open access
Reference intervals of C2-C7 lateral spinous process deviation in Chinese adults
, 1, 1, 1, 2
Affiliations- Department of TCM Orthopaedics and Traumatology, School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, China
- Department of Orthopaedic, Hainan Traditional Chinese Medicine Hospital, Haikou, Hainan, China
open access
Abstract
Background: Lateral spinous process deviation (LSPD) is a commonly used morphological
parameter in the anatomical study of the cervical spinous process.
However, quantitative studies on this issue are still lacking. In this study we aimed
to establish reference intervals of C2-C7 LSPD in the adult Chinese population and
provide decision-making information for clinical practitioners.
Materials and methods: This was a retrospective study of 92 adult patients
who received neck computed tomography scans, including 42 females and
50 males meeting the inclusion criteria. Three-dimensional reconstruction and
anatomical measurements were performed using Mimics Research 19.0 and
3-Matic Research 11.0.
Results: The inter-observer reliability of LSPD measurement in this study was
excellent (intraclass correlation coefficient value > 0.93). Only 2 cases of LSPD
angles of 90 degrees were found, which means most cervical spinous process exist
deviation. The reference interval for the C2-C7 LSPD angle was (85.11, 94.75)
degrees. The C2 LSPD showed the different directions to C5 and C7 (p < 0.05).
In the C4 vertebrae, the male tends to have greater LSPD angles than the female
(T = –2.013, p = 0.047). In the C2 vertebrae, there was a statistically significant but
weak correlation between age and LSPD angles (r = 0.24, p = 0.029). There was
no statistically significant effect of sex or age on other levels of cervical vertebrae.
Conclusions: Cervical spinous process deviation of less than 5 degrees on either
side is a common morphological manifestation in Chinese adults. Thus, LSPD may
not be an indicator for clinical care. Moreover, the vertebrae may have opposite
directions of LSPD in the upper levels (C2-C4) and lower levels (C5-C7).
Abstract
Background: Lateral spinous process deviation (LSPD) is a commonly used morphological
parameter in the anatomical study of the cervical spinous process.
However, quantitative studies on this issue are still lacking. In this study we aimed
to establish reference intervals of C2-C7 LSPD in the adult Chinese population and
provide decision-making information for clinical practitioners.
Materials and methods: This was a retrospective study of 92 adult patients
who received neck computed tomography scans, including 42 females and
50 males meeting the inclusion criteria. Three-dimensional reconstruction and
anatomical measurements were performed using Mimics Research 19.0 and
3-Matic Research 11.0.
Results: The inter-observer reliability of LSPD measurement in this study was
excellent (intraclass correlation coefficient value > 0.93). Only 2 cases of LSPD
angles of 90 degrees were found, which means most cervical spinous process exist
deviation. The reference interval for the C2-C7 LSPD angle was (85.11, 94.75)
degrees. The C2 LSPD showed the different directions to C5 and C7 (p < 0.05).
In the C4 vertebrae, the male tends to have greater LSPD angles than the female
(T = –2.013, p = 0.047). In the C2 vertebrae, there was a statistically significant but
weak correlation between age and LSPD angles (r = 0.24, p = 0.029). There was
no statistically significant effect of sex or age on other levels of cervical vertebrae.
Conclusions: Cervical spinous process deviation of less than 5 degrees on either
side is a common morphological manifestation in Chinese adults. Thus, LSPD may
not be an indicator for clinical care. Moreover, the vertebrae may have opposite
directions of LSPD in the upper levels (C2-C4) and lower levels (C5-C7).
Keywords
morphology, cervical vertebra, lateral spinous process deviation, computerized tomography, retrospective analysis
About this articleTitle
Reference intervals of C2-C7 lateral spinous process deviation in Chinese adults
Journal
Issue
Article type
Original article
Pages
892-897
Published online
2022-09-27
Page views
713
Article views/downloads
558
DOI
Pubmed
Bibliographic record
Folia Morphol 2023;82(4):892-897.
Keywords
morphology
cervical vertebra
lateral spinous process deviation
computerized tomography
retrospective analysis
Authors
L.-Q. Liao
Z.-Y. Feng
H. Yang
Y.-K. Li
M.-X. Chen
References (18)- Amevo B, Aprill C, Bogduk N. Abnormal instantaneous axes of rotation in patients with neck pain. Spine (Phila Pa 1976). 1992; 17(7): 748–756.
- Cohen SP. Epidemiology, diagnosis, and treatment of neck pain. Mayo Clin Proc. 2015; 90(2): 284–299.
- Corum M, Aydin T, Medin Ceylan C, et al. The comparative effects of spinal manipulation, myofascial release and exercise in tension-type headache patients with neck pain: A randomized controlled trial. Complement Ther Clin Pract. 2021; 43: 101319.
- Farmer PK, Snodgrass SJ, Buxton AJ, et al. An investigation of cervical spinal posture in cervicogenic headache. Phys Ther. 2015; 95(2): 212–222.
- Gradl G, Maier-Bosse T, Penning R, et al. Quantification of C2 cervical spine rotatory fixation by X-ray, MRI and CT. Eur Radiol. 2005; 15(2): 376–382.
- Greiner TM. Shape analysis of the cervical spinous process. Clin Anat. 2017; 30(7): 894–900.
- Gross A, Langevin P, Burnie SJ, et al. Manipulation and mobilisation for neck pain contrasted against an inactive control or another active treatment. Cochrane Database Syst Rev. 2015(9): CD004249.
- Haneline MT, Young M. A review of intraexaminer and interexaminer reliability of static spinal palpation: a literature synthesis. J Manipulative Physiol Ther. 2009; 32(5): 379–386.
- Hing W, Hall T, Mulligan B. The Mulligan Concept of Manual Therapy. 2E. Elsevier, Australia 2015: 21–324.
- Ji-Hong F, Li-Ping Wu, Yi-Kai Li, et al. Variable morphology of the axis vertebrae in 100 specimens: implications for clinical palpation and diagnostic imaging. J Manipulative Physiol Ther. 2010; 33(2): 125–131.
- Joseph E. The muscle and bone palpation manual: with trigger points, referral patterns and stretching. Elsevier, Mosby 2015: 102.
- Liao LQ, Li YK, Yuan F, et al. Morphological characteristics of the spinous process of axis: clinical implications for cervical spine manipulation. J Manipulative Physiol Ther. 2019; 42(1): 82–88.
- Macpherson BC, Campbell C. C2 rotation and spinous process deviation in migraine: cause or effect or coincidence? Neuroradiology. 1991; 33(6): 475–477.
- Maitland GD, Hengeveld E, Banks K. Maitland's Vertebral Manipulation. 7th ed. Elsevier, Oxford 2005: 65–261.
- Maitland GD, Hengeveld E, Banks K. Maitland’s Vertebral Manipulation. 8th ed. Elsevier, Philadelphia, PA 2014: 7–256.
- Tang S, Liu H, Zhang Y. Spinous process deviation and disc degeneration in lumbosacral segment. J Surg Res. 2015; 193(2): 713–717.
- Triano JJ, Budgell B, Bagnulo A, et al. Review of methods used by chiropractors to determine the site for applying manipulation. Chiropr Man Therap. 2013; 21(1): 36.
- Zhang L, Luo Z, Wang H, et al. An anatomical study of the spinous process of the seventh cervical vertebrae based on the three-dimensional computed tomography reconstruction. Exp Ther Med. 2018; 16(2): 511–516.
