Determining the Relationship Between Cervical Lordosis and Neck Complaints

McAviney, Jeb; Schulz, Dan; Bock, R. Darrell; Harrison, Deed E.; Holland, Burt

doi:10.1016/j.jmpt.2005.02.015

Cited by 223 publications

(203 citation statements)

References 12 publications

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“…Toward this end, physicians frequently use functional radiometry that uses radiographs of lateral views of the cervical spine 15) . Fig 1. A, ARA from the C2 through C7 vertebrae using the posterior tangent method for analysis of the angle of cervical lordosis is depicted 7) . B, A measure of AWB is shown.…”

Section: Discussionmentioning

confidence: 99%

“…B, A measure of AWB is shown. The horizontal displacement of the posterior superior body corner of the C2 vertebra is compared to a vertical line originating at the posterior inferior body corner of the C7 vertebra 7) . C, drawing showing the technique for measuring rangers of flexion and extension motions on plain lateral radiographs of the cervical spine: range of flexion and extension = α°+β °.…”

Section: Discussionmentioning

confidence: 99%

“…Absolute rotation angles (ARA) 7) , to examine the degree of cervical lordosis, anterior weight bearings (AWB) 7) to examine forward head posture, and ranges of flexion and extension motion (RFEM) 8) , to examine the necks' flexion and extension angles were measured. ARA is the angle formed by the intersection of lines that extending from the posterior surface of the C2 and C7 vertebrae's pyramids.…”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Correlations between and Absolute Rotation Angle, Anterior Weight Bearing, Range of Flexion and Extension Motion in Cervical Herniated Nucleus Pulposus

Gong

Ma³

2010

J Phys Ther Sci

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Abstract.[Purpose] We attempted to examine the range of motion (rotation, flexion and extension) of the neck and forward head posture in patients with a cervical herniated nucleus pulposus (C-HNP) and in normal persons through radiometry; and examined the correlations between the ranges of these motions and C-HNP.[Subjects] The study subjects were 15 patients with C-HNP at level 5 or 6 (C5-6, (males=5, females=10) and 15 normal persons (males=5, females=10). [Methods] We analyzed the degree of cervical lordosis of patients with C-HNP at C5-6 and normal adults and compared them using radiographs of their lateral views. We observed the absolute rotation angles (ARA), anterior weight bearings (AWB) and ranges of flexion and extension motion (RFEM).[Results] The results indicated that as ARA increased, AWB decreased and RFEM increased. In particular, we confirmed that as AWB increased, RFEM decreased. [Conclusion] This study identified a remarkably decreased range of cervical motion in patients with C-HNP compared to normal persons, along with misalignments of the cervical spine due to from increased forward head posture.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Correlations between and Absolute Rotation Angle, Anterior Weight Bearing, Range of Flexion and Extension Motion in Cervical Herniated Nucleus Pulposus

Gong

Ma³

2010

J Phys Ther Sci

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“…The radiographic evaluation has long been considered as a gold standard for studying the cervical intervertebral motions. Several studies explored the intervertebral angles or spinal curvature by lateral plain radiographs [3,5,7,8,17,21,28], but the translation movements between spinal segments attracted limited attentions. The abnormal or excessive translations between vertebrae in the sagittal plane are clinically important clues to dysfunction or instability.…”

Section: Introductionmentioning

confidence: 99%

The quantitative measurements of the intervertebral angulation and translation during cervical flexion and extension

