![]() Fewer studies have examined this phenomenon in the cervical spine: some have identified a relationship between the number of levels of cervical spine degeneration and the chronicity of the complaint or (in women only) the associated disability others have shown that asymptomatic individuals with degenerative changes of C6/7 are significantly more likely to develop neck pain in the future (10 years later) whilst others, still, have failed to find any significant relationship between degenerative changes and pain. The finding that degenerative changes of the cervical spine are common in asymptomatic individuals has challenged the notion of cause and effect on the other hand, systematic reviews reveal that degeneration shows a consistent (albeit weak) association with pain, at least for the lumbar spine. The prevalence of neck pain in the normal population aged over 40 is approximately 20% and hence the question of the clinical significance of such radiological changes is of great importance. In contrast to radicular symptomatology, which is anatomically defined and can usually be explained by the presence of osteophytes or narrowing of the intervertebral foramen at the corresponding vertebral level, there is still uncertainty as to whether more widespread clinical symptoms such as axial neck pain can be attributed to observed radiographic changes. The most typical changes observed include osteoarthritis of the facets with reduced joint space and disc space narrowing. This should be given due consideration in the differential diagnosis of patients with neck pain.ĭegenerative changes of the cervical spine, evident on radiographic examination, are part of the normal physiologic ageing process. not necessarily indicative of the cause of pain. The presence of such structural abnormalities in the patient with neck pain must be considered coincidental, i.e. In the group with neck pain, there was no association between any of the clinical characteristics (duration, frequency, intensity of pain radiating pain sensory/motor disturbances disability healthcare utilisation) and either global cervical curvature or segmental angles. The average segmental angle at the kyphotic level was 6.5° in the pain group and 6.3° in the group without pain, with a range of 5–10° in each group. Twenty-three per cent of the people with neck pain and 17% of those without neck pain showed a segmental kyphosis deformity of more than 4° in at least one segment-most frequently at C4/5, closely followed by C5/6 and C3/4. No significant difference between the two groups could be found in relation to the global curvature, the segmental angles, or the incidence of straight-spine or kyphotic deformity ( P > 0.05). ![]() The global curvature of the cervical spine (C2–C7) and each segmental angle were measured from the radiographs, using the posterior tangent method, and examined in relation to neck complaints. Based on the latter, subjects were divided into a group with neck pain ( N = 54) and a group without neck pain ( N = 53). Sagittal radiographs of the cervical spine were taken and a questionnaire was completed, enquiring about neck pain and disability in the last 12 months. One hundred and seven volunteers, who were otherwise undergoing treatment for lower extremity problems in our hospital, took part. The aim of this study was to examine the correlation between the presence of neck pain and alterations of the normal cervical lordosis in people aged over 45 years. Nonetheless, such changes may also remain clinically silent. Degenerative changes of the cervical spine are commonly accompanied by a reduction or loss of the segmental or global lordosis, and are often considered to be a cause of neck pain.
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