Objective: To investigate the association between atlanto-occipital radiographic alignment in flexion and cervical spondylosis (CS).
Methods: This is a retrospective case-control study. CS patients were recruited from our hospital, and the age/gender/body mass index (BMI)-matched healthy controls were selected from the subjects in health examinations at the same hospital between January 2015 and May 2019. A total of 464 subjects was included in the study. There are 282 males and 182 females. The ages of patients were 20 to 67 years, and the mean age was 33.9 years. CS patients were considered the case group. Based on surgical treatments, they were subdivided into non-operation group and operation group. The operation group and non-operation group had 45 and 187 patients, respectively, while 232 subjects were included in the control group. The angle between McGregor's line and C line (O-C angle) was evaluated on images taken in flexion (F-OC) and neutral positions (N-OC) independently. The relationship between the FOC (FOC=F-OC-N-OC) and Neck Disability Index (NDI) was examined, and the involvement of the FOC in the onset of CS was analyzed. Receiver operating characteristic (ROC) curve analysis was performed to determine the optimal cut-off for detecting an increased risk of CS.
Results: The median follow-up time was 51.6 months (25-115 months). The case groups, especially the operation group, tended to be older (55.8 ± 11.2 vs 41.6 ± 13.8 vs 23.5 ± 5.5 years, P < 0.001), have a higher NDI score (12.2 ± 4.5 vs 6.2 ± 2.1 vs 3.2 ± 1.2, P < 0.001), and longer medical history (10.5 ± 9.5 vs 6.8 ± 11.2 years, P < 0.001). One-way analysis of variance showed statistically significant differences in FOC between the control and case groups (1.4° ± 1.2° vs 3.6° ± 1.9° vs 7.2° ± 2.0°, P < 0.001). Besides, a post-hoc Tukey test showed a lower FOC in the operation group compared with that in the non-operation group (1.4° ± 1.2° vs 3.6° ± 1.9°, P < 0.001). Using FOC as a radiological predictive model to predict CS, the cut-off value was 4.2°. Using FOC as a radiological predictive model to predict CS, the area under the curve (AUC) was 0.86 (95% CI: 0.78-0.92, P < 0.001). In the univariable risk analysis model, conditional logistic regression showed that the FOC level was an independent factor with an important role in the risk of CS. The odds rose to 8.2 times when FOC reached the level under 4.2° (OR = 8.2; 95% CI: 6.4-10.0; P < 0.001). There existed a significant negative correlation between FOC levels and NDI (r = -0.451, P = 0.016).
Conclusions: Stiff O-C , which is defined as FOC ≤ 4.2°, represented decreased flexion dysfunction of atlanto-occipital joint and is closely associated with high risk for the occurrence of CS. This finding could show a possible relationship between upper and lower cervical spine and help spine surgeons to understand the pathological process of CS and implement appropriate management.
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http://dx.doi.org/10.1111/os.12928 | DOI Listing |
Cancer Treat Rev
December 2024
SOLTI Cancer Research Group, Barcelona, Spain; Statistics Unit, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain. Electronic address:
Introduction: Antibody-drug conjugates (ADCs) trastuzumab-deruxtecan (T-DXd) and sacituzumab-govitecan (SG) provided significant progression-free survival (PFS) and overall survival (OS) improvements over chemotherapy (CT) in pretreated hormone receptor-positive (HR+) and triple-negative (TN)/HER2-low metastatic breast cancer (MBC). However, no direct comparison between the two exists, nor with the more recent datopotamab-deruxtecan (Dato-DXd).
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Lung Cancer
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State Key Laboratory of Oncology in South China, Guangzhou, China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, China; Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China. Electronic address:
Background: Primary pulmonary lymphoepithelioma-like carcinoma (PLELC) is a rare subtype of non-small-cell lung cancer. This study aims to compare the efficacy and safety of perioperative PD-1/PD-L1 inhibitor plus chemotherapy versus chemotherapy alone in stage II-IIIB PLELC patients.
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J Vet Intern Med
December 2024
Veterinary Research Scholars Program (VRSP), University of Missouri College of Veterinary Medicine, Columbia, Missouri 65211, USA.
Background: Whereas restoration of fecal consistency after treatment with clioquinol for chronic diarrhea and free fecal water syndrome has been attributed to its antiprotozoal properties, actions of clioquinol on the colonic bacterial microbiota have not been investigated.
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Otolaryngol Head Neck Surg
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Department of Otorhinolaryngology, Gazi University Faculty of Medicine, Ankara, Turkey.
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J Med Case Rep
December 2024
Department of Neurosurgery, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.
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