Kuo

Lan

et al. 2007

Eur Spine J

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The insufficient exploration of intervertebral translation during flexion and extension prevents the further understanding of the cervical biomechanics and treating the cervical related dysfunction. The objective of this study was to quantitatively measure the continuous intervertebral translation of healthy cervical spine during flexion and extension by videofluoroscopic technique. A total of 1,120 image sequences were analyzed for 56 healthy adult subjects by a precise image protocol during cervical flexion and extension. Our results showed there were no statistical angular differences among five spinal levels in either flexion or extension, except for the comparison between C2/3 (13.5°) and C4/5 (22.6°) angles. During cervical flexion, the smallest anterior translations were 0.7 mm at C2/3 level, followed by 0.9 mm at C6/7, 1.0 mm at C3/4, 1.1 mm at C5/6, and the largest 1.2 mm at C4/5 levels. The significantly greater translations were measured in the posterior direction at C3/4 (1.1 mm, P = 0.037), C4/5 (1.3 mm, P = 0.039), and C5/6 (1.2 mm, P = 0.005) levels than in the anterior one. The relatively fluctuant and small average posterior translation fashion at C6/7 level (0.4 mm) possibly originated from the variations in the direction of translation during cervical extension among subjects. Normalization with respect to the widths of individual vertebrae showed the total translation percentages relative to the adjacent vertebrae were 9.5, 13.7, 16.6, 15.0, and 8.6% for C2/3 to C6/7 levels, respectively, and appeared to be within the clinical-accepted ranges of translation in cervical spine. The intervertebral translations of cervical spine during flexion and extension movements were first described in quality and quantity based on the validated radiographic protocol. This analysis of the continuous intervertebral translations may be further employed to diagnose translation abnormalities like hypomobility or hypermobility and to monitor the treatment effect on cervical spines.

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“…The literature offers some hints that reconstruction of cervical lordosis might be favourable concerning clinical outcome and neurologic recovery [32,70,72,113]. However, the question of any influence of a distinct amount of lordotic realignement following the reconstruction of the multilevel decompressed cervical spine demands further investigation [12].…”

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confidence: 99%

4- and 5-level anterior fusions of the cervical spine: review of literature and clinical results

et al. 2007

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In the future, there will be an increased number of cervical revision surgeries, including 4-and more-levels. But, there is a paucity of literature concerning the geometrical and clinical outcome in these challenging reconstructions. To contribute to current knowledge, we want to share our experience with 4-and 5-level anterior cervical fusions in 26 cases in sight of a critical review of literature. At index procedure, almost 50% of our patients had previous cervical surgeries performed. Besides failed prior surgeries, indications included degenerative multilevel instability and spondylotic myelopathy with cervical kyphosis. An average of 4.1 levels was instrumented and fused using constrained (26.9%) and non-constrained (73.1%) screw-plate systems. At all, four patients had 3-level corpectomies, and three had additional posterior stabilization and fusion. Mean age of patients at index procedure was 54 years with a mean follow-up intervall of 30.9 months. Preoperative lordosis C2-7 was 6.5°in average, which measured a mean of 15.6°at last follow-up. Postoperative lordosis at fusion block was 14.4°in average, and 13.6°at last follow-up. In 34.6% of patients some kind of postoperative change in construct geometry was observed, but without any catastrophic construct failure. There were two delayed unions, but finally union rate was 100% without any need for the Halo device. Eleven patients (42.3%) showed an excellent outcome, twelve good (46.2%), one fair (3.8%), and two poor (7.7%). The study demonstrated that anterior-only instrumentations following segmental decompressions or use of the hybrid technique with discontinuous corpectomies can avoid the need for posterior supplemental surgery in 4-and 5-level surgeries. However, also the review of literature shows that decreased construct rigidity following more than 2-level corpectomies can demand 360°instrumentation and fusion. Concerning construct rigidity and radiolographic course, constrained plates did better than non-constrained ones. The discussion of our results are accompanied by a detailed review of literature, shedding light on the biomechanical challenges in multilevel cervical procedures and suggests conclusions.

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Determining the Relationship Between Cervical Lordosis and Neck Complaints

Cited by 223 publications

References 12 publications

Correlations between and Absolute Rotation Angle, Anterior Weight Bearing, Range of Flexion and Extension Motion in Cervical Herniated Nucleus Pulposus

Correlations between and Absolute Rotation Angle, Anterior Weight Bearing, Range of Flexion and Extension Motion in Cervical Herniated Nucleus Pulposus

The quantitative measurements of the intervertebral angulation and translation during cervical flexion and extension

4- and 5-level anterior fusions of the cervical spine: review of literature and clinical results

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