Skip to main content Skip to main navigation menu Skip to site footer

Correlation between Loss of Cervical Lordosis and Degenerative Diseases of the Sub-axial Cervical Spine Columns

Abstract

Background: Subaxial cervical spine is the cervical segment which commonly undergo degenerative changes. There are numerous cervical lordosis angle measurement, however posterior tangential method is considered more accurate to detect any degenerative related changes.

Aim: This study aimed to find the profile of cervical lordotic curve among patients with cervical degenerative disease, and to determine the correlation between degenerative process of subaxial cervical spine columns and cervical curve malalignment.

Method: A cross sectional study was conducted by adopting the posterior tangent measurement. Cervical alignment was measured from cervical MRI mid sagittal section to identify loss of cervical lordotic and the presence of kyphosis. Degenerative disease of each vertebral column of subaxial cervical spine, anterior and posterior were evaluated. Spearman correlation test was done to identify the relationship between degenerative process of each column of subaxial cervical spine with loss of cervical lordosis and the presence of kyphosis. Multivariate analysis was done to adjust the effect of confounding variable.

Result: Total of 90 subjects with male predominance (62%), mean age 54± 1.3 years. Neck pain contributes the most presenting complain (92%). As many as 51 subjects have hypo-lordosis, while 32 subjects have kyphotic changes. There was no significant correlation between degenerative process of each column of subaxial cervical spine and loss of cervical lordotic, but significant correlation was found between posterior listhesis and cervical kyphosis defomity. (p < 0.05).

Conclusion: There was significant correlation between cervical kyphotic malalignment with posterior listheis  in all three vertebra columns instead of hypo-lordosis.

References

  1. Scheer J, Tang J, Smith J, Acosta F, Protopsaltis T, Blondel B, et al. Cervical spine alignment, sagittal deformity, and clinical implications. Journal of Neurosurgery: Spine. 2013;19(2):141-159.
  2. Been E, Shefi S, Soudack M. Cervical lordosis: the effect of age and gender. The Spine Journal. 2017;17(6):880-888.
  3. Kong L, Tian W, Cao P, Wang H, Zhang B, Shen Y. Predictive factors associated with neck pain in patients with cervical disc degeneration: A cross-sectional study focusing on Modic changes. Medicine (Baltimore). 2017;96(43):e8447.
  4. McAviney J, Schulz D, Bock R, Harrison D, Holland B. Determining the relationship between cervical lordosis and neck complaints. Journal of Manipulative and Physiological Therapeutics. 2005;28(3):187-193.
  5. Harrison DD, Harrison DE, Janik TJ, Cailliet R, Ferrantelli JR, Haas JW, et al. Modeling of the sagittal cervical spine as a method to discriminate hypolordosis: Results of elliptical and circular modeling in 72 asymptomatic subjects, 52 acute neck pain subjects, and 70 chronic neck pain subjects. Spine (Phila Pa 1976). 2004;29:2485–2492.
  6. Ha B, Sim H, Lyo I, Park E, Kwon S, Park J. Comparisons of two-level discectomy and fusion with cage alone versus single-level corpectomy and fusion with plate in the treatment of cervical degenerative disc disease. Korean Journal of Spine. 2012; 9(3):197.
  7. Kumagai G, Ono A, Numasawa T, Wada K, Inoue R, Iwasaki H, et al. Association between roentgenographic findings of the cervical spine and neck symptoms in a Japanese community population. J Orthop Sci. 2014;19(3):390–397. doi: 10.1007/s00776-014-0549-8.
  8. Aşkin A, Bayram K, Demirdal Ü, Atar E, Arifoğlu karaman Ç, Güvendi E, et al. The evaluation of cervical spinal angle in patients with acute and chronic neck pain. Turk J Med Sci. 2017;47:806-811.
  9. Oktenoğlu T, Ozer AF, Ferrara LA, Andalkar N, Sarioğlu AC, Benzel EC. Effects of cervical spine posture on axial load bearing ability: A biomechanical study. J Neurosurg. 2001;94(1):108–114.
  10. Edmondston S, Ussing K, Allison G. Endurance and fatigue characteristics of the neck flexor and extensor muscles during isometric tests in patients with postural neck pain. Man Ther. 2011;16(4):332–338.
  11. Dai L. Disc degeneration and cervical instability. Correlation of magnetic resonance imaging with radiography. Spine (Phila Pa 1976). 1998;23(16):1734-1738.
  12. Goel A. Not neural deformation or compression but instability is the cause of symptoms in degenerative spinal disease. J Craniovertebral Junction Spine. 2014;5:141-142.
  13. Swartz EE, Floyd RT, Cendoma M. Cervical spine functional anatomy and the biomechanics of injury due to compressive loading. J Athl Train. 2005;40(3):155–161.
  14. Öğrenci A, Koban O, Yaman O, Dalbayrak S, Mesut Yılmaz M. The effect of technological devices on cervical lordosis. Maced J Med Sci. 2018;6(3):467–471.
  15. Hiratzka J, Ching A, Hart R. Degenerative cervical kyphosis: treatment, complications, and outcomes. Seminars in Spine Surgery. 2011;23(3):165-169.
  16. Tsai Y, Weng M, Chen T, Hsieh Y, Chen C, Huang M. Correlation between the ossification of nuchal ligament and clinical cervical disorders. The Kaohsiung Journal of Medical Sciences. 2012;28(10):538-544.
  17. An Y, Li J, Li Y, Shen Y. Characteristics of Modic changes in cervical kyphosis and their association with axial neck pain. J Pain Res. 2017; 10: 1657–1661.
  18. Lee SH, Kim KT, Seo EM, Suk KS, Kwack YH, Son ES. The influence of thoracic inlet alignment on the craniocervical sagittal balance in asymptomatic adults. J Spinal Disord Tech. 2012;5:E41–E47.
  19. Grob D, Frauenfelder H, Mannion A. The association between cervical spine curvature and neck pain. European Spine Journal. 2006;16(5):669-678.
  20. Gore D. Roentgenographic Findings in the cervical spine in asymptomatic persons. Spine. 2001;26(22):2463-2466.
  21. Yukawa Y, Kato F, Suda K, Yamagata M, Ueta T. Age-related changes in osseous anatomy, alignment, and range of motion of the cervical spine. Part I: Radiographic data from over 1,200 asymptomatic subjects. European Spine Journal. 2012;21(8):1492-1498.
  22. Kim H, Lenke L, Oshima Y, Chuntarapas T, Mesfin A, Hershman S, et al. Cervical Lordosis Actually Increases With Aging and Progressive Degeneration in Spinal Deformity Patients. Spine Deformity. 2014;2(5):410-414.

How to Cite

Martadiani, E. D., Asih, M. W., Laksminigsih, N. S., Tjan, A., & Widyasari, N. (2019). Correlation between Loss of Cervical Lordosis and Degenerative Diseases of the Sub-axial Cervical Spine Columns. Bali Medical Journal, 8(3), 878–885. https://doi.org/10.15562/bmj.v8i3.1560

HTML
7

Total
6

Share

Search Panel

Elysanti Dwi Martadiani
Google Scholar
Pubmed
BMJ Journal


Made Widhi Asih
Google Scholar
Pubmed
BMJ Journal


Nyoman Srie Laksminigsih
Google Scholar
Pubmed
BMJ Journal


Anastasia Tjan
Google Scholar
Pubmed
BMJ Journal


Nyoman Widyasari
Google Scholar
Pubmed
BMJ Journal