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Cervical Vertebral Axis Flattening: Demographics and Causes

Yıl 2022, Cilt: 11 Sayı: 2, 250 - 256, 31.08.2022

Adnan Demirel Burhan Adak

https://doi.org/10.47493/abantmedj.1133849
Cited By: 1

Öz

Objective: The neck is an important region that connects the head and body with the vital structures it contains. Pain originating from the cervical vertebral axis constitutes a significant part of the pain in this region and is the most common musculoskeletal problem after low back pain. Deviations such as decreased cervical lordosis or the development of kyphosis are associated with pain and disability. Although cervical axis flattening is a very common condition, there is not enough data on its causes. The aim of this study is to investigate the coexisting diseases that may be associated with flattening cervical lordosis.
Materials and Methods: Cervical radiographs of the cases were taken in the neutral position and the cervical axis angle was measured between C2-C7 by the Cobb method. A regional detailed physical examination was performed for the locomotor system and the Beck Depression and Beck Anxiety scales were filled in. A cervical MRI was performed in all cases. Three months later, regional detailed physical examinations and radiography were performed again. Cases in which lordosis flattening continued in the last cervical radiographs were considered chronic. The cases were divided into two groups: acute and chronic phases.
Results: 25% of the acute cases were diagnosed with fibromyalgia syndrome (FMS),45% of them with tension-type headache (TTHA), 45% of them cervical spondylosis (CS), 30% of them with cervical disc herniation (CDH), 15% of them with myofascial pain syndrome (MPS), 10% of them with anxiety, and 10% of them with depression. In cases with chronic phases, 60% of them were diagnosed with FMS, 45% of them with TTHA, 22.5% of them with CS, 55% of them with CDH, 17.5% of them with MPS, 30% of them with anxiety, 7.5% of them with depression and 20% of them with migraine.
Conclusion: We think that in cases with flattening cervical lordosis, it would be more appropriate to evaluate whether the current situation is a cause or a result and to determine the treatment according to the underlying disease.

