Cervical Spine
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.
Modelling of the Sagittal Cervical Spine as a method to discriminate Hypolordosis
PUBLISHED: Spine (Phila Pa 1976). 2004 Nov 15;29(22):2485-92. Pub Med: https://www.ncbi.nlm.nih.gov/pubmed/15543059
TITLE: Modelling of the sagittal cervical spine as a method to discriminate hypolordosis: results of elliptical and circular modelling in 72 asymptomatic subjects, 52 acute neck pain subjects, and 70 chronic neck pain subjects.
AUTHORS: Harrison DD1, Harrison DE, Janik TJ, Cailliet R, Ferrantelli JR, Haas JW, Holland B.
CONCLUSIONS: The mean cervical lordosis for all groups could be closely modelled with a circle. Pain groups had hypolordosis and larger radiuses of curvature compared with the normal group.
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.
Cervical Spine Sagittal Alignment and clinical outcome after Anterior Cervical Discectomy and Fusion
PUBLISHED: Am J Orthop (Belle Mead NJ). 2012 Jun;41(6):E81-4. Referenced Pub Med: https://www.ncbi.nlm.nih.gov/pubmed/22837996
AUTHORS: Gum JL1, Glassman SD, Douglas LR, Carreon LY.
RESULTS: Receiver operating characteristic curve analysis showed that a postoperative cervical lordosis of at least 6° predicted achievement of MCID for NDI (8 point change in NDI).
This suggests that maintenance or restoration of overall cervical lordosis is important in achieving a successful result after Anterior Cervical Discectomy and Fusion (ACDF).
