men and 60 women) from among 497 volunteers who underwent magnetic resonance imaging (MRI) and plain radiographs of the cervical spine between 1994 and 1996 (follow-up rate 18.1%). The mean age at the initial study was 35.5±13.4 years (11-65 y). We compared initial MRIs and follow-up MRIs, conducted at an average of 21.6 years after the initial study, for (1) decreased signal intensity of the intervertebral disks, (2) posterior disk protrusion, and (3) disk-space narrowing from C2-3 to C7-T1. Subjects were grouped by age at follow-up (under 40 vs. 40 y and older) and by a lordotic or nonlordotic cervical sagittal alignment at baseline. We assessed neck pain, stiff shoulders, and upper-arm numbness at follow-up, and examined associations between clinical symptoms and MRI parameters. Progressive changes during the 20-year period included a decrease in disk signal intensity (84.4% of subjects), posterior disk protrusion (86.7%), and disk-space narrowing (17.8%). No significant association was observed between sagittal alignment and decreased disk signal intensity, posterior disk protrusion, or disk-space narrowing. Among subjects over the age of 40, progressive degenerative changes at C7-T1 were significantly more frequent in nonlordotic subjects (90.9%) compared with those with cervical lordosis (54.2%, P=0.032). The prevalence of clinical symptoms was similar in lordotic and nonlordotic subjects at follow-up. Nonlordotic cervical alignment was related to the progression of disk degeneration at C7-T1 but not other levels. Cervical alignment did not affect the development of clinical symptoms in healthy subjects. Level III.
MeSH Terms
- Adolescent
- Adult
- Aged
- Aging
- Cervical Vertebrae
- Child
- Female
- Follow-Up Studies
- Humans
- Intervertebral Disc Degeneration
- Longitudinal Studies
- Magnetic Resonance Imaging
- Male
- Middle Aged
- Posture
- Survivors
- Young Adult
A cross-sectional study. To investigate the correlation of cervical spine alignment changes with aging in asymptomatic population. Previous studies demonstrated the influence of lumbar and thoracic spine on cervical spine alignment, but few has reported the cervical spine alignment change along with aging in asymptomatic population. Asymptomatic population were divided into four groups according to different ages (Group A: ≤20 years; Group B: 21-40 years; Group C: 41-60 years; Group D: ≥61 years). Each group was composed of 30 subjects. The following parameters were measured: C0-1 Cobb angle, C1-2 Cobb angle, C2-7 Cobb angle, C1-7 sagittal vertical axis (C1-7 SVA), C2-7 SVA, central of gravity to C7 sagittal vertical axis (CG-C7 SVA), Thoracic Inlet Angle (TIA), Neck Tilt (NT), cervical tilt, cranial tilt, T1 slope (TS), TS-CL, and ANOVA statistical method was used to analyze the differences among four groups, and then, linear regression analysis was performed to analyze correlation of the cervical spine alignment with the aging. C1-7 SVA, C2-7 SVA, CG-C7 SVA, TIA, NT, TS, and cranial tilt were found statistically different among four groups (P < 0.01). From Group A to Group D, the mean C1-7 SVA were 30.7, 26.0, 21.8, and 36.9 mm, the mean C2-7 SVA were 18.7, 14.7, 11.9, and 24.7 mm, and the mean CG-C7 SVA were 19.6, 16.6, 9.4, and 26.7 mm. The mean TIA were 62.4°, 65.0°, 71.8°, and 76.9°, the mean NT were 39.4°, 43.8°, 46.3°, and 48.2°, the mean TS were 23.0°, 21.1°, 25.5°, and 28.7°, and the mean cranial tilt were 5.7°, 4.8°, 3.0°, and 9.5°. Further linear regression indicated that TIA (r = 0.472; P < 0.0001), NT (r = 0.337; P = 0.0006), and TS (r = 0.299; P = 0.0025) were positively correlated with aging. A gradual increase of TIA, NT, and TS, accompanied with an increased CL, is found along with aging in asymptomatic population, among which TIA, NT, and TS are significantly correlated with physiological nature of aging.
