Association between cervical lordotic curvature and cervical muscle cross‐sectional area in patients with loss of cervical lordosis

Yoon, Seo Yeon; Moon, Hyun Im; Lee, Sang Chul; Eun, Na Lae; Kim, Yong Wook

doi:10.1002/ca.23074

Cited by 46 publications

(40 citation statements)

References 26 publications

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“…However, no significant correlation was detected between the sagittal alignment of the cervical spine and clinical symptoms. [21–22] In contrast, we confirmed a strong correlation between cervical lordosis and disc herniation, which can greatly improve the diagnosis of cervical spondylosis (Table 3).…”

Section: Discussionsupporting

confidence: 50%

Correlation between cervical lordosis and cervical disc herniation in young patients with neck pain

et al. 2019

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Abnormal cervical curvature and cervical disc herniation are closely related to neck pain and should be taken into account before any treatment. However, studies have rarely reported on the correlation between cervical lordosis and cervical disc herniation in patients with neck pain. Therefore, in this study, we collect young neck pain patients with abnormal cervical curvature to evaluate the relationship between cervical lordosis and cervical disc herniation. Three hundred patients below 40 years old with neck pain were enrolled. Patient sex, age, apical vertebra, segment of intervertebral disc protrusionl, sagittal diameter of spinal duramater, saggital diameter of spinal canal, height of disc space were recorded, and the cervical curvature, and degree of cervical spinal cord compression (G/F ratio) were calculated. The change of degree of disc herniation and degree of cervical spinal cord compression were analyzed in different cervical curvature groups. Further more, collected these patients who had improved cervical curvature over a period of time, to compare the changes of degree of disc herniation, G/F ratio, and height of disc space. The median age of patients with kyphosis was lower than those with lordosis and straight cervical spine. The degree of disc herniation was higher in the straight and kyphosis groups compared to the lordosis group. Cervical lordosis was inversely correlated with the degree of disc herniation and positively with G/F ratio. Cervical curvature was significantly affected by sex, age, and the degree of disc herniation. With the improvement of cervical lordotic curvature, the degree of disc herniation decreased and height of disc space increased. The degree of disc herniation and cervical spinal cord compression are inversely correlated to cervical lordosis in young neck pain patients, and the degree of disc herniation and height of disc space can recover with the recovery of cervical lordotic curvature. These findings may indicating a link between cervical curvature and degenerative changes which have important clinical implications.

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Section: Discussionsupporting

confidence: 50%

Correlation between cervical lordosis and cervical disc herniation in young patients with neck pain

et al. 2019

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“…[15] In addition to these skeletal changes in the cervical spine, the muscles and soft tissue that support the neck work harder to compensate for biomechanical instability creating soft-tissue weakness and damage. [1617] As such, since the basilar artery is formed by the anterior spinal artery which courses through the spinal cord and the vertebral arteries which course cephalad through the transverse foramina of the first six vertebrae, prolonged aberrant stresses and strains applied to the spine will be applied to the vasculature within the spine. [181920]…”

Section: Discussionmentioning

confidence: 99%

Increase in cerebral blood flow indicated by increased cerebral arterial area and pixel intensity on brain magnetic resonance angiogram following correction of cervical lordosis

Katz¹,

Katz²,

Fedorchuk³

et al. 2019

Brain Circ

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CONTEXT: Loss of cervical lordosis is associated with decreased vertebral artery hemodynamics. AIM: The aim of this study is to evaluate cerebral blood flow changes on brain magnetic resonance angiogram (MRA) in patients with loss of cervical lordosis before and following correction of cervical lordosis. SETTINGS AND DESIGN: This study is a retrospective consecutive case series of patients in a private practice. MATERIALS AND METHODS: Cervical lordosis of seven patients (five females and two males, 28–58 years) was measured on lateral cervical radiographs ranging from −13.1° to 19.0° (ideal is −42.0°). Brain MRAs were analyzed for pixel intensities representing blood flow. Pixel intensity of the cerebral vasculature was quantified, and percentage change was determined. STATISTICAL ANALYSIS USED: A Student's t-test established significance of the percentage change in cerebral blood flow between pre- and postcervical lordosis adjustment images. Regression analysis was performed. An a priori analysis determined correlation between cervical lordosis and change in MRA pixel intensity. The statistician was blinded to the cervical lordosis. 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. Further studies are needed to confirm these findings and understand clinical implications.

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“…[1014] A better understanding of the anatomy, variants, and function of the neck is important in helping diagnosis and treating various pathological conditions of the CCJ. [202122232425]…”

Section: Discussionmentioning

confidence: 99%

Superficial anterior atlanto-occipital ligament: Anatomy of a forgotten structure with relevance to craniocervical stability

Kikuta

Iwanaga

Watanabe

et al. 2019

J Craniovert Jun Spine

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Introduction: The superficial anterior atlanto-occipital ligament (SAAOL) is a narrowband located anterior to the anterior atlanto-occipital membrane. Nearly forgotten, it has not been well described in older anatomical textbooks and is missing in the current anatomical literature. As all of the binding structures of the craniocervical junction (CCJ) are important in maintaining stability, this study aims to clarify the anatomy and potential function of the SAAOL. Materials and Methods: The CCJ from ten fresh-frozen cadavers was studied. These specimens were derived from three males and seven females, and the age at death ranged from 57 to 91 years (mean, 79.8 years). The length, width, and thickness of the SAAOL were measured. In five specimens, the force to failure was recorded. Results: The SAAOL was found between the anterior tubercle of the atlas and the occiput and located as central thick fibers in front of the anterior atlanto-occipital membrane in 9 (90%) specimens. In one specimen, the vertical band to the occipital bone did not attach to the anterior tubercle of the atlas, but extended to the anterior aspect of the axis. The mean length, width, and thickness of the SAAOL were 19.8, 6.2, and 0.6 mm, respectively. The force to failure for the ligament was 38.8 N. Conclusion: The SAAOL was a constant structure of the anterior atlanto-occipital joint. This ligament seems to be a secondary stabilizer of the CCJ by limiting the extension of CCJ. Knowledge of this ligament may help in further understanding of craniocervical stability.

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Association between cervical lordotic curvature and cervical muscle cross‐sectional area in patients with loss of cervical lordosis

Cited by 46 publications

References 26 publications

Correlation between cervical lordosis and cervical disc herniation in young patients with neck pain

Correlation between cervical lordosis and cervical disc herniation in young patients with neck pain

Increase in cerebral blood flow indicated by increased cerebral arterial area and pixel intensity on brain magnetic resonance angiogram following correction of cervical lordosis

Superficial anterior atlanto-occipital ligament: Anatomy of a forgotten structure with relevance to craniocervical stability

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