{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:36:44Z","timestamp":1792787804827,"version":"4.5.0"},"reference-count":24,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T00:00:00Z","timestamp":1769040000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T00:00:00Z","timestamp":1769040000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Scientific Research Startup Fund of Henan Cancer Hospital","award":["zx2156"],"award-info":[{"award-number":["zx2156"]}],"id":[{"id":"https:\/\/ror.org\/043ek5g31","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Henan Provincial Science and Technology Research Project","award":["252102311199"],"award-info":[{"award-number":["252102311199"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Spine Journal"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Study design<\/jats:title>\n                    <jats:p>Retrospective study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aimed to measure cervical sagittal alignment parameters on upright digital tomosynthesis (DTS) and supine magnetic resonance imaging (MRI) in patients with cervical spondylotic myelopathy (CSM) and evaluate the difference and correlation of cervical curvature in different postures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      101 CSM patients underwent both standing DTS and supine MRI. Parameters including O-C2 angle, cervical lordosis (CL), C2-7 sagittal vertical axis (C2-7 SVA), neck tilt (NT), T1 slope (T1S), thoracic inlet angle (TIA), cervical tilt, and cranial tilt were measured. Intraclass correlation coefficients (ICC) was used to assess inter-observer reliability. Paired\n                      <jats:italic toggle=\"yes\">t<\/jats:italic>\n                      -tests and Pearson correlation analyses were applied to investigate the difference and correlation of parameters in standing and supine position.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      All parameters measured on DTS and MRI showed excellent reliability (ICC &gt;0.8). Significant differences were observed in O-C2 (DTS: \u221224.2 \u00b1 11.2\u00b0 vs MRI: \u221214.3 \u00b1 6.6\u00b0,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), CL (DTS: \u221215.2\u00b0 \u00b1 4.4\u00b0 vs MRI: \u22128.1\u00b0 \u00b1 3.6\u00b0,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), C2-7 SVA (DTS: 23.6 \u00b1 11.0\u00a0mm vs MRI: 16.5 \u00b1 8.5\u00a0mm,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), T1S (DTS: 26.3\u00b0 \u00b1 8.4\u00b0 vs MRI: 18.2\u00b0 \u00b1 6.6\u00b0,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), Cervical tilt (DTS: 16.4\u00b0 \u00b1 5.6\u00b0 vs MRI: 11.9\u00b0 \u00b1 6.5\u00b0,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), and cranial tilt (DTS: 9.8\u00b0 \u00b1 9.3\u00b0 vs MRI: 6.6\u00b0 \u00b1 8.3\u00b0,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.015). Strong correlations existed for O-C2 (r = 0.834,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), CL (r = 0.870,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), and T1S (r = 0.875,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>DTS reliably quantifies standing cervical alignment, particularly for cervicothoracic junction (CTJ) parameters obscured on radiography. Positional variations between standing and supine postures significantly impact cervical sagittal alignment. O-C2, CL and T1S obtained in supine position are considered meaningful parameters for evaluating cervical alignment in standing position.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21925682261419060","type":"journal-article","created":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T23:40:52Z","timestamp":1769125252000},"page":"2959-2965","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Difference and Correlation Between Standing and Supine Cervical Sagittal Alignment: DTS vs MRI"],"prefix":"10.1177","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6492-7479","authenticated-orcid":false,"given":"Shengbiao","family":"Ma","sequence":"first","affiliation":[{"name":"The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer 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