MeSH Terms
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Aging
- Cervical Vertebrae
- Child
- Cross-Sectional Studies
- Disability Evaluation
- Female
- Humans
- Male
- Middle Aged
- Neck
- Radiography
- Skull
- Young Adult
Keywords
- Aging
- Asymptomatic population
- Cervical spine alignment
- Radiology
A retrospective radiographic study. The aim of this study is to demonstrate that lumbar retrolisthesis serves as an important compensatory mechanism and to identify the possible factor related to lumbar retrolisthesis. Lumbar instability is one of the common degenerative changes, which presents as 2 radiologic features: anterolisthesis and retrolisthesis. Compared with the extensive studies on anterolisthesis, limit data are available on the characteristics and clinical relevance of lumbar retrolisthesis. In this study, 105 adult patients with low back pain were prospectively recruited, of which 60 patients had retrolisthesis (group 1) and 45 patients had anterolisthesis (group 2). Another 40 healthy age-matched adults (group 3) were also included to serve as the control group. Sagittal spinopelvic parameters were measured from the standing lateral radiograph, including thoracic kyphosis (TK), thoracolumbar kyphosis (TLK), lumbar lordosis (LL), pelvic incidence (PI), sacrum slope (SS), pelvic tilt (PT), sagittal vertical axis (SVA), spinosacral angle (SSA), and C7 tilt (C7T). In addition, disk degeneration was quantitatively evaluated by Pfirrmann score on T2-weighted magnetic resonance images in patients with retrolisthesis. For all the sagittal parameters, SVA, PI, SS, and LL in retrolisthesis group were found to be significantly lower than those in the anterolisthesis group and in the control group, respectively (P<0.05), whereas TLK in retrolisthesis group was significantly larger than other 2 groups (P<0.01). In addition, the average Pfirrmann disk score was 2.11 at levels with retrolisthesis indicating that the disks were not severely degenerated. Lumbar retrolisthesis, together with thoracolumbar kyphosis, appears to be associated with mechanisms associated with regulation of sagittal balance. Low PI and disk instability due to degeneration may contribute to the development and progression of retrolisthesis.
MeSH Terms
- Adult
- Aged
- Aging
- Biomechanical Phenomena
- Female
- Humans
- Intervertebral Disc Degeneration
- Lumbar Vertebrae
- Male
- Middle Aged
- Pelvis
- Postural Balance
A comprehensive understanding of normative sagittal profile is necessary for adult spinal deformity. Roussouly described four sagittal alignment types based on sacral slope, lumbar lordosis, and location of lumbar apex. However, the lower limb, a newly described component of spinal malalignment compensation, is missing from this classification. This study aims to propose a full-body sagittal profile classification in an asymptomatic population based on full-body imaging. This is a retrospective analysis of a prospective single-center study of 116 asymptomatic volunteers. Cluster analysis including all sagittal parameters was first performed, and then ANOVA was performed between sub-clusters to eliminate the non-significantly different parameters. This loop was repeated until all parameters were significantly different between each sub-cluster. Three types of full-body sagittal profiles were finalized according to cluster analysis with ten radiographic parameters: hyperlordosis type (77 subjects), neutral type (28 subjects), and compensated type (11 subjects). Radiographic parameters included knee angle, pelvic shift, pelvic angle, PT, PI-LL, C7-S1 SVA, TPA, T1 slope, C2-C7 angle, and C2-C7 SVA. Age was significantly different across compensation types, while BMI and gender were comparable. Age-matched subjects were randomly selected with 11 subjects in each type. ANOVA analysis revealed that all parameters but PT and C2-C7 angle remained significantly different. The current three compensation types of full-body sagittal profiles in asymptomatic adults included significant changes from cervical region to knee, indicating that subjects should be evaluated with full-length imaging. All three types exist regardless of age, but the distribution may vary.
MeSH Terms
- Adult
- Aged
- Aging
- Cluster Analysis
- Female
- Humans
- Knee Joint
- Lower Extremity
- Lumbar Vertebrae
- Male
- Middle Aged
- Pelvic Bones
- Prospective Studies
- Radiography
- Retrospective Studies
- Spine
- Young Adult
Keywords
- Asymptomatic volunteers
- Full-body profile
- Lower limbs
- Sagittal alignment
The global spinal sagittal alignment varies widely among healthy individuals as it is affected by not only race, but also aging. We investigated age-related changes in the spinal alignment in asymptomatic Japanese individuals. The subjects comprised 220 individuals without any spine-related neurological symptoms or treatment history thereof who visited our outpatient clinic. Lateral radiographs of the whole spine were taken for all subjects in the standing position. Based on the images obtained, spino-pelvic parameters were calculated using Jackson's method so as to analyze any correlations with age. TIA, TK, and C2-C7A were found to markedly increase with age from late middle age (P < 0.05). No correlation with aging was found for lumbosacral parameters or sagittal balance (P > 0.05). However, there were 22 subjects (10%) with C7SVA > 50 mm, with those aged 70 years or older accounting for half of this subpopulation. Sagittal balance tended to be retained even in elderly subjects if lumbosacral lordosis was large enough to compensate for thoracic kyphosis. A very strong correlation was found between the L1 slope and whole-spine sagittal balance (P < 0.0001, r = -0.497). Increases in cervicothoracic curvature occurring along with thoracic deformation underlie age-related changes in the spine. In contrast, the lumbosacral spine compensates in such a manner so as to maintain the sagittal balance. The whole-spine sagittal balance can deteriorate if the compensatory changes in the lumbosacral spine are insufficient. The L1 slope is a central parameter that defines the whole-spine sagittal balance. PI; pelvic incidence; SS; sacral slope; PT; pelvic tilt; LL; lumbar lordosis; C7SVA; C7 sagittal vertical axis; SSA; spinosacral angle; TK; thoracic kyphosis; C2-C7SVA; C2-C7 sagittal vertical axis; C2-C7A; C2-C7 Angle; TIA; thoracic inlet angle; NT; neck tilt.
