Evidence map›Paper›PMID 34009398›Full record

ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2021

The odontoid-CSVL distance in a global population of asymptomatic volunteers: normative values and implications for spinal coronal alignment.

Scott L Zuckerman, Zeeshan M Sardar, Christopher S Lai, Gerard F Marciano, Mena G Kerolus, Ian A Buchanan, Alex S Ha, Meghan Cerpa, Michael P Kelly, Stéphane Bourret and 7 more

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Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.0field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors at 5 institutions in 4 countries.

Scott L ZuckermanDepartment of Orthopedic Surgery, Columbia University Medical Center, The Och Spine Hospital at New York Presbyterian, New York, USA.
Zeeshan M SardarDepartment of Orthopedic Surgery, Columbia University Medical Center, The Och Spine Hospital at New York Presbyterian, New York, USA.
Christopher S LaiDepartment of Orthopedic Surgery, Columbia University Medical Center, The Och Spine Hospital at New York Presbyterian, New York, USA.
Gerard F MarcianoDepartment of Orthopedic Surgery, Columbia University Medical Center, The Och Spine Hospital at New York Presbyterian, New York, USA.
Mena G KerolusDepartment of Orthopedic Surgery, Columbia University Medical Center, The Och Spine Hospital at New York Presbyterian, New York, USA.
Ian A BuchananDepartment of Orthopedic Surgery, Columbia University Medical Center, The Och Spine Hospital at New York Presbyterian, New York, USA.
Alex S HaDepartment of Orthopedic Surgery, Columbia University Medical Center, The Och Spine Hospital at New York Presbyterian, New York, USA.
Meghan CerpaDepartment of Orthopedic Surgery, Columbia University Medical Center, The Och Spine Hospital at New York Presbyterian, New York, USA. zuckerman.scott@gmail.com.ORCID 0000-0002-5931-7067
Michael P KellyDepartment of Orthopaedic Surgery, Washington University, St. Louis, MO, USA.
Stéphane BourretSurgical Research Lab, Bordeaux University Hospital, Spine Unit 2, Bordeaux, France.
Kazuhiro HasegawaNiigata Spine Surgery Center, Niigata City, Japan.
Hee-Kit WongDepartment of Orthopedic Surgery, National University Hospital (Singapore), 5 Lower Kent Ridge Rd, Singapore, 119074, Singapore.
Gabriel LiuDepartment of Orthopedic Surgery, National University Hospital (Singapore), 5 Lower Kent Ridge Rd, Singapore, 119074, Singapore.
Hwee Weng Dennis HeyDepartment of Orthopedic Surgery, National University Hospital (Singapore), 5 Lower Kent Ridge Rd, Singapore, 119074, Singapore.
Hend RiahiInstitut Kassab D'orthopédie, Ksar Said La Manouba, Tunis, Tunisia.
Jean-Charles Le HuecSurgical Research Lab, Bordeaux University Hospital, Spine Unit 2, Bordeaux, France.
Lawrence G LenkeDepartment of Orthopedic Surgery, Columbia University Medical Center, The Och Spine Hospital at New York Presbyterian, New York, USA.
NewYork–Presbyterian Hospital · USNational University Hospital · SGUniversité de Bordeaux · FRManouba University · TNWashington University in St. Louis · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeIn a population of asymptomatic volunteers across 5 countries, we sought to: (a) establish normative values of the Odontoid-Central Sacral Vertical Line (OD-CSVL) across patient factors, and (b) assess correlations of OD-CSVL with other radiographic parameters.

methodsA prospective, cross-sectional study of asymptomatic adult volunteers, ages 18-80 years, were enrolled across 5 countries (France, Japan, Singapore, Tunisia, United States) forming the Multi-Ethnic Alignment Normative Study (MEANS) cohort. Included volunteers had no known spinal disorder(s), no significant neck/back pain (VAS ≤ 2; ODI ≤ 20), and no significant scoliosis (Cobb ≤ 20°). Radiographic measurements included commonly used coronal alignment parameters (mm) and angles (°). OD-CSVL was defined as the difference between the odontoid plumb line (line from the tip of the odontoid vertically down) and the CSVL (vertical line from the center of the sacrum). Chi-square, student's t tests, Kruskal-Wallis, Wilcoxon rank-sum, linear regression, and Pearson's correlation were used with significance at p < 0.05.

results467 volunteers were included with normative OD-CSVL values by age decade, gender, BMI, and country. Mean ± SD OD-CSVL was 8.3 mm ± 6.5 mm and 31 (6.6%) volunteers were almost perfectly aligned (OD-CSVL < 1 mm). A linear relationship was seen between OD-CSVL with both age (p < 0.001) and BMI (p = 0.015). Significant variation was seen between OD-CSVL and 5 different ethnicities (p = 0.004). OD-CSVL correlated best with other coronal radiographic parameters, C7-CSVL (r = 0.743, p < 0.001), OD-knee (r = 0.230, p < 0.001), CAM-knee (r = 0.612, p < 0.001), and regional TL cobb angle (r = 0.4214, p = 0.005).

conclusionAmong asymptomatic volunteers, increased OD-CSVL was significantly associated with increased age, increased BMI, and ethnicity, but not gender. OD-CSVL correlated strongest with C7-CSVL, TL cobb angle, OD-knee, and CAM-knee. OD-CSVL. These results support further study of OD-CSVL in symptomatic adult spine deformity patients.

Indexed as

Odontoid ProcessScoliosisAdolescentAdultAgedAged, 80 and overCross-Sectional StudiesHumansMiddle AgedProspective StudiesRetrospective StudiesSacrumYoung AdultAsymptomatic cohortMulti-ethnic alignment normative study (MEANS)Normative spinal alignmentOD-CSVLOdontoid-central sacral vertical line

Identifiers

PMID34009398
OpenAlexW3160657353

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.