Cervical spine geometry correlated to cervical degenerative disease in a symptomatic group

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Cervical spine geometry correlated to cervical degenerative disease in a symptomatic group
Received 21 March 2002; received in revised form 8 May 2002
Raymond Wiegand, DCa, Norman W Kettner, DCb, Deborah Brahee, DCc, Nelson Marquina, DC, PhDd
Journal of Manipulative and Physiological Therapeutics
Elsevier

Abstract
Objective
To investigate whether a statistical correlation exists between lateral cervical geometry and cervical pathology, as identified on neutral anteroposterior (AP) and lateral radiographs within a symptomatic group; describe the cervical pathology and determine its location and frequency; and identify the subjectĚs age, sex, and chief complaint.

Setting
Department of radiology at a chiropractic college.

Methods
One hundred eighty-six consecutive pairs of AP and lateral cervical radiographs were reviewed for pathology. A 5-category severity scale was used to describe degenerative joint disease, the most common pathological finding. The subjectĚs age, sex, and symptoms were recorded. Geometric analysis was focused on vertebral position, alignment, and gravitational loading acquired from the neutral lateral cervical radiograph.

Results
Regression and discriminant analysis identified 5 geometric variables that correctly classified pathology subjects from nonpathology subjects 79% of the time. Those variables were: (1) forward flexion angle of the lower cervical curve; (2) gravitational loading on the C5 superior vertebral end plate; (3) horizontal angle of C2 measured from its inferior vertebral end plate; (4) disk angle of C3; and (5) posterior disk height of C5. Degenerative joint disease was the most common pathological finding identified within discrete age, sex, and symptom groups.

Conclusion
We identified 5 geometric variables from the lateral cervical spine that were predictive 79% of the time for cervical degenerative joint disease. There were discrete age, sex, and symptom groups, which demonstrated an increased incidence of degenerative joint disease.

Keywords: Cervical Vertebrae, Joint Diseases, Radiography
a Research Associate, Logan College of Chiropractic, Chesterfield, Mo, USA

b Chair, Department of Radiology, Logan College of Chiropractic, Chesterfield, Mo, USA

c New York Chiropractic College, Seneca Falls, NY, USA

d Clinical Technologies Research, LLC, USA

Submit requests for reprints to: Dr Raymond Wiegand, Logan College of Chiropractic, PO Box 1065, Chesterfield, MO 63006-1065, USA

PII: S0161-4754(03)00068-X

doi:10.1016/S0161-4754(03)00068-X

© 2003 JMPT. Published by Elsevier Inc. All rights reserved.

Copyright © 2007 Elsevier, Inc. All rights reserved

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