Sagittal alignment of the cervical spine after neck injury

Beltsios, M.; Savvidou, Olga D.; Mitsiokapa, Evanthia; Mavrogenis, Andreas F.; Kaspiris, Angelos; Efstathopoulos, Nicolas; Papagelopoulos, Panayiotis J.

doi:10.1007/s00590-012-0966-3

Cited by 29 publications

(18 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The standing or sitting position of the patient, pelvic tilt, and the position of the head during filming may affect the cervical spinal curvature (4,8,20). For this reason, in order to get an accurate measurement, the patient must be filmed in neutral posture and the patient's head must also be in a neutral position (20). Therefore, in our study, we preferred using the tangent method in the global evaluation of the cervical spinal angle, evaluating the results with two specialists who reached a consensus and filmed with the standard X-ray method in the studies.…”

Section: Discussionmentioning

confidence: 99%

The evaluation of cervical spinal angle in patients with acute and chronic neck pain

Aşkın¹,

Bayram²,

Demirdal³

et al. 2017

Turk J Med Sci

View full text Add to dashboard Cite

Background/aim: Clinicians associate the changes in cervical lordosis with neck pain, but there is no clear consensus on this. We aimed to investigate the relationships of cervical angles, neck pain, disability, and the psychological status of the patients with acute and chronic neck pain.Materials and methods: A total of 110 patients with neck pain were included in this study. Demographic and clinical characteristics of the patients were recorded. The lordosis angle was determined by the posterior tangent method. A visual analog scale (VAS), the Neck Disability Index (NDI), and the Hospital Anxiety and Depression (HAD) scale were administered to all patients. Results:The mean cervical lordosis angle was 23.10 ± 8.07 degrees. A statistically negative correlation was detected between cervical angle and duration of disease (P < 0.05). The cervical angle of the acute neck pain group was higher than that of the chronic pain group (P < 0.05). There was no difference between the acute and chronic neck pain groups with respect to VAS, NDI, and HAD scores (P > 0.05). Conclusion:We found that the cervical angle was significantly lower in chronic neck pain patients when compared to acute patients, and patients with higher pain scores had more severe disability and that disability increased with the duration of disease.

show abstract

Section: Discussionmentioning

confidence: 99%

The evaluation of cervical spinal angle in patients with acute and chronic neck pain

Aşkın¹,

Bayram²,

Demirdal³

et al. 2017

Turk J Med Sci

View full text Add to dashboard Cite

show abstract

“…This has led some practitioners to place emphasis on the restoration of the lordotic curve as an important outcome measure for their treatment [ 8 , 11 , 30 ]. However, other researchers have suggested that a lack of lordosis is a normal variant and therefore not a cause of symptoms for neck pain [ 14 – 18 ].…”

Section: Discussionmentioning

confidence: 99%

“…Given the time frame, it seems reasonable to suggest that positioning may not have been standardised across time. In addition, others [ 13 – 18 ] found no association between lordosis and neck pain, and in a literature review Gay [ 16 ] concluded that the curve of the cervical spine had little prognostic significance. Further, a more recent systematic review concluded that an association between cervical lordosis and spinal pain was not supported by the epidemiological evidence, albeit much of the research reviewed was found to be of low methodological quality [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

Does cervical lordosis change after spinal manipulation for non-specific neck pain? A prospective cohort study

et al. 2015

View full text Add to dashboard Cite

BackgroundThe association between cervical lordosis (sagittal alignment) and neck pain is controversial. Further, it is unclear whether spinal manipulative therapy can change cervical lordosis. This study aimed to determine whether cervical lordosis changes after a course of spinal manipulation for non-specific neck pain.MethodsPosterior tangents of C2 and C6 were drawn on the lateral cervical fluoroscopic images of 29 patients with subacute/chronic non-specific neck pain and 30 healthy volunteers matched for age and gender, recruited August 2011 to April 2013. The resultant angle was measured using ‘Image J’ digital geometric software. The intra-observer repeatability (measurement error and reliability) and intra-subject repeatability (minimum detectable change (MDC) over 4 weeks) were determined in healthy volunteers. A comparison of cervical lordosis was made between patients and healthy volunteers at baseline. Change in lordosis between baseline and 4-week follow-up was determined in patients receiving spinal manipulation.ResultsIntra-observer measurement error for cervical lordosis was acceptable (SEM 3.6°) and reliability was substantial ICC 0.98, 95 % CI 0.962–0991). The intra-subject MDC however, was large (13.5°). There was no significant difference between lordotic angles in patients and healthy volunteers (p = 0.16). The mean cervical lordotic increase over 4 weeks in patients was 2.1° (9.2) which was not significant (p = 0.12).ConclusionsThis study found no difference in cervical lordosis (sagittal alignment) between patients with mild non-specific neck pain and matched healthy volunteers. Furthermore, there was no significant change in cervical lordosis in patients after 4 weeks of cervical spinal manipulation.