MeSH Terms
- Adult
- Aged
- Aged, 80 and over
- Aging
- Cervical Vertebrae
- Cohort Studies
- Female
- Humans
- Japan
- Male
- Middle Aged
- Postural Balance
- Posture
- Spinal Cord
- Spine
- Young Adult
Keywords
- Global spinal alignment
- Japanese population
- age-related variations
Human beings stand upright with the chain of balance beginning at the feet, progressing to the lower limbs (ankles, knees, hip joints, pelvis), each of the spinal segments, and then ending at the cranium to achieve horizontal gaze and balance using minimum muscle activity. The details of the alignment and balance of the chain, however, are not clearly understood, due to the lack of information regarding the three-dimensional (3D) orientation of all bony elements in relation to the gravity line (GL). We performed a clinical study to clarify the standing sagittal alignment of whole axial skeletons in reference to the GL using the EOS slot-scanning 3D X-ray imaging system with simultaneous force plate measurement in a healthy human population. The GL was defined as a vertical line drawn through the centre of vertical pressure measured by the force plate. The present study yielded a complete set of physiological alignment measurements of the standing axial skeleton from the database of 136 healthy subjects (a mean age of 39.7 years, 20-69 years; men: 40, women: 96). The mean offset of centre of the acoustic meati from the GL was 0.0 cm. The offset of the cervical and thoracic vertebrae was posterior to the GL with the apex of thoracic kyphosis at T7, 5.0 cm posterior to the GL. The sagittal alignment changed to lordosis at the level of L2. The apex of the lumbar lordosis was L4, 0.6 cm anterior to the GL, and the centre of the base of the sacrum (CBS) was just posterior to the GL. The hip axis (HA) was 1.4 cm anterior to the GL. The knee joint was 2.4 cm posterior and the ankle joint was 4.8 cm posterior to the GL. L4-, L5- and the CBS-offset in subjects in the age decades of 40s, 50s and 60s were significantly posterior to those of subjects in their 20s. The L5- and CBS-offset in subjects in their 50s and 60s were also significantly posterior to those in subjects in their 30s. HA was never posterior to the GL. In the global alignment, there was a positive correlation between offset of C7 vertebra from the sagittal vertical axis (a vertical line drawn through the posterior superior corner of the sacrum in the sagittal plane) and age, but no correlation was detected between the centre of the acoustic meati-GL offset and age. Cervical lordosis (CL), pelvic tilt (PT), pelvic incidence, hip extension, knee flexion and ankle dorsiflexion increased significantly with age. Our results revealed that aging induces trunk stooping, but the global alignment is compensated for by an increase in the CL, PT and knee flexion, with the main function of CL and PT to maintain a horizontal gaze in a healthy population.
MeSH Terms
- Adult
- Aged
- Female
- Gravitation
- Humans
- Male
- Middle Aged
- Postural Balance
- Posture
- Radiography
- Skeleton
- Young Adult
Keywords
- aging
- force plate measurement
- gravity line
- sagittal whole body alignment
- standing balance
To investigate the bone mineral density (BMD) of cervical vertebrae in a population-stratified manner and correlate with that of the lumbar vertebrae. Five hundred and ninety-eight healthy volunteers (254 males, 344 females), ranging from 20 to 64 years of age, were recruited for volumetric BMD (vBMD) measurements by quantitative computed tomography. Basic information (age, height, weight, waistline, and hipline), and vBMD of the cervical and lumbar vertebrae (C2-7 and L2-4) were recorded. Comparisons among sex, age groups and different levels of vertebrae were analyzed using analysis of variance. Linear regression was performed for relevance of different vertebral levels. The vBMD of cervical and lumbar vertebrae was higher in females than males in each age group. The vBMD of the cervical and lumbar vertebrae in males and the vBMD of lumbar vertebrae in females decreased with aging. In each age group, the vBMD of the cervical vertebrae was higher than that of the lumbar vertebrae with gradual decreases from C2 to C7 except for C3; moreover, the vBMD of C6 and C7 was significantly different from that of C2-5. Correlations of vBMD among different cervical vertebrae (females: r = 0.62-0.94; males: r = 0.63-0.94) and lumbar vertebrae (males: r = 0.93-0.98; females: r = 0.82-0.97) were statistically significant at each age group. The present study provided normative data of cervical vertebrae in an age- and sex-stratified manner. Sex differences in vBMD prominently vary with age, which can be helpful to design a more comprehensive pre-operative surgical plan.