Anahtar Kelimeler

Cervical Spine Lordosis Radiography

Kaynakça

  • 1. Cohen, S.P. Epidemiology, diagnosis, and treatment of neck pain. in Mayo Clinic Proceedings. 2015. Elsevier.
  • 2. Hoy, D.G., et al., The epidemiology of neck pain. Best Pract Res Clin Rheumatol, 2010. 24(6): p. 783-92.
  • 3. Scheer, J.K., et al., Cervical spine alignment, sagittal deformity, and clinical implications: a review. J Neurosurg Spine, 2013. 19(2): p. 141-59.
  • 4. Dwyer, A., C. Aprill, and N. Bogduk, Cervical zygapophyseal joint pain patterns. I: A study in normal volunteers. Spine (Phila Pa 1976), 1990. 15(6): p. 453-7.
  • 5. Alpayci, M. and S. Ilter, Isometric exercise for the cervical Extensors can help restore physiological lordosis and reduce neck pain: a randomized controlled trial. American journal of physical medicine & rehabilitation, 2017. 96(9): p. 621-626.
  • 6. Been, E., S. Shefi, and M. Soudack, Cervical lordosis: the effect of age and gender. Spine J, 2017. 17(6): p. 880-888.
  • 7. Budancamanak, M., et al., Protective effects of thymoquinone and methotrexate on the renal injury in collagen-induced arthritis. Arch Toxicol, 2006. 80(11): p. 768-76.
  • 8. Ferrara, L., The biomechanics of cervical spondylosis. Adv Orthop. 2012; 2012: 493605.
  • 9. Kaiser, J.A. and B.A. Holland, Imaging of the cervical spine. Spine (Phila Pa 1976), 1998. 23(24): p. 2701-12.
  • 10. McAllister, A.S., U. Nagaraj, and R. Radhakrishnan, Emergent Imaging of Pediatric Cervical Spine Trauma. Radiographics, 2019. 39(4): p. 1126-1142.
  • 11. Tins, B.J. and V.N. Cassar-Pullicino, Imaging of acute cervical spine injuries: review and outlook. Clin Radiol, 2004. 59(10): p. 865-80.
  • 12. Grob, D., H. Frauenfelder, and A. Mannion, The association between cervical spine curvature and neck pain. European Spine Journal, 2007. 16(5): p. 669-678.
  • 13. Cote, P., et al., Apophysial joint degeneration, disc degeneration, and sagittal curve of the cervical spine. Can they be measured reliably on radiographs? Spine, 1997. 22(8): p. 859-864.
  • 14. Gore, D.R., S.B. Sepic, and G.M. Gardner, Roentgenographic findings of the cervical spine in asymptomatic people. Spine (Phila Pa 1976), 1986. 11(6): p. 521-4.
  • 15. Harrison, D.D., et al., 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, 2004. 29(22): p. 2485-2492.
  • 16. Owens, E., Cervical curvature assessment using digitized radio-graphic analysis. Chiropr Res J, 1990. 4: p. 47-62.
  • 17. Helliwell, P., P. Evans, and V. Wright, The straight cervical spine: does it indicate muscle spasm? The Journal of bone and joint surgery. British volume, 1994. 76(1): p. 103-106.
  • 18. Boyle, J.J., N. Milne, and K.P. Singer, Influence of age on cervicothoracic spinal curvature: an ex vivo radiographic survey. Clin Biomech (Bristol, Avon), 2002. 17(5): p. 361-7.
  • 19. Gumina, S., et al., The relationship between chronic type III acromioclavicular joint dislocation and cervical spine pain. BMC Musculoskeletal Disorders, 2009. 10(1): p. 1-7.
  • 20. Bair, M.J. and E.E. Krebs, Fibromyalgia. Ann Intern Med, 2020. 172(5): p. ITC33-ITC48.
  • 21. Baykara, r.a., fibromyalji sendromunda kinezyofobi: obezite, ağri şiddeti, yüksek hastalik aktivitesi ilişkisi. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi. 24(1): p. 128-135.
  • 22. Cathcart, S., et al., Stress and tension-type headache mechanisms. Cephalalgia, 2010. 30(10): p. 1250-67.
  • 23. Crystal, S.C. and M.S. Robbins, Epidemiology of tension-type headache. Curr Pain Headache Rep, 2010. 14(6): p. 449-54.
  • 24. Kaynak Key, F.N., S. Donmez, and U. Tuzun, Epidemiological and clinical characteristics with psychosocial aspects of tension-type headache in Turkish college students. Cephalalgia, 2004. 24(8): p. 669-74.
  • 25. Cailliet, R., D. Ananthalkrishnan, and S. Burns, Neck pain: anatomy pathophysiology, and diagnosis, in Physical medicine and rehabilitation secrets. 2008, Elsevier Health Sciences Philadelphia. p. 319-322.
  • 26. Okada, E., et al., Does the sagittal alignment of the cervical spine have an impact on disk degeneration? Minimum 10-year follow-up of asymptomatic volunteers. European Spine Journal, 2009. 18(11): p. 1644-1651.
  • 27. Thoomes, E.J., et al., Lack of uniform diagnostic criteria for cervical radiculopathy in conservative intervention studies: a systematic review. Eur Spine J, 2012. 21(8): p. 1459-70.
  • 28. Plastaras, C.T. and A.B. Joshi, The electrodiagnostic evaluation of radiculopathy. Phys Med Rehabil Clin N Am, 2011. 22(1): p. 59-74.
  • 29. McAviney, J., et al., Determining the relationship between cervical lordosis and neck complaints. Journal of manipulative and physiological therapeutics, 2005. 28(3): p. 187-193.
  • 30. Borg-Stein, J. and D.G. Simons, Myofascial pain. Archives of physical medicine and rehabilitation, 2002. 83: p. S40-S47.
  • 31. Staud, R., Future perspectives: pathogenesis of chronic muscle pain. Best Pract Res Clin Rheumatol, 2007. 21(3): p. 581-96.
  • 32. Graff-Radford, S.B., et al., Effects of transcutaneous electrical nerve stimulation on myofascial pain and trigger point sensitivity. Pain, 1989. 37(1): p. 1-5.
  • 33. Cummings, T.M. and A.R. White, Needling therapies in the management of myofascial trigger point pain: a systematic review. Arch Phys Med Rehabil, 2001. 82(7): p. 986-92.
  • 34. Fishbain, D.A., et al., Male and female chronic pain patients categorized by DSM-III psychiatric diagnostic criteria. Pain, 1986. 26(2): p. 181-197.
  • 35. Küey, L., Birinci basamakta depresyon: tanıma, ele alma, yönlendirme. Psikiyatri Dünyası, 1998. 1: p. 5-12.
  • 36. Kayahan, B., et al., On beş-kırk dokuz yaşları arasındaki kadınlarda depresyon prevalansı ve depresyon şiddeti ile risk faktörleri arasındaki ilişki. Anadolu Psikiyatri Dergisi, 2003. 4(4): p. 208-219.
  • 37. Aydin, H. and L. Tamam, Anksiyöz depresyon: Bir depresyon alt grubu mu? Anadolu Psikiyatri Dergisi, 2005. 6(3): p. 177-187.
  • 38. Baykan, B., et al., Migraine incidence in 5 years: a population-based prospective longitudinal study in Turkey. J Headache Pain, 2015. 16(1): p. 103.
  • 39. Ertas, M., et al., One-year prevalence and the impact of migraine and tension-type headache in Turkey: a nationwide home-based study in adults. J Headache Pain, 2012. 13(2): p. 147-57.
  • 40. Manzoni, G.C. and L.J. Stovner, Epidemiology of headache. Handb Clin Neurol, 2010. 97: p. 3-22.
  • 41. Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia, 2018. 38(1): p. 1-211.
  • 42. Baykan, B., et al., Migraine incidence in 5 years: a population-based prospective longitudinal study in Turkey. J Headache Pain, 2015. 16: p. 103.
  • 43. Tokmak, M., İstanbul Üniversitesi Diş Hekimliği Fakültesi Ortodonti Anabilim Dalına başvurmuş hastalarda servikal vertebra anomalilerinin incelenmesi. 2017.
  • 44. Punnett, L. and D.H. Wegman, Work-related musculoskeletal disorders: the epidemiologic evidence and the debate. J Electromyogr Kinesiol, 2004. 14(1): p. 13-23.

