Cervical Lordosis in Asymptomatic Individuals; Systematic Review and Meta-Analysis

Year 2022, Volume: 44 Issue: 6, 822 - 828, 28.11.2022

Gülüm Sarğın Canan Yenitürk Baydar Hatice Azizoğlu

https://doi.org/10.20515/otd.1055795

Abstract

The cervical spine has the greatest sagittal movement of the spine and the cervical spine alignment is very important in terms of function and posture by affecting the thoracic sagittal alignment. Cervical lordosis has important clinical and surgical implications. The aim of this study is to evaluate the relationship of cervical lordosis with age and gender in individuals without signs of cervical spinal disease and to examine the presence and extent of cervical lordosis. Our search algorithm included studies published between 2017 and 2021. Eligible studies were searched using Pubmed, OVID, Clinical Key and Google Scholar databases between April 1, 2021 and May 25, 2021. Only English and Turkish studies were included. After scanning, a total of 10,138 titles and abstracts were found. Of these, 51 full-text articles were analyzed. A total of 5 articles were included in our analysis with our inclusion-exclusion criteria. It was determined that two of the studies were prospective, two were retrospective and one was observational cross-sectional. As a result of the meta-analysis, it was determined that there was a 1% difference between total slope lordosis pains according to gender. The slope between the cervical lordosis angles in women showed a 2% difference. Likewise, it was analyzed that there was a 2% difference in the slope between the cervical lordosis angles in men. Gender and age-related lordosis gradients should be considered in surgical interventions involving cervical stabilization or restoration.

Keywords

Servical lordozis or C2- C7 lordozis, age, gender, asymptomatic individuals

Asemptomatik Bireylerde Cervical Lordozis ; Sistematik Derleme ve Meta-analiz

Abstract

Servical omurga omurganın en büyük sagittal hareketine sahiptir ve servical omurga dizilimi torasik sagittal dizilimi etkileyerek fonksiyon ve duruş bakımından oldukça önemlidir. Servical lordozun önemli klinik ve cerrahi etkileri vardır. Servical spinal hastalık bulgusu olmayan bireylerde cervical lordozisin yaş ve cinsiyet ile ilişkisini değerlendirip, cervical lordozisin varlığını ve kapsamını incelemektir. Arama algoritmamızda, 2017 ile 2021 tarihleri arasında yayınlanan araştırmalar dahil edildi. Uygun araştırmalar CINAHL Complete, MEDLİNE, OVİD, Clinical Key ve Google Scholar veritabanları kullanılarak 1 Nisan 2021-25 Mayıs 2021 tarihleri arasında tarama yapıldı. Sadece İngilizce ve Türkçe çalışmalar dahil edildi. Tarama sonrası toplam10.138 başlık ve özet bulundu. Bunların içinden 51 tam metin makale analiz edildi. Analizimize dahil etme- hariç tutma kriterlerimizle toplamda 5 makale dahil edildi. Çalışmaların iki tanesi prospective, iki tanesi retrospective ve bir tanesi de observetional kesitsel türde olduğu belirlendi. Yapılan metaanaliz sonucu cinsiyete göre total eğim lordoz acıları arasında %1’lik bir farklılık olduğu belirlendi. Kadınlarda servikal lordoz açıları arasındaki eğim %2’lik farklılık gösterdi. Aynı şekilde erkeklerde de servikal lordoz açıları arasındaki eğim %2’lik bir farklılık gösterdiği analiz edildi. Servical lordoz stabilizasyonu veya restorasyonu içeren cerrahi müdahalelerde cinsiyet ve yaşa bağlı değişen lordoz eğimleri göz önünde bulundurulmalıdır.