MeSH Terms
- Adult
- Aging
- Anthropometry
- Asian Continental Ancestry Group
- Bone Density
- Cervical Vertebrae
- Female
- Humans
- Linear Models
- Lumbar Vertebrae
- Male
- Middle Aged
- Reference Values
- Sex Characteristics
- Tomography, X-Ray Computed
- Young Adult
Keywords
- Bone density
- Cervical
- Computed tomography
- Lumbar
- Normal
- Population
- Quantitative
- Vertebra
This cross-sectional study was conducted on the skeletal remains of individuals of known sex, age, and ethnic origin. The vertebral bodies of levels C3-C7 were measured and analyzed. Whereas many studies were performed on the size and shape of the vertebral bodies in the thoracic and lumbar spines, few have focused on the cervical vertebral bodies. Thus, there is insufficient data in the literature on the anatomy of the cervical spine, especially based on large study populations. To establish a large database on cervical vertebral bodies' size and shape and analyze their association with demographic parameters. The population studied was composed of 277 individuals, adult males and females of African American (AA) and European American (EA) origin. The skeletal remains are housed at the Hamman-Todd Osteological collection (Cleveland Museum of Natural History, Cleveland, OH). A 3-D digitizer was used to measure the size and shape of the C3-C7 vertebral bodies. Descriptive statistics were carried out for all measurements. t Test and one-way analysis of variance were performed to assess differences in vertebral bodies' size and shape between different demographical groups (by age, sex, and ethnicity). The vertebral bodies and foramina are significantly wider, more elongated, and higher in males compared to females. AA females and males manifest significantly greater vertebral bodies (width and length) in the upper and midcervical region (vertebrae C3-C5) than EA females and males. Nevertheless, the heights of the C3 and C4 vertebral bodies are significantly smaller among the AA population, regardless of sex. The vertebral foramina's width does not differ significantly between the two ethnic groups, independent of sex, whereas they tend to be elongated in the EA group (significant for C3, C5, C7). For most vertebrae, no significant differences were found in the superior facets' length between AA and EA males and females. Cervical vertebral bodies become wider and more elongated with age, although the changes in the latter dimension are much more pronounced than in the former. Notably, the body shape of the cervical vertebrae changes gradually from a more round shape (C3 length/width index=0.84) to a more oval one (C7 length/width index =0.65). This is due to the fact that the width dimensions increase by almost 40% from C3 to C7, whereas the length dimensions increase only by approximately 10%. Furthermore, there is a significant reduction in body height with age in C3-C6. In contrast, no significant changes in vertebral foramen size with age were found. The cervical vertebral bodies' shape and size are sex-dependent phenomena, that is, in all parameters studied, the dimensions were greater in males than in females. For the midcervical level, there is a difference in body shape between individuals of different ethnic origins. The cervical vertebral bodies also exhibit considerable size and shape changes with age, that is, they become more elongated (oval shaped), wider, and shorter. In contrast, vertebral foramen size is age independent.
MeSH Terms
- Adult
- African Americans
- Body Height
- Cervical Vertebrae
- Cross-Sectional Studies
- European Continental Ancestry Group
- Female
- Humans
- Lumbar Vertebrae
- Male
- Middle Aged
- Organ Size
Keywords
- Aging
- Cervical spine
- Skeletal study
- Spinal anatomy
- Vertebral body
- Vertebral foramen
Significant variations exist in the footprint size of cervical vertebral endplates. In anterior cervical spine surgery, an implant that maximizes coverage of the endplate and contacts the apophyses may reduce subsidence and decrease risk of endplate fracture. The ability to accurately predict a patient's vertebral endplate size may be helpful for surgeons to preoperatively choose the optimal implant for the patient's specific anatomy. The purpose of this study was to (1) demonstrate the range of vertebral endplate sizes between individual patients and cervical levels and (2) determine if vertebral endplate size can be predicted based on patient characteristics and vertebral level. Fifty cervical computed tomography scans of patients 18 to 65 years old were selected for analysis. Superior vertebral endplate sizes of C3-C7 were measured medial-laterally and anteriorly-posteriorly. The medial-laterally measurement was taken from the midbody coronal view at the flat central region of the superior endplate, and the anteriorly-posteriorly measurement was taken at the midbody axial view from the front to back edge of the vertebral body. Age, height, weight, gender, and race were recorded for all patients. One-way analysis of variance, linear regressions, and multivariate regressions were performed. Patient height, age, gender, and race accounted for 51% to 71% of the variance between individuals, and endplate size increased by 1 mm in width and 0.6 mm in depth for each progressively more caudal vertebral level. Vertebral endplate size could be reliably calculated based on patient height, age, gender, and vertebral level. These data may be useful to assist surgeons in preoperative planning for patient-specific implant selection. [Orthopedics. 2016; 39(3):e526-e531.].
