Sagittal Balance

Wednesday, May 6th, 2020
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The efficacy of Cervical Lordosis rehabilitation for nerve root function, pain, and segmental motion in Cervical Spondylotic Radiculopathy

PUBLISHED: PhysioTherapy 2011; 97 Supplement: 846-847.

AUTHORS: Moustafa IM, Diab AM, Ahmed A, Harrison DE.

CONCLUSIONS: Improved lordosis in the study group was associated with significant improvements in nerve root function, VAS rating, and translational and rotational motions of the lower cervical spine.

Only in the study group were the results maintained at long-term follow up.

IMPLICATIONS: Appropriate physical rehabilitation for Cervical Spondylotic Radiculopathy should include cervical sagittal curve correction, as it is may to lead greater and longer lasting improved function.

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Sunday, January 12th, 2020
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Does improvement towards a normal Cervical Sagittal configuration aid in the management of Cervical Myofascial Pain Syndrome

PUBLISHED: BMC Musculoskelet Disord. 2018 Nov 12;19(1):396. doi: 10.1186/s12891-018-2317-y. Pub Med:

AUTHORS: Moustafa IM, Diab AA, Hegazy F, Harrison DE.

CONCLUSION: The addition of the denneroll cervical orthotic to a multimodal program positively affected chronic myofascial cervical pain syndrome (CMCPS) outcomes at long term follow up.

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Thursday, January 9th, 2020
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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:

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.

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Wednesday, January 8th, 2020
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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:

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.

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Sunday, December 1st, 2019
schoolboy with open book on white background. Isolated 3D image

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.

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Friday, June 21st, 2019
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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:

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.

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Friday, June 21st, 2019
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A Normal Sagittal Spinal Configuration: A Desirable Clinical Outcome

PUBLISHED: J Manipulative Physiol Ther. 1996 Jul-Aug;19(6):398-405. Pub Med:

AUTHORS: Harrison DD, Troyanovich SJ, Harrison DE, Janik TJ, Murphy DJ.

CONCLUSION: The usual, typical or normal configuration of the cervical spine in the sagittal dimension is a lordosis with a range of 16.5-66 degrees when measured as tangent lines along the cervical curve of the posterior vertebral body margins of C2 and C7.

An analysis of stresses and strains supports this claim, as do studies from the scientific literature that attempt to measure and classify average cervical configuration from large population bases.

The use of normative data as a gauge against which to measure patients’ structural health and as an outcome of the degree of success or failure of chiropractic interventions seem to be logical consequences of these findings.

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