Keywords

Servical lordozis or C2- C7 lordozis, yaş, cinsiyet, asemptomatik bireyler

References

• 1. Owens E., Hoiris K.,Cervical curvature assessment using digitized radiographic analysis,Chiropr Res J. 1996;4; s. 47 – 62
• 2. Guo GM., J Li, QX Diao, TH Zhu et all. Cervical lordosis in asymptomatic individuals: a meta-analysis, J Orthop Surg Res 2018;13, 147 .
• 3. Moore KL, Persaud TVN. Klinik Yönleriyle İnsan Embriyolojisi, Çev. Ed. Yıldırım M, Nobel Tıp Kitapevleri, 2002, İstanbul.
• 4. Scheer Justin K, Tang Jessica A, Smith Justin S, et al. Cervical spine alignment, sagittal deformity, and clinical implications: a review. J Neurosurg Spine. 2013;19:141–59.
• 5. Daffin L The Impact Of The Cervical Lordosis on Postrul Sway Parameters in Asymptomatic Participitans , Doctor of Philosophy, University of the Sunshine Coast, 2019 .Australia.
• 6. Emmanuelle C-V, Jean-Marc M-T, Jérôme P, et all. Sagittal spino-pelvic alignment in chronic low back pain. Eur Spine J. 2011;20:634–40
• 7. Labelle H, Mac-Thiong JM, Roussouly P. Spino-pelvic sagittal balance of spondylolisthesis: a review and classification. Eur Spine J. 2011;20641–6.
• 8. Been E. , Shefi S., Zilka LR. , Soudac M. Foramen magnum orientation and its relationship to cervical lordosis: a model for reconstructing cervical curvature in archaeological and extinct hominin specimens,.Advances Anthropol ,2014; s. 133 - 140
• 9. Nightingale RW, McElhaney JH, Richardson WJ, Best TM, Myers BS. Experimental impact injury to the cervical spine: related to head movement and injury mechanism. J Bone Joint Surgery Am.1996 ;78:412–21.
• 10. Schwab F, Lafage V, Patel A, et al. Sagittal plane considerations and the pelvis in the adult patient. Spine (Phila Pa 1976). 2009;34:1828–33
• 11. Zhu Y, An Z, Zhang Y, Wei H, Dong L. Predictive formula of cervical lordosis in asymptomatic young population. J Orthop Surg Res. 2020;15:2.
• 12. Yochum T., Rowe L., Fundamentals of skeletal radiology (2nd ed.), Williams & Wilkins , Baltimore, 1996; s. 181
• 13. Gore DR, Sepic SB, Gardner GM. Roentgenographic findings of the cervical spine in asymptomatic people. Spine (Phila Pa 1976). 1986;11:521-4.
• 14. McAviney J, Schulz D, Bock R, Harrison DE, Holland B. Determining the relationship between cervical lordosis and neck complaints. J Manipulative Physiol Ther. 2005;28:187-93.
• 15. Kawakami M, Tamaki T, Yoshida M, Hayashi N, Ando M, Yamada H. Axial symptoms and cervical alignments after cervical anterior spinal fusion for patients with cervical myelopathy. J Spinal Disord.1999 ;12:50–6
• 16. Le Huec JC, Thompson W, Mohsinaly Y, Barrey C, Faundez A. Sagittal balance of the spine. Eur Spine J. 2019;28:1889-1905.
• 17. Harrison DE, Cailliet R, Harrison DD, Janik TJ, Holland B. A new 3-point bending traction method for restoring cervical lordosis and cervical manipulation: a nonrandomized clinical controlled trial. Arch Phys Med Rehabil 2002 ;83:447–53.
• 18. Ezra D, Kalichman L, Simonovich A. The associtaion between cervical lordosis anda ge,sex, history of cervical trauma and sedentarity: A CT study 2020;ISSN ;2640-7957
• 19. Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med. 2009 18;151:264-9, W64.
• 20. Been E, Shefi S, Soudack M. Cervical lordosis: the effect of age and gender. Spine J. 2017 ;17:880-888
• 21. Nasreddine MA, RR Pratali, CEG Barsotti et al Radiographic alignment of Spine on a Sample Of asymptomatic Subjects. Columna/ Coluna 2017 ;
• 22. Hu L, Lv Y, Lin Y. Correlations and Age-Related Changes of Cervical Sagittal Parameters in Adults Without Symptoms of Cervical Spinal Disease. Spine (Phila Pa 1976). 2020;45:E1542-E1548
• 23. Moore KL, Dalley AF. Kliniğe Yönelik Anatomi, 4. Baskı, Çev. Ed. ahinolu K, İstanbul,Nobel Tıp Kitabevleri, 2007
• 24. Yukawa Y., Kato F., Suda K., Yamagata M., Ueta T. Age-related changes in the bony anatomy, alignment, and range of motion of the cervical spine. Part I: Radiographic data from more than 1,200 asymptomatic subjects, Eur Spine J. 2012; 21;1492 -1498
• 25. Grob D, Frauenfelder H, Mannion AF. The association between cervical spine curvature and neck pain. Eur Spine J. 2007;16:669–78
• 26. 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: 390–7.