MeSH Terms
- Adolescent
- Adult
- Aged
- Aging
- Body Height
- Body Mass Index
- Cervical Vertebrae
- Female
- Humans
- Male
- Middle Aged
- Observer Variation
- Patient Selection
- Prostheses and Implants
- Sex Characteristics
- Tomography, X-Ray Computed
- Young Adult
Cross-Sectional Cohort Study OBJECTIVE.: To describe age-stratified normative values of novel occipitocervical, cervical, and cervicothoracic alignment parameters. Full-body radiographic images obtained without stitching or vertical distortion represent an ideal method to evaluate occipitocervical alignment and horizontal gaze. One hundred twenty adults with no back or neck symptoms were recruited. Age, sex, body mass index, Neck Disability Index (NDI), and Oswestry Disability Index scores were recorded. Radiographic parameters measured included: center sacral vertebral line, chin brow vertical angle (CBVA), orbital tilt (OrT), orbital slope, occipital slope (OS), occipital incidence, occiput-C2 (O-C2) lordosis, cervical lordosis (C2-C7, CL), T1 slope (TS), neck tilt, thoracic inlet angle (TIA), cervicothoracic kyphosis (C6-T4), and C2-C7 sagittal vertical axis (C2-7 SVA). Interobserver reliability was calculated for all measurements (intraclass correlation coefficient, ICC). A Pearson correlation was used to determine relationships between variables. A total of 115 patients were analyzed; average age as 50.1 years (range 22-78). All measured variables had an ICC >0.6. CL (r = -0.33, P < 0.001), TS (r = 0.42, P < 0.001), TIA (r = 0.24, P = 0.010), and C7 SVA (r = 0.48, P < 0.001) all increased with age. OrT (r = -0.88, P < 0.001) and OS (r = 0.73, P < 0.001) were both strongly correlated with CBVA and each other (r = -0.83, P ≤ 0.001). Both measures were also correlated with the C2-C7 SVA (OrT, r = 0.41, P < 0.001; OS, r = -0.29, P = 0.002) and O-C2 angle (OrT, r = 0.46, P < 0.001; OS, r = -0.28, P = 0.003). C6-T4 angulations was negatively correlated with NDI scores in this population (r = -0.25, P = 0.007). We present age-based normative values for occipitocervical, cervicothoracic, and cervical alignment parameters using a novel biplanar radiographic imaging technique. We introduce measures of craniocervical alignment that might provide surgeons with an intuitive way to account for the position of the orbit when planning cervical deformity correction. 4.
MeSH Terms
- Adult
- Aged
- Aging
- Cervical Vertebrae
- Cross-Sectional Studies
- Female
- Humans
- Kyphosis
- Lordosis
- Male
- Middle Aged
- Prospective Studies
- Radiography
- Reproducibility of Results
- Thoracic Vertebrae
- Young Adult
Objectives To assess the relationship between cross-sectional area of internal jugular veins and brain volumes in healthy individuals without neurologic disease. Methods A total of 193 healthy individuals without neurologic disease (63 male and 130 female; age > 20 to < 70 years) received magnetic resonance venography and structural brain magnetic resonance imaging at 3T. The internal jugular vein cross-sectional area was assessed at C2-C3, C4, C5-C6, and C7-T1. Normalized whole brain volume was assessed. Partial correlation analyses were used to determine associations. Results There was an inverse relationship between normalized whole brain volume and total internal jugular vein cross-sectional area (C7-T1: males r = -0.346, p = 0.029; females r = -0.301, p = 0.002). After age adjustment, association of normalized whole brain volume and normalized gray matter volume with internal jugular vein cross-sectional area became positive in males (normalized whole brain volume and right internal jugular vein cross-sectional area (C2-C3) changed from r = -0.163 to r = 0.384, p = 0.002), but not in the females. Conclusion Sex differences exist in the relationship between brain volume and internal jugular vein cross-sectional area in healthy individuals without neurologic disease.
MeSH Terms
- Adult
- Aging
- Atrophy
- Brain
- Female
- Humans
- Jugular Veins
- Magnetic Resonance Angiography
- Male
- Middle Aged
- Prospective Studies
Keywords
- Healthy individuals without neurologic disease
- aging
- brain atrophy
- internal jugular veins
- magnetic resonance imaging
- magnetic resonance venography
- sex
Cervical spondylosis is well accepted as a common degenerative change in the cervical spine. Compelling evidence has shown that the incidence of cervical spondylosis increases with age. However, the relationship between age and the incidence of cervical spondylosis remains obscure. It is essential to note the relationship between age and the incidence of cervical spondylosis through more and more clinical data. In the case-controlled study reported here, retrospective clinical analysis of 1,276 cases of cervical spondylosis has been conducted. We analyzed the general clinical data, the relationship between age and the incidence of cervical spondylosis, and the relationship between age-related risk factors and the incidence of cervical spondylosis. A chi-square test was used to analyze the associations between different variables. Statistical significance was defined as a P-value of less than 0.05. The imaging examination demonstrated the most prominent characteristic features of cervical spondylosis: bulge or herniation at C3-C4, C4-C5, and C5-C6. The incidence of cervical spondylosis increased with aging before age 50 years and decreased with aging after age 50 years, especially in the elderly after 60 years old. The occurrence rate of bulge or herniation at C3-C4, C4-C5, C5-C6, and C6-C7 increased with aging before age 50 years and decreased with aging after age 50 years, especially after 60 years. Moreover, the incidence of hyperosteogeny and spinal stenosis increased with aging before age 60 years and decreased with aging after age 60 years, although there was no obvious change in calcification. The age-related risk factors, such as hypertension, hyperlipidemia, diabetes, cerebral infarct, cardiovascular diseases, smoking, and drinking, have no relationship with the incidence of cervical spondylosis. A decreasing proportion of cervical spondylosis with aging occurs in the elderly, while the proportion of cervical spondylosis increases with aging in the young and the adults. This investigation implicates that aging is not only a contributor to the clinical performance of cervical spondylosis in the elderly, although the incidence of cervical spondylosis is proportional to the progress of age.
