{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T23:20:38Z","timestamp":1793834438828,"version":"4.6.1"},"reference-count":29,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2018,5,22]],"date-time":"2018-05-22T00:00:00Z","timestamp":1526947200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81772399"],"award-info":[{"award-number":["81772399"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["81571190"],"award-info":[{"award-number":["81571190"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Acta Radiol"],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Ossification of the nuchal ligament (ONL) caused by chronic injury to the nuchal ligament (NL) is very common in instability-related cervical disorders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To determine possible correlations between ONL, sagittal alignment, and segmental stability of the cervical spine.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods<\/jats:title>\n                    <jats:p>Seventy-three patients with cervical spondylotic myelopathy (CSM) and ONL (ONL group) and 118 patients with CSM only (control group) were recruited. Radiographic data included the characteristics of ONL, sagittal alignment and segmental stability, and ossification of the posterior longitudinal ligament (OPLL). We performed comparisons in terms of radiographic parameters between the ONL and control groups. The correlations between ONL size, cervical sagittal alignment, and segmental stability were analyzed. Multivariate logistic regression was used to identify the independent risk factors of the development of ONL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>C2\u2013C7 sagittal vertical axis (SVA), T1 slope (T1S), T1S minus cervical lordosis (T1S-CL) on the lateral plain, angular displacement (AD), and horizontal displacement (HD) on the dynamic radiograph increased significantly in the ONL group compared with the control group. The size of ONL significantly correlated with C2\u2013C7 SVA, T1S, AD, and HD. The incidence of ONL was higher in patients with OPLL and segmental instability. Cervical instability, sagittal malalignment, and OPLL were independent predictors of the development of ONL through multivariate analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Patients with ONL are more likely to have abnormal sagittal alignment and instability of the cervical spine. Thus, increased awareness and appreciation of this often-overlooked radiographic finding is warranted during diagnosis and treatment of instability-related cervical pathologies and injuries.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0284185118778866","type":"journal-article","created":{"date-parts":[[2018,5,23]],"date-time":"2018-05-23T00:50:51Z","timestamp":1527036651000},"page":"196-203","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":13,"title":["Radiographic analysis of the correlation between ossification of the nuchal ligament and sagittal alignment and segmental stability of the cervical spine in patients with cervical spondylotic myelopathy"],"prefix":"10.1177","volume":"60","author":[{"given":"Jinwei","family":"Ying","sequence":"first","affiliation":[{"name":"The Second School of Clinical Medicine, Southern Medical University, Guangzhou, PR China"},{"name":"Department of Orthopedic Surgery, Navy General Hospital, Beijing, PR China"},{"name":"Department of Orthopaedics, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Honglin","family":"Teng","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunfan","family":"Qian","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingying","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Radiology, Navy General Hospital, Beijing, PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tianyong","family":"Wen","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Navy General Hospital, Beijing, PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dike","family":"Ruan","sequence":"additional","affiliation":[{"name":"The Second School of Clinical Medicine, Southern Medical University, Guangzhou, PR China"},{"name":"Department of Orthopedic Surgery, Navy General Hospital, Beijing, PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0966-0112","authenticated-orcid":false,"given":"Minyu","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2018,5,22]]},"reference":[{"key":"bibr1-0284185118778866","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200001010-00003"},{"key":"bibr2-0284185118778866","doi-asserted-by":"publisher","DOI":"10.1002\/ca.10121"},{"key":"bibr3-0284185118778866","first-page":"305","volume":"21","author":"Mitchell BS","year":"1998","journal-title":"J Manipulative Physiol Ther"},{"key":"bibr4-0284185118778866","first-page":"301","volume":"61","author":"Kadri PA","year":"2007","journal-title":"Neurosurgery"},{"key":"bibr5-0284185118778866","doi-asserted-by":"publisher","DOI":"10.1097\/00002517-200002000-00005"},{"key":"bibr6-0284185118778866","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199611010-00013"},{"key":"bibr7-0284185118778866","doi-asserted-by":"publisher","DOI":"10.1016\/j.kjms.2012.04.016"},{"key":"bibr8-0284185118778866","first-page":"305","volume":"23","author":"Luo J","year":"2010","journal-title":"Zhongguo Gu Shang"},{"key":"bibr9-0284185118778866","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9290(85)90202-7"},{"key":"bibr10-0284185118778866","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000138309.11926.72"},{"key":"bibr11-0284185118778866","doi-asserted-by":"publisher","DOI":"10.1016\/S0733-8619(18)31042-9"},{"key":"bibr12-0284185118778866","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000222019.84095.23"},{"key":"bibr13-0284185118778866","first-page":"417","volume":"97","author":"Scapinelli R","year":"1963","journal-title":"J Anat"},{"key":"bibr14-0284185118778866","first-page":"29","volume":"13","author":"Scapinelli R","year":"1988","journal-title":"Rays"},{"key":"bibr15-0284185118778866","doi-asserted-by":"publisher","DOI":"10.3171\/2013.4.SPINE12838"},{"key":"bibr16-0284185118778866","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000000722"},{"key":"bibr17-0284185118778866","doi-asserted-by":"publisher","DOI":"10.1227\/NEU.0b013e31826100c9"},{"key":"bibr18-0284185118778866","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e3182a7f449"},{"key":"bibr19-0284185118778866","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2010.08.031"},{"key":"bibr20-0284185118778866","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200008150-00011"},{"key":"bibr21-0284185118778866","first-page":"255","volume":"8","author":"Li J","year":"1998","journal-title":"Chinese Journal of Spine and Spinal Cord"},{"key":"bibr22-0284185118778866","doi-asserted-by":"crossref","first-page":"E7","DOI":"10.1097\/BRS.0000000000000037","volume":"39","author":"Wang H","year":"2014","journal-title":"Spine"},{"key":"bibr23-0284185118778866","doi-asserted-by":"publisher","DOI":"10.1002\/uog.13320"},{"key":"bibr24-0284185118778866","first-page":"89","volume":"106","author":"Ohtsuka K","year":"1987","journal-title":"Foresight"},{"key":"bibr25-0284185118778866","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000000791"},{"key":"bibr26-0284185118778866","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2013.06.059"},{"key":"bibr27-0284185118778866","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000002250"},{"key":"bibr28-0284185118778866","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000001264"},{"key":"bibr29-0284185118778866","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e3182a7eb9e"}],"container-title":["Acta Radiologica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0284185118778866","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0284185118778866","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0284185118778866","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T15:21:56Z","timestamp":1777389716000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0284185118778866"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,5,22]]},"references-count":29,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2019,2]]}},"alternative-id":["10.1177\/0284185118778866"],"URL":"https:\/\/doi.org\/10.1177\/0284185118778866","relation":{},"ISSN":["0284-1851","1600-0455"],"issn-type":[{"value":"0284-1851","type":"print"},{"value":"1600-0455","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,5,22]]}}}