Original Articles

Correlation between loss of cervical lordosis and the degree of cervical disc herniation

Ni Nyoman Widyasari, Elysanti Dwi Martadiani , Made Widhi Asih, I Gde Raka Widiana, Firman Parulian Sitanggang, Putu Patriawan

Ni Nyoman Widyasari
Radiology Resident Program, Faculty of Medicine, Universitas Udayana-Sanglah Hospital, Bali, Indonesia

Elysanti Dwi Martadiani
Radiology Department, Faculty of Medicine, Universitas Udayana-Sanglah Hospital, Bali, Indonesia. Email: elysantidm@unud.ac.id

Made Widhi Asih
Radiology Department, Faculty of Medicine, Universitas Udayana-Sanglah Hospital, Bali, Indonesia

I Gde Raka Widiana
Internal Medicine Department, Faculty of Medicine, Universitas Udayana-Sanglah Hospital, Bali, Indonesia

Firman Parulian Sitanggang
Radiology Department, Faculty of Medicine, Universitas Udayana-Sanglah Hospital, Bali, Indonesia

Putu Patriawan
Radiology Department, Faculty of Medicine, Universitas Udayana-Sanglah Hospital, Bali, Indonesia
Online First: March 02, 2021 | Cite this Article
Widyasari, N., Martadiani, E., Asih, M., Widiana, I., Sitanggang, F., Patriawan, P. 2021. Correlation between loss of cervical lordosis and the degree of cervical disc herniation. Indonesia Journal of Biomedical Science 15(1): 43-47. DOI:10.15562/ijbs.v15i1.288


Background: Chronic neck pain is a common health problem and is increasingly relevant in health-related quality of life, not only in industrialized countries. The etiology of neck pain is very complex and may be associated with disc herniation, facet joints, muscles, and ligaments that cervical stability will gradually decrease and can cause damage and lead to loss of cervical lordosis. However, studies rarely report the correlation between cervical lordosis and cervical herniation in patients with neck pain. The purpose of this study was to determine the profile of cervical lordosis curves in patients with chronic neck pain and prove the correlation between the degree of cervical disc herniation with loss of cervical lordosis.

Method: This study was designed as an analytic study with a retrospective cross-sectional approach. Cervical lordosis curves are measured from mid sagittal cervical MRI while the degree of cervical disc herniation is evaluated using a herniation score. The Spearman correlation test and a simple linear regression test were performed to assess the relationship between loss of cervical lordosis and cervical herniation severity. Multivariate analysis was performed to adjust for the effect of confounding variables.

Result: A total of 67 study samples, 64.2% male and 35.8% female, with an average age of 54.7 ± 12.5. Cervical lordosis angle was found not normal (86.6%), most are in the form of hypolordosis (41.8%) and kyphosis (43.3%). The most herniation was in protrusion stage (47.8%). There was a significant correlation between the loss of the cervical lordosis and the degree of disc herniation (r -0.259, and p-value 0.034), each increase of one cervical disc herniation score affects the angle of the lordosis curve by -1.9 degrees, with a coefficient value of B = -1,914 (95% CI, p = 0.026).

 

Conclusion: there is a significant correlation between loss of cervical lordosis and cervical disc herniation (p <0.05).

 

References

Lippa L, Lippa L, Cacciola F. Loss of cervical lordosis: What is the prognosis? J Craniovertebr Junction Spine. 2017;8(1):9-14. doi: 10.4103/0974-8237.199877.

Misailidou V, Malliou P, Beneka A, Karagiannidis A, Godolias G. Assessment of patients with neck pain: a review of definitions, selection criteria, and measurement tools. J Chiropr Med. 2010;9(2):49-59. doi: 10.1016/j.jcm.2010.03.002.

Been E, Shefi S, Soudack M. Cervical lordosis: the effect of age and gender. The Spine Journal. 2017;17(6): 880-888. DOI : http://dx.doi.org/doi: 10.1016/j.spinee.2017.02.007

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. DOI: 10.1097/MD.0000000000008447.

Amin RM, Andrade NS, Neuman BJ. Lumbar Disc Herniation. Curr Rev Musculoskelet Med. 2017;10(4):507-516. doi: 10.1007/s12178-017-9441-4.

Harrison DD, Harrison DE, Janik TJ, Cailliet R, Ferrantelli JR, Haas JW, Holland B. 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; 29:2485–92.

Helliwell PS, Evans PF, Wright V. The straight cervical spine: Does it indicate muscle spasm? J Bone Joint Surg Br. 1994;76:103–6.

Gao K, Zhang J, Lai J, Liu W, Lyu H, Wu Y, Lin Z, Cao Y. Correlation between cervical lordosis and cervical disc herniation in young patients with neck pain. Medicine (Baltimore). 2019;98(31):e16545. doi: 10.1097/MD.0000000000016545.

Martadiani ED, Asih MW, Laksminingsih NS, Tjan A, Widyasari N. Correlation between Loss of Cervical Lordosis and Degenerative Diseases of the Sub-axial Cervical Spine Columns. Bali Medical Journal. 2019;8(3):698-705. DOI:10.15562/bmj.v8i3.1560


No Supplementary Material available for this article.
Article Views      : 0
PDF Downloads : 0