MeSH Terms
- Adult
- Age Distribution
- Aged
- Aged, 80 and over
- Aging
- Case-Control Studies
- Cervical Vertebrae
- China
- Female
- Hospitals
- Humans
- Incidence
- Male
- Middle Aged
- Retrospective Studies
- Risk Factors
- Sex Distribution
- Spondylosis
Keywords
- aging
- cervical spondylosis
- incidence
- risk factor
To evaluate the signal intensity (SI) of the intervertebral discs of the cervical spine on magnetic resonance (MR) fluid sensitive sequences, and correlate this to secondary signs of degeneration on MR and radiographs as well as to age. A total of 265 patients aged ≥16 with back pain (≥3-months, <2-year, onset <45-years) from the SPondyloArthritis Caught Early (SPACE) cohort were included. Sagittal 1.5 T MR images and lateral radiographs of the cervical spine were independently evaluated by two readers for: SI of the intervertebral discs using a grading system based of Pfirrmann (grade 1 normal/bright SI; 2 inhomogeneous/bright SI; 3 inhomogeneous/mildly decreased SI; 4 inhomogeneous/markedly decreased SI; 5 signal void), disc herniation and Modic changes (MRI) and disc space narrowing, osteophytes and sclerosis (radiograph). Readers were blinded for clinical information. Descriptive statistics were used for characteristics and prevalence of findings, and regression analysis was used for age and grades. Of 265 patients (36% male, mean age 30), 221 (83%) patients had 1 to 6 discs (median 4) with decreased SI. Of 1,590 discs, 737 (46%) were grade 1; 711 (45%) grade 2; 133 (8%) grade 3; 8 (1%) grade 4 and 1 (0%) grade 5. Secondary signs of degeneration were rare and seen predominantly in C5-C7 and appear to be related to signal loss grade 3 and 4. Low signal intensity of intervertebral discs in absence of secondary degenerative signs in the cervical spine on fluid sensitive MR images might be pre-existing and part of the natural course.
MeSH Terms
- Adolescent
- Adult
- Aging
- Axis, Cervical Vertebra
- Cerebrospinal Fluid
- Female
- Humans
- Image Enhancement
- Image Interpretation, Computer-Assisted
- Intervertebral Disc
- Intervertebral Disc Degeneration
- Magnetic Resonance Imaging
- Male
- Middle Aged
- Observer Variation
- Reproducibility of Results
- Sensitivity and Specificity
- Signal-To-Noise Ratio
- Young Adult
Keywords
- Cervical spine
- Fluid sensitive MR
- Signal intensity of intervertebral discs
The cause of syringomyelia in patients with Chiari I remains uncertain. Cervical spine anatomy modifies CSF velocities, flow patterns, and pressure gradients, which may affect the spinal cord. We tested the hypothesis that cervical spinal anatomy differs between Chiari I patients with and without syringomyelia. We identified consecutive patients with Chiari I at 3 institutions and divided them into groups with and without syringomyelia. Five readers measured anteroposterior cervical spinal diameters, tonsillar herniation, and syrinx dimensions on cervical MR images. Taper ratios for C1-C7, C1-C4, and C4-C7 spinal segments were calculated by linear least squares fitting to the appropriate spinal canal diameters. Mean taper ratios and tonsillar herniation for groups were compared and tested for statistical significance with a Kruskal-Wallis test. Inter- and intrareader agreement and correlations in the data were measured. One hundred fifty patients were included, of which 49 had syringomyelia. C1-C7 taper ratios were smaller and C4-C7 taper ratios greater for patients with syringomyelia than for those without it. C1-C4 taper ratios did not differ significantly between groups. Patients with syringomyelia had, on average, greater tonsillar herniation than those without a syrinx. However, C4-C7 taper ratios were steeper, for all degrees of tonsil herniation, in patients with syringomyelia. Differences among readers did not exceed differences among patient groups. The tapering of the lower cervical spine may contribute to the development of syringomyelia in patients with Chiari I.
