Cervical Lordosis

Prospective, Randomised, Double-Blind Clinical Study evaluating the correlation of Clinical Outcomes and Cervical Sagittal Alignment
PUBLISHED: Neurosurgery. 2011 May;68(5):1309-16; discussion 1316. doi: 10.1227/NEU.0b013e31820b51f3. PUB MED: https://www.ncbi.nlm.nih.gov/pubmed/21792113
AUTHORS: Villavicencio AT, Babuska JM, Ashton A, Busch E, Roeca C, Nelson EL, Mason A, Burneikiene S.
RESULTS: Patients who had maintained or improved segmental sagittal alignment, regardless of graft type, achieved a higher degree of improvement in Short Form-36 Physical Component Summary and Neck Disability Index scores. This was statistically significant (P < .038).
CONCLUSION: Maintaining a consistent segmental sagittal alignment or increasing segmental lordosis was related to a higher degree of improvement in clinical outcomes.
Spinal Centre Note: Appears surgeons are picking up what Chiropractic BioPhysics practitioners have been talking about. Well done.

Association between Cervical Lordotic Curvature and Cervical Muscle cross‐sectional area in patients with Loss of Cervical Lordosis
PUBLISHED: Clin Anat. 2018 Jul;31(5):710-715. doi: 10.1002/ca.23074. Epub 2018 Apr 14. Pub Med: https://www.ncbi.nlm.nih.gov/pubmed/29575212
AUTHORS: Yoon SY1, Moon HI1, Lee SC2, Eun NL3, Kim YW2.
CONCLUSION: There is a significant relationship between cervical muscle imbalance, including extensor muscle weakness, and loss of cervical lordosis.
Spinal Centre Note: Muscular strengthening needs to be combined with structural correction of the cervical lordosis to obtain the best outcome.

Does improvement towards a normal Cervical Sagittal configuration aid in the management of Lumbosacral Radiculopathy
PUBLISHED: 2015, Journal of Chiropractic Medicine 14 (2). Pub Med: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4523573/
AUTHORS: Moustafa IM, Diab AA, Harrison DE.
Proceedings of the 13th World Federation of Chiropractic Biennial Congress / ECU Convention, Athens, Greece, May 13-16, 2015. Paper #184 Mediterranean Region Award Winning Paper.
INITIAL CONCLUSIONS: Improvement of normal cervical sagittal configuration aids in the management and rehabilitation of patients with lumbosacral disc disruption and radiculopathy.

Determining the relationship between Cervical Lordosis and Neck Complaints
PUBLISHED: J Manipulative Physiol Ther. 2005 Mar-Apr;28(3):187-93. Pub Med: https://www.ncbi.nlm.nih.gov/pubmed/15855907
AUTHORS: McAviney J, Schulz D, Bock R, Harrison DE, Holland B.
RESULTS: Patients with lordosis of 20 degrees or less were more likely to have cervicogenic symptoms.
The association between cervical pain and lordosis of 0 degrees or less was significant.
Patients with cervical pain had less lordosis and this was consistent over all age ranges.
CONCLUSION: We found a statistically significant association between cervical pain and lordosis < 20 degrees and a “clinically normal” range for cervical lordosis of 31 degrees to 40 degrees.
Maintenance of a lordosis in the range of 31 degrees to 40 degrees could be a clinical goal for chiropractic treatment.

Cervical Cord Compression and Whole-Spine Sagittal Balance
Published: World Neurosurg. 2019 Oct;130:e709-e714. doi: 10.1016/j.wneu.2019.06.198. Epub 2019 Jul 4.
Authors: Yuk CD1, Kim TH2, Park MS2, Kim SW2, Chang HG2, Kim JH1, Ahn JH1, Chang IB1, Song JH1, Oh JK3.
- Department of Neurosurgery, Hallym University Sacred Heart Hospital, Anyang, Korea.
- Department of Orthopedics, Hallym University Sacred Heart Hospital, Anyang, Korea.
- Department of Neurosurgery, Hallym University Sacred Heart Hospital, Anyang, Korea.
OBJECTIVE: We sought to investigate the relationship between cervical cord compression and factors related to whole-spine sagittal balance.
CONCLUSIONS: Cervical cord compression is more likely to develop in patients with sagittal imbalance. It is important to use whole-spine radiograph and whole-spine T2 scout magnetic resonance imaging to analyze CCI in these patients.

Increase in Cerebral Blood Flow indicated by increased Cerebral Arterial area and pixel intensity on brain magnetic resonance angiogram following correction of Cervical Lordosis.
PUBLISHED: Brain Circ. 2019 Jan-Mar;5(1):19-26. doi: 10.4103/bc.bc_25_18. Epub 2019 Mar 27. Pub Med: https://www.ncbi.nlm.nih.gov/pubmed/31001596
AUTHORS: Katz EA1, Katz SB1, Fedorchuk CA2, Lightstone DF2, Banach CJ1, Podoll JD3.
RESULTS: Pixel intensity increased 23.0%-225.9%, and a Student’s t-test determined that the increase was significant (P < 0.001). Regression analysis of the change in pixel intensity versus the cervical lordosis showed that as the deviation from a normal cervical lordosis increases, percentage change in pixel intensity on MRA decreases.
CONCLUSION: These results indicate that correction of cervical lordosis may be associated with an immediate increase in cerebral blood flow.

Comparison of Axial and Flexural Stresses in Lordosis and three Buckled Configurations of the Cervical Spine
PUBLISHED: Clin Biomech (Bristol, Avon). 2001 May;16(4):276-84. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/11358614
AUTHORS: Harrison DE, Harrison DD, Janik TJ, William Jones E, Cailliet R, Normand M.
CONCLUSIONS: The stresses in kyphotic areas are very large and opposite in direction compared to a normal lordosis.
This analysis provides the basis for the formation of osteophytes (Wolff’s Law) on the anterior margins of vertebrae in kyphotic regions of the sagittal cervical curve.
This indicates that any kyphosis is an undesirable configuration in the cervical spine.