show abstract

“…However, more recent studies indicated that changes in spinal curvature were not associated with a clinically significant injury. 54,111 For example, Beltsios and colleagues 8 indicated that presence of abnormal curvatures was not more common following neck injury and that abnormal curvatures should be considered normal variants and not pathological alignment. Grob and colleagues 35 found no association between any clinical characteristics of neck pain and cervical spine curvature.…”

Section: Cervical Spinal Posturementioning

confidence: 99%

Whiplash-Associated Disorders: Occupant Kinematics and Neck Morphology

Stemper¹,

Corner²

2016

J Orthop Sports Phys Ther

View full text Add to dashboard Cite

FIGURE 1.Initial phases of head-neck response to automotive rear impacts. The rear impact initiates with the occupant in a neutral upright position. As the thorax is accelerated anteriorly, the head remains stationary during the retraction phase, producing an S-shaped cervical spine curvature. Eventually, loads from the thorax are transferred up the cervical spine and the head-neck complex transitions into extension, with the cervical spine in an overall C-shaped extension curvature. The head eventually rebounds forward (not shown), and the cervical spine then transitions into flexion. Used with permission from Stemper et al. 93 Copyright ©2011 Wiley-Liss, Inc. foam/springs and rearward deflection, which absorb energy and decrease impact severity for the occupant. The magnitude of seatback deformation and deflection is dependent on the occupant's torso mass and center of gravity. Greater mass and higher center of gravity contribute to greater deflection and decreased overall impact severity. Average female body mass is 20% lighter and torso height is 8% shorter. 30,31 Therefore, the ability to deflect the seatback is decreased in females, who would experience more severe loading on the head-neck complex during a given rear impact.This section highlighted the role of body size on cervical spine injury risk during automotive rear impacts, advancing the theory that size-based mismatches between the vehicle seat and occupant anthropometrics contribute to greater injury risk for smaller occupants. This concept would hold true for either males or females, but may help explain the preponderance of whiplash injuries in females due to their generally smaller body size. Shorter sitting height can result in head interaction with the bottom of the head restraint, which increases injury risk. However, taller occupants with incorrectly adjusted head restraints also experience increased injury risk due to the head rotating over the head restraint and increasing extension moments on the cervical spine. Decreased body mass and shorter center-of-torso mass in smaller occupants also contribute to decreased dynamic energy absorption of the seatback. While these differences illustrate mechanisms of increased injury risk for smaller occupants, other morphological differences may also contribute. Differences in Head and Neck MorphologyGiven that a majority of injuries resulting from automotive rear impacts affect the cervical spine, 9 differences in headneck morphology can influence injury risk. Once again, sex-based differences will be used to demonstrate this concept. Neck slenderness, a mechanical term body sizes farther from those standards may not be protected as well.Research studies report that head-tohead restraint backset is lower in females than in males due to rearward incline of automotive seats and decreased sitting height for average females compared to males.12 Sitting height for average females is approximately 6 cm shorter than that for average males. 30,31 This means that the posterior aspect of the head for the comp...

show abstract

Sagittal alignment of the cervical spine after neck injury

Cited by 29 publications

References 21 publications

The evaluation of cervical spinal angle in patients with acute and chronic neck pain

The evaluation of cervical spinal angle in patients with acute and chronic neck pain

Does cervical lordosis change after spinal manipulation for non-specific neck pain? A prospective cohort study

Whiplash-Associated Disorders: Occupant Kinematics and Neck Morphology

Contact Info

Product

Resources

About