MeSH Terms
- Adult
- Aging
- Arnold-Chiari Malformation
- Cervical Vertebrae
- Encephalocele
- Female
- Foramen Magnum
- Hernia
- Humans
- Magnetic Resonance Imaging
- Male
- Observer Variation
- Reproducibility of Results
- Sex Characteristics
- Spinal Canal
- Spine
- Syringomyelia
The corticospinal (CS) tract is essential for voluntary movement, but what we know about the organization and development of the CS tract remains limited. To determine the total cortical area innervating the seventh cervical spinal cord segment (C7), which controls forelimb movement, we injected a retrograde tracer (fluorescent microspheres) into C7 such that it would spread widely within the unilateral gray matter (to >80%), but not to the CS tract. Subsequent detection of the tracer showed that, in both juvenile and adult mice, neurons distributed over an unexpectedly broad portion of the rostral two-thirds of the cerebral cortex converge to C7. This even included cortical areas controlling the hindlimbs (the fourth lumbar segment, L4). With aging, cell densities greatly declined, mainly due to axon branch elimination. Whole-cell recordings from spinal cord cells upon selective optogenetic stimulation of CS axons, and labeling of axons (DsRed) and presynaptic structures (synaptophysin) through cotransfection using exo utero electroporation, showed that overgrowing CS axons make synaptic connections with spinal cells in juveniles. This suggests that neuronal circuits involved in the CS tract to C7 are largely reorganized during development. By contrast, the cortical areas innervating L4 are limited to the conventional hindlimb area, and the cell distribution and density do not change during development. These findings call for an update of the traditional notion of somatotopic CS projection and imply that there are substantial developmental differences in the cortical control of forelimb and hindlimb movements, at least in rodents.
MeSH Terms
- Aging
- Animals
- Animals, Newborn
- Axons
- Cell Count
- Cervical Cord
- Forelimb
- Hindlimb
- Lumbar Vertebrae
- Mice
- Movement
- Pyramidal Tracts
- Spinal Cord
Keywords
- channelrhodopsin2
- corticospinal projection
- development
- synapse elimination
- topography
- transient synapse
Disc space narrowing, osteophytes, and disc degeneration are common and increase with aging. Few animal models are appropriate for the study of spontaneous age-related cervical disc degeneration. We used the sand rat, a member of the gerbil family with well-recognized age-related lumbar disc degeneration, to determine whether spontaneous cervical disc degeneration differed from lumbar degeneration when evaluated by (1) radiologic and (2) histologic measures. Animals 2 to 25 months of age were used in these analyses. Cervical and lumbar discs of 99 sand rats were analyzed with radiology, and cervical discs of 67 sand rats were studied with histology. Lateral digital radiographs of cervical and lumbar spines were scored for presence or absence of wedging, disc space narrowing, osteophytes, end plate calcification, and irregular disc margins at C2-C3 through C6-C7 and T12-L1 through L7-S1. Percentages for presence were calculated and statistically analyzed for younger (range, 2-11.9 months old) versus older (range, 12.0-25 months old) animals. Cervical discs in younger animals exhibited a greater proportion of irregular margins compared with lumbar sites (94% versus 83%; p = 0.02; 95% CI for difference, 2.7, 19.0%). In older animals, cervical discs showed a greater proportion of osteophytes than did lumbar discs (7% versus 0%; p < 0.0001). The incidence of disc space narrowing was greater in cervical versus lumbar sites (99% versus 90%; p = 0.0008). Cervical spine sites which contained osteophytes morphologically showed irregular disc margins and revealed an extrusion of herniated disc material in the osteophytes. Radiologic and morphologic studies confirmed age-related disc degeneration in the cervical spine of the sand rat. Clinical cervical aging studies have shown that 14% of asymptomatic subjects younger than 40 years have abnormal MRI scans with an increase to 50% by 50 years old. We studied an economic rodent model for cervical age-related spontaneous disc.