Servikal Vertebral Aks Düzleşmesi: Demografi ve Nedenler

Yıl 2022, Cilt: 11 Sayı: 2, 250 - 256, 31.08.2022

Adnan Demirel Burhan Adak

https://doi.org/10.47493/abantmedj.1133849
Cited By: 1

Öz

Amaç: Boyun baş ve gövdede yer alan hayati yapıları birleştiren önemli bir bölgedir. Servikal bölge ağrılarının önemli bir kısmını vertebral aks kaynaklı ağrılar oluşturur ve bel ağrılarından sonra en sık karşılaşılan kas-iskelet sorunudur. Servikal lordozdaki azalma ve kifoz gelişimi gibi sapmalar ağrı ve disabilite ile ilişkilidir. Servikal aks düzleşmesi çok sık rastlanılan bir durum olmakla birlikte nedenleri ile ilgili yeterli veri bulunmamaktadır. Bu çalışmanın amacı servikal lordoz düzleşmesi ile birlikte görülen ve ilişkili olabilecek hastalıkları araştırmaktır.
Gereç ve Yöntemler: Katılımcıların servikal radyografileri nötral pozisyonda alındı. Servikal aks açısı Cobb metodu ile C2-C7 arasından ölçüldü, buna ek olarak servikal manyetik rezonans görüntüleri değerlendirildi. Katılımcıların lokomotor sistem için bölgesel ayrıntılı fizik muayeneleri yapılarak, Beck Depresyon ve Beck Anksiyete Ölçekleri dolduruldu. Katılımcılara 3 ay sonra tekrar bölgesel ayrıntılı fizik muayene ve X-ray incelemesi yapıldı. Son servikal radyografilerde lordotik düzleşmenin devam ettiği olgular kronik süreçli olarak kabul edildi. Olgular akut ve kronik süreçli olmak üzere iki gruba ayrıldı.
Bulgular: Akut olguların %25’i fibromiyalji sendromu (FMS), %45’i gerilim tipi baş ağrısı (GTBA), %45’i servikal spondiloz (SS), %30’u servikal disk hernisi (SDH), %15’i miyofasiyal ağrı sendromu (MAS), %10’u anksiyete, %10’u depresyon tanısı aldı. Kronik süreçli olgularda ise %60’ı FMS, %45’i GTBA, %22,5’i SS, %55’i SDH, %17,5’i MAS, %30’u anksiyete, %7,5’u depresyon ve %20 migren tanısı aldı.
Sonuç: Servikal lordoz düzleşmeli olgularda mevcut durumun sebep mi yoksa sonuç mu olduğudunun değerlendirilmesi ve tedavinin atta yatan hastalığa göre belirlenmesinin daha uygun olacağını düşünmekteyiz.

