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Original Article| Volume 28, ISSUE 3, P187-193, March 2005

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Determining the Relationship Between Cervical Lordosis and Neck Complaints

      Objective

      To investigate the presence of a “functionally normal” cervical lordosis and identify if this and the amount of forward head posture are related to neck complaints.

      Methods

      Using the posterior tangent method, an angle of cervical lordosis was measured from C2 through C7 vertebrae on 277 lateral cervical x-rays. Anterior weight bearing was measured as the horizontal distance of the posterior superior body of the C2 vertebra compared to a vertical line drawn superiorly from the posterior inferior body of the C7 vertebra. The measurements were sorted into 2 groups, cervical complaint and noncervical complaint groups. The data were then partitioned into age by decades, sex, and angle categories.

      Results

      Patients with lordosis of 20° or less were more likely to have cervicogenic symptoms (P < .001). The association between cervical pain and lordosis of 0° or less was significant (P < .0001). The odds that a patient with cervical pain had a lordosis of 0° or less was 18 times greater than for a patient with a noncervical complaint. Patients with cervical pain had less lordosis and this was consistent over all age ranges. Males had larger median cervical lordosis than females (20° vs 14°) (2-sided Mann-Whitney U test, P = .016). When partitioned by age grouping, this trend is significant only in the 40- to 49-year-old range (2-sided Mann-Whitney U test, P < .01).

      Conclusion

      We found a statistically significant association between cervical pain and lordosis <20° and a “clinically normal” range for cervical lordosis of 31° to 40°. Maintenance of a lordosis in the range of 31° to 40° could be a clinical goal for chiropractic treatment.

      Key Indexing Terms

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      References

        • Harger B.L.
        • Taylor J.A.M.
        • Haas M.
        • Nyiendo J.
        Chiropractic radiologists: a survey of chiropractors' attitudes and patterns of use.
        J Manipulative Physiol Ther. 1997; 20: 311-314
        • Marchiori D.M.
        • Hawk C.
        • Howe J.
        Chiropractic radiologists: a survey of demographics, abilities, educational attitudes and practice trends.
        J Manipulative Physiol Ther. 1998; 21: 392-398
        • Gay R.
        The curve of the cervical spine—variations and significance.
        J Manipulative Physiol Ther. 1993; 15: 591-694
        • Gore D.
        • Sepic S.
        • Gardner G.
        Roentgenographic findings of the cervical spine in asymptomatic people.
        Spine. 1986; 11: 521-524
        • Hardacker J.W.
        • Shuford R.F.
        • Capicotto P.N.
        • Pryor P.W.
        Radiographic standing cervical segmental alignment in adult volunteers without neck symptoms.
        Spine. 1997; 22: 1472-1480
        • Harrison D.E.
        • Harrison D.D.
        • Haas J.W.
        CBP Structural rehabilitation of the cervical spine. Harrison CBP Seminars, Inc., Evanston (Wyo)2002: 42-45
        • Harrison D.D.
        • Harrison D.L.J.
        Pathological stress formations on the anterior vertebral body in the cervicals.
        in: Suh C.H. The proceedings of the 14th Annual Biomechanics Conference on the Spine. Mechanical Engineering Dept, Univ of Colorado, Colorado1983: 31-50
        • Harrison D.
        • Janik T.
        • Troyanovich S.
        • Holland B.
        Comparisons of lordotic cervical spine curvatures to a theoretical model of the sagittal cervical spine.
        Spine. 1996; 21: 667-675
        • Vernon H.
        • Steiman I.
        • Hagino C.
        Cervicogenic dysfunction in muscle contraction headache and migraine—a descriptive study.
        J Manipulative Physiol Ther. 1992; 15: 418-429
        • Braaf M.M.
        • Rosner S.
        Trauma of the cervical spine as a cause of chronic headache.
        J Trauma. 1975; 15: 441-446
        • Nagasawa A.
        • Sakakibara T.
        • Takahashi A.
        Roentgenographic findings of the cervical spine in tension-type headache.
        Headache. 1993; 33: 90-95
        • Masarsky C.
        • Todres-Masarsky M.
        Somatovisceral aspects of chiropractic—an evidence based approach.
        Churchill Livingstone, New York (NY)2001
        • Yochum T.
        • Rowe L.
        Essentials of skeletal radiology. 2nd ed. Williams & Wilkins, Baltimore1996: 181
        • Owens E.
        • Hoiris K.
        Cervical curvature assessment using digitized radiographic analysis.
        Chiropr Res J. 1990; 4: 47-62
        • Gore D.R.
        Roentgenographic findings in the cervical spine in asymptomatic persons. A ten-year follow-up.
        Spine. 2001; 26: 2463-2466
        • Cote P.
        • Cassidy J.D.
        • Yong-Hing K.
        • Sibley J.
        • Loewy J.
        Apophysial joint degeneration, disc degeneration, and sagittal curve of the cervical spine.
        Spine. 1997; 22: 859-864
        • Marshall D.L.
        • Tuchin P.J.
        Correlation of cervical lordosis measurement with incidence of motor vehicle accidents.
        J Aust Chiropr Osteopathy. 1996; 5: 79-85
        • Harrison D.E.
        • Harrison D.D.
        • Colloca C.J.
        • Betz J.
        • Janik T.J.
        • Holland B.
        Repeatability of posture overtime, x-ray positioning, and x-ray line drawing: an analysis of six control groups.
        J Manipulative Physiol Ther. 2003; 26: 87-98
        • Harrison D.E.
        • Harrison D.D.
        • Cailliet R.
        • Troyanovich S.J.
        • Janik T.J.
        • Holland B.
        Cobb method or Harrison posterior tangent method: which is better for lateral cervical analysis?.
        Spine. 2000; 25: 2072-2078
        • Harrison D.E.
        • Cailliet R.
        • Harrison D.D.
        • Janik T.J.
        • Holland B.
        New 3-point bending traction method of restoring cervical lordosis combined with cervical manipulation: non-randomized clinical control trial.
        Arch Phys Med Rehabil. 2002; 83: 447-453
        • Harrison D.E.
        • Harrison D.D.
        • Betz J.
        • Janik T.J.
        • Holland B.
        • Colloca C.
        Increasing the cervical lordosis with CBP seated combined extension-compression and transverse load cervical traction with cervical manipulation: non-randomized clinical control trial.
        J Manipulative Physiol Ther. 2003; 26: 139-151
        • Harrison D.E.
        • Jones W.E.
        • Janik T.J.
        • Harrison D.D.
        Evaluation of flexural stresses in the vertebral body cortex and trabecular bone in three cervical configurations with an elliptical shell model.
        J Manipulative Physiol Ther. 2002; 26: 391-401
        • Penning L.
        Kinematics of cervical spine injury. A functional radiological hypothesis.
        Eur Spine J. 1995; 130: 317-326