MeSH Terms
- Age Factors
- Aging
- Animals
- Cervical Vertebrae
- Disease Models, Animal
- Female
- Gerbillinae
- Intervertebral Disc Degeneration
- Lumbar Vertebrae
- Male
- Radiography
Experimental, controlled, animal study. To use non-invasive magnetic resonance imaging (MRI) to corroborate invasive studies showing progressive expansion of a hemorrhagic lesion during the early hours after spinal cord trauma and to assess the effect of glibenclamide, which blocks Sur1-Trpm4 channels implicated in post-traumatic capillary fragmentation, on lesion expansion. Baltimore. Adult female Long-Evans rats underwent unilateral impact trauma to the spinal cord at C7, which produced ipsilateral but not contralateral primary hemorrhage. In series 1 (six control rats and six administered glibenclamide), hemorrhagic lesion expansion was characterized using MRI at 1 and 24 h after trauma. In series 2, hemorrhagic lesion size was characterized on coronal tissue sections at 15 min (eight rats) and at 24 h after trauma (eight control rats and eight administered glibenclamide). MRI (T2 hypodensity) showed that lesions expanded 2.3±0.33-fold (P<0.001) during the first 24 h in control rats, but only 1.2±0.07-fold (P>0.05) in glibenclamide-treated rats. Measuring the areas of hemorrhagic contusion on tissue sections at the epicenter showed that lesions expanded 2.2±0.12-fold (P<0.001) during the first 24 h in control rats, but only 1.1±0.05-fold (P>0.05) in glibenclamide-treated rats. Glibenclamide treatment was associated with significantly better neurological function (unilateral BBB scores) at 24 h in both the ipsilateral (median scores, 9 vs 0; P<0.001) and contralateral (median scores, 12 vs 2; P<0.001) hindlimbs. MRI is an accurate non-invasive imaging biomarker of lesion expansion and is a sensitive measure of the ability of glibenclamide to reduce lesion expansion.
MeSH Terms
- Aging
- Animals
- Disease Models, Animal
- Female
- Glyburide
- Hemorrhage
- Magnetic Resonance Imaging
- Rats
- Rats, Long-Evans
- Spinal Cord Injuries
- Treatment Outcome
Accumulated evidence shows how important spinal posture is for aged populations in maintaining independence in everyday life. However, the cross-sectional designs of most previous studies prevent elucidation of the relationship between spinal posture and future dependence in activities of daily living (ADL). We tried to clarify the association by measuring spinal posture noninvasively in a community-based prospective cohort study of older adults, paying particular attention to thoracic curvature, lumbar curvature, sacral hip angle, and inclination to determine which parameter is most strongly associated with dependence in ADL. Spinal posture was evaluated in 804 participants (338 men, 466 women, age range: 65-94 years) who were independent in ADL at baseline. We defined dependence in ADL as admission to a nursing home or need of home assistance. During the 4.5-year follow-up period, 126 (15.7%) participants became dependent in ADL. The relationship between the spinal posture parameters and outcome was assessed by dividing the participants into sex-specific quartiles of the parameters. Only inclination (angle subtended between the vertical and a line joining C7 to the sacrum) was associated with outcome, although lumbar curvature also showed a marginal association. The age- and sex-adjusted odds ratio for a 1 unit increase in the quartiles of inclination was 1.79 (confidence interval: 1.44, 2.23). After mutual adjustment for the 4 parameters, statistical significance for inclination still remained, with no substantial changes in the association estimates. This study indicates that spinal inclination is associated with future dependence in ADL among older adults.
MeSH Terms
- Activities of Daily Living
- Aged
- Aged, 80 and over
- Aging
- Cohort Studies
- Female
- Follow-Up Studies
- Geriatric Assessment
- Humans
- Independent Living
- Japan
- Locomotion
- Lumbosacral Region
- Male
- Muscle Strength
- Musculoskeletal Diseases
- Postural Balance
- Posture
- Prospective Studies
- Spine
Retrospective study. To determine age-related changes in cervical sagittal alignment using whole-spine standing radiographs in asymptomatic adults. Modern surgical techniques have emphasized the importance of maintaining proper sagittal alignment. But there is a paucity of literature investigating age-related changes in cervical sagittal alignment. One hundred healthy unoperated adults who were free of spinal problems obtained whole-spine standing radiographs. They consisted of 2 groups divided by age: those in their 20s and those older than 60 years. Each group had an equal ratio of males and females. Distances from C2 as well as C7 plumb lines to the following points were measured: thoracic and lumbar apex as well as the posterior superior corner of the S1 vertebral body. In addition, Cobb angles for C0-C2, C2-C7, thoracic kyphotic angle, lumbar lordotic angle, and T1 sagittal slope angles were measured. The distance between the C2 and C7 plumb lines did not vary with age. The thoracic apex shifted caudally from T6 in the younger group to T7 in the older group. The most common lumbar apex was L4 for both groups. The distance from C2, as well as C7 plumb lines to the posterior superior corner of the S1 vertebral body, as well as the thoracic apex increased significantly in the older group. On the contrary, the distance from the 2 plumb lines to the lumbar apex decreased in the older group. Also, C2-C7 angle increased and T1 sagittal slope angle decreased in the older group compared with the younger group. However, no difference was found for the other Cobb angles between the 2 groups. The distances between the plumb lines from C2 and C7 were maintained but C2-C7 sagittal angle increased with aging.
MeSH Terms
- Adult
- Age Factors
- Aged
- Aging
- Cervical Vertebrae
- Female
- Humans
- Lumbar Vertebrae
- Middle Aged
- Posture
- Radiography
- Retrospective Studies
- Sacrum
- Thoracic Vertebrae
- Young Adult