Anahtar Kelimeler

Servikal Omurga Lordoz Radyografi

Kaynakça

  • 1. Cohen, S.P. Epidemiology, diagnosis, and treatment of neck pain. in Mayo Clinic Proceedings. 2015. Elsevier.
  • 2. Hoy, D.G., et al., The epidemiology of neck pain. Best Pract Res Clin Rheumatol, 2010. 24(6): p. 783-92.
  • 3. Scheer, J.K., et al., Cervical spine alignment, sagittal deformity, and clinical implications: a review. J Neurosurg Spine, 2013. 19(2): p. 141-59.
  • 4. Dwyer, A., C. Aprill, and N. Bogduk, Cervical zygapophyseal joint pain patterns. I: A study in normal volunteers. Spine (Phila Pa 1976), 1990. 15(6): p. 453-7.
  • 5. Alpayci, M. and S. Ilter, Isometric exercise for the cervical Extensors can help restore physiological lordosis and reduce neck pain: a randomized controlled trial. American journal of physical medicine & rehabilitation, 2017. 96(9): p. 621-626.
  • 6. Been, E., S. Shefi, and M. Soudack, Cervical lordosis: the effect of age and gender. Spine J, 2017. 17(6): p. 880-888.
  • 7. Budancamanak, M., et al., Protective effects of thymoquinone and methotrexate on the renal injury in collagen-induced arthritis. Arch Toxicol, 2006. 80(11): p. 768-76.
  • 8. Ferrara, L., The biomechanics of cervical spondylosis. Adv Orthop. 2012; 2012: 493605.
  • 9. Kaiser, J.A. and B.A. Holland, Imaging of the cervical spine. Spine (Phila Pa 1976), 1998. 23(24): p. 2701-12.
  • 10. McAllister, A.S., U. Nagaraj, and R. Radhakrishnan, Emergent Imaging of Pediatric Cervical Spine Trauma. Radiographics, 2019. 39(4): p. 1126-1142.
  • 11. Tins, B.J. and V.N. Cassar-Pullicino, Imaging of acute cervical spine injuries: review and outlook. Clin Radiol, 2004. 59(10): p. 865-80.
  • 12. Grob, D., H. Frauenfelder, and A. Mannion, The association between cervical spine curvature and neck pain. European Spine Journal, 2007. 16(5): p. 669-678.
  • 13. Cote, P., et al., Apophysial joint degeneration, disc degeneration, and sagittal curve of the cervical spine. Can they be measured reliably on radiographs? Spine, 1997. 22(8): p. 859-864.
  • 14. Gore, D.R., S.B. Sepic, and G.M. Gardner, Roentgenographic findings of the cervical spine in asymptomatic people. Spine (Phila Pa 1976), 1986. 11(6): p. 521-4.
  • 15. Harrison, D.D., et al., 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, 2004. 29(22): p. 2485-2492.
  • 16. Owens, E., Cervical curvature assessment using digitized radio-graphic analysis. Chiropr Res J, 1990. 4: p. 47-62.
  • 17. Helliwell, P., P. Evans, and V. Wright, The straight cervical spine: does it indicate muscle spasm? The Journal of bone and joint surgery. British volume, 1994. 76(1): p. 103-106.
  • 18. Boyle, J.J., N. Milne, and K.P. Singer, Influence of age on cervicothoracic spinal curvature: an ex vivo radiographic survey. Clin Biomech (Bristol, Avon), 2002. 17(5): p. 361-7.
  • 19. Gumina, S., et al., The relationship between chronic type III acromioclavicular joint dislocation and cervical spine pain. BMC Musculoskeletal Disorders, 2009. 10(1): p. 1-7.
  • 20. Bair, M.J. and E.E. Krebs, Fibromyalgia. Ann Intern Med, 2020. 172(5): p. ITC33-ITC48.
  • 21. Baykara, r.a., fibromyalji sendromunda kinezyofobi: obezite, ağri şiddeti, yüksek hastalik aktivitesi ilişkisi. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi. 24(1): p. 128-135.
  • 22. Cathcart, S., et al., Stress and tension-type headache mechanisms. Cephalalgia, 2010. 30(10): p. 1250-67.
  • 23. Crystal, S.C. and M.S. Robbins, Epidemiology of tension-type headache. Curr Pain Headache Rep, 2010. 14(6): p. 449-54.
