Are the standard parameters of cervical spine alignment and range of motion related to age, sex, and cervical disc degeneration?

Abstract

<jats:sec> <jats:title>OBJECT</jats:title> <jats:p>The aims of this study were 1) to establish the standard parameters of alignment and total and segmental range of motion (ROM) of the cervical spine in the asymptomatic population, and 2) to identify factors that influence cervical ROM and alignment.</jats:p></jats:sec> <jats:sec> <jats:title>METHODS</jats:title> <jats:p>The authors measured 636 standard cervical lateral, flexion, and extension plain radiographs of 212 asymptomatic volunteers. The relationship between cervical alignment and total ROM was assessed with simple linear regression. Multivariate linear regression was used to determine the effect of the influential factors on cervical alignment and total and segmental ROM.</jats:p></jats:sec> <jats:sec> <jats:title>RESULTS</jats:title> <jats:p>The mean value for C2–7 cervical alignment was 21.40° ± 12.15°, and the mean value for total ROM was 63.59° ± 15.37°. Sex was a significant factor in cervical alignment, total ROM, and segmental ROM for C2–3 and C5–6 (p &lt; 0.05). Age had a significant negative association with both the total ROM and all of the segmental ROM measurements (p &lt; 0.05). Cervical disc degeneration at the level of interest had a significant negative association with C4–5, C5–6, and C6–7 ROM (p &lt; 0.05).</jats:p></jats:sec> <jats:sec> <jats:title>CONCLUSIONS</jats:title> <jats:p>Cervical alignment in female subjects was 2.47° lower than that in male subjects. Total ROM was 3.86° greater in female than in male subjects and decreased 6.46° for each decade of aging. Segmental ROM decreased 1.28° for each decade of aging and 2.26° for each category increase in disc degeneration at the level of interest.</jats:p></jats:sec>

Patient's Subjective Impression of Cervical Range of Motion

“…We used ROM as an outcome measure because current literature suggests that it is restricted in chronic neck pain and that it decreases with age. 42,43,[46][47][48] Normal values for CROM have been reported in asymptomatic participants. 5 In our study, left rotation (20°), right rotation (14°), flexion (12°), and extension (8°) differed most compared with asymptomatic age-matched controls.…”

“…For one study, our results were similar for flexion but not for extension and rotation. 42 This was possibly because that study only included women, who typically have greater ROM, 43 and excluded participants with psychiatric, vestibular, and dizziness complaints. 42 Patients with neck pain, especially those with acute whiplash disorder, are known to have dizziness and sensorimotor impairments due to disturbed cervical spine receptors, 44,45 so we excluded this group; but, some patients may have had a traumatic neck injury that caused dizziness or vertigo.…”

Imaging Factors that Distinguish Between Patients with Asymptomatic and Symptomatic Cervical Spondylotic Myelopathy with Mild to Moderate Cervical Spinal Cord Compression

“…Previous studies have shown that the process of degenerative changes in the cervical spine, including cervical flexion and extension activity, diminish following the emergence of cervical symptoms [ 17 ]. These previous findings are supported by the findings of the present study, which showed that the overall range of movement (ROM) of the cervical spine in the two groups was less than in the general population.…”

Correlation between kinematic sagittal parameters of the cervical lordosis or head posture and disc degeneration in patients with posterior neck pain: retrospective cross-sectional study

“…Loss of cervical lordosis is the most common disorder of sagittal cervical balance. [30,33] Although the sagittal alignment of the cervical vertebrae can vary with age and sex, [8,30] the natural sagittal curve of the cervical spine is known to have a lordosis [7,12,19]. Harrison et al reported a mean C2-C7 lordotic angle of -26.89° ± 9.72° in 72 healthy participants.…”

“…Harrison et al reported a mean C2-C7 lordotic angle of -26.89° ± 9.72° in 72 healthy participants. [12] Liu et al demonstrated a mean C2-C7 lordotic angle of -21.40° ± 12.15° in 212 asymptomatic volunteers [19]. The estimated prevalence of loss of cervical lordosis in patients with posterior neck pain is approximately 42%.…”