Cervical sagittal alignment differences according to scapular rotational posture: A retrospective radiographic study

Area of Science:

• Orthopedics
• Biomechanics
• Radiology

Background:

• Scapular posture influences cervical spine biomechanics due to anatomical connections.
• Abnormal scapular positioning is linked to neck pain and altered muscle activity.
• Limited radiographic data exists on scapular rotation and cervical sagittal alignment.

Purpose of the Study:

• To compare cervical sagittal alignment parameters between patients with upward rotation (UR) and downward rotation (DR) scapular postures.
• To investigate the relationship between scapular rotational posture and cervical sagittal alignment.
• To identify potential biomechanical interactions in cervicoscapular dysfunction.

Main Methods:

• Retrospective analysis of cervical spine X-ray images from patients with neck symptoms.
• Classification of participants into UR and DR groups based on scapular rotational posture.
• Measurement of cervical sagittal alignment parameters (C0-C2 angle, C2-C7 Cobb angle, C2-C7 SVA, K-line tilt, functional spinal unit angles).

Main Results:

• The DR group exhibited greater C2-C7 sagittal vertical axis (SVA) and K-line tilt compared to the UR group.
• A smaller C4-C5 functional spinal unit angle was observed in the DR group.
• Scapular rotational posture negatively correlated with C2-C7 SVA and K-line tilt; C2-C7 SVA predicted DR posture.

Conclusions:

• Downward scapular rotation is associated with altered cervical sagittal alignment, specifically increased anterior cervical translation.
• The findings suggest a biomechanical link between scapular rotational posture and cervical sagittal balance.
• Assessing scapular posture may offer valuable clinical insights for cervicoscapular dysfunction in neck pain patients.