  • 24. Kaynak Key, F.N., S. Donmez, and U. Tuzun, Epidemiological and clinical characteristics with psychosocial aspects of tension-type headache in Turkish college students. Cephalalgia, 2004. 24(8): p. 669-74.
  • 25. Cailliet, R., D. Ananthalkrishnan, and S. Burns, Neck pain: anatomy pathophysiology, and diagnosis, in Physical medicine and rehabilitation secrets. 2008, Elsevier Health Sciences Philadelphia. p. 319-322.
  • 26. Okada, E., et al., Does the sagittal alignment of the cervical spine have an impact on disk degeneration? Minimum 10-year follow-up of asymptomatic volunteers. European Spine Journal, 2009. 18(11): p. 1644-1651.
  • 27. Thoomes, E.J., et al., Lack of uniform diagnostic criteria for cervical radiculopathy in conservative intervention studies: a systematic review. Eur Spine J, 2012. 21(8): p. 1459-70.
  • 28. Plastaras, C.T. and A.B. Joshi, The electrodiagnostic evaluation of radiculopathy. Phys Med Rehabil Clin N Am, 2011. 22(1): p. 59-74.
  • 29. McAviney, J., et al., Determining the relationship between cervical lordosis and neck complaints. Journal of manipulative and physiological therapeutics, 2005. 28(3): p. 187-193.
  • 30. Borg-Stein, J. and D.G. Simons, Myofascial pain. Archives of physical medicine and rehabilitation, 2002. 83: p. S40-S47.
  • 31. Staud, R., Future perspectives: pathogenesis of chronic muscle pain. Best Pract Res Clin Rheumatol, 2007. 21(3): p. 581-96.
  • 32. Graff-Radford, S.B., et al., Effects of transcutaneous electrical nerve stimulation on myofascial pain and trigger point sensitivity. Pain, 1989. 37(1): p. 1-5.
  • 33. Cummings, T.M. and A.R. White, Needling therapies in the management of myofascial trigger point pain: a systematic review. Arch Phys Med Rehabil, 2001. 82(7): p. 986-92.
  • 34. Fishbain, D.A., et al., Male and female chronic pain patients categorized by DSM-III psychiatric diagnostic criteria. Pain, 1986. 26(2): p. 181-197.
  • 35. Küey, L., Birinci basamakta depresyon: tanıma, ele alma, yönlendirme. Psikiyatri Dünyası, 1998. 1: p. 5-12.
  • 36. Kayahan, B., et al., On beş-kırk dokuz yaşları arasındaki kadınlarda depresyon prevalansı ve depresyon şiddeti ile risk faktörleri arasındaki ilişki. Anadolu Psikiyatri Dergisi, 2003. 4(4): p. 208-219.
  • 37. Aydin, H. and L. Tamam, Anksiyöz depresyon: Bir depresyon alt grubu mu? Anadolu Psikiyatri Dergisi, 2005. 6(3): p. 177-187.
  • 38. Baykan, B., et al., Migraine incidence in 5 years: a population-based prospective longitudinal study in Turkey. J Headache Pain, 2015. 16(1): p. 103.
  • 39. Ertas, M., et al., One-year prevalence and the impact of migraine and tension-type headache in Turkey: a nationwide home-based study in adults. J Headache Pain, 2012. 13(2): p. 147-57.
  • 40. Manzoni, G.C. and L.J. Stovner, Epidemiology of headache. Handb Clin Neurol, 2010. 97: p. 3-22.
  • 41. Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia, 2018. 38(1): p. 1-211.
  • 42. Baykan, B., et al., Migraine incidence in 5 years: a population-based prospective longitudinal study in Turkey. J Headache Pain, 2015. 16: p. 103.
  • 43. Tokmak, M., İstanbul Üniversitesi Diş Hekimliği Fakültesi Ortodonti Anabilim Dalına başvurmuş hastalarda servikal vertebra anomalilerinin incelenmesi. 2017.
  • 44. Punnett, L. and D.H. Wegman, Work-related musculoskeletal disorders: the epidemiologic evidence and the debate. J Electromyogr Kinesiol, 2004. 14(1): p. 13-23.
Toplam 44 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Klinik Tıp Bilimleri
Bölüm Araştırma Makaleleri
Yazarlar

Adnan Demirel 0000-0002-2974-8560

Burhan Adak 0000-0001-9739-4242

Yayımlanma Tarihi 31 Ağustos 2022
Gönderilme Tarihi 21 Haziran 2022
Yayımlandığı Sayı Yıl 2022 Cilt: 11 Sayı: 2

Kaynak Göster

APA Demirel, A., & Adak, B. (2022). Servikal Vertebral Aks Düzleşmesi: Demografi ve Nedenler. Abant Medical Journal, 11(2), 250-256. https://doi.org/10.47493/abantmedj.1133849
AMA Demirel A, Adak B. Servikal Vertebral Aks Düzleşmesi: Demografi ve Nedenler. Abant Med J. Ağustos 2022;11(2):250-256. doi:10.47493/abantmedj.1133849
Chicago Demirel, Adnan, ve Burhan Adak. “Servikal Vertebral Aks Düzleşmesi: Demografi Ve Nedenler”. Abant Medical Journal 11, sy. 2 (Ağustos 2022): 250-56. https://doi.org/10.47493/abantmedj.1133849.
EndNote Demirel A, Adak B (01 Ağustos 2022) Servikal Vertebral Aks Düzleşmesi: Demografi ve Nedenler. Abant Medical Journal 11 2 250–256.
IEEE A. Demirel ve B. Adak, “Servikal Vertebral Aks Düzleşmesi: Demografi ve Nedenler”, Abant Med J, c. 11, sy. 2, ss. 250–256, 2022, doi: 10.47493/abantmedj.1133849.
ISNAD Demirel, Adnan - Adak, Burhan. “Servikal Vertebral Aks Düzleşmesi: Demografi Ve Nedenler”. Abant Medical Journal 11/2 (Ağustos 2022), 250-256. https://doi.org/10.47493/abantmedj.1133849.
JAMA Demirel A, Adak B. Servikal Vertebral Aks Düzleşmesi: Demografi ve Nedenler. Abant Med J. 2022;11:250–256.
MLA Demirel, Adnan ve Burhan Adak. “Servikal Vertebral Aks Düzleşmesi: Demografi Ve Nedenler”. Abant Medical Journal, c. 11, sy. 2, 2022, ss. 250-6, doi:10.47493/abantmedj.1133849.
Vancouver Demirel A, Adak B. Servikal Vertebral Aks Düzleşmesi: Demografi ve Nedenler. Abant Med J. 2022;11(2):250-6.

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