Sagittal alignment of the cervical spine after neck injury

Eur J Orthop Surg Traumatol. 2013 Jul;23 Suppl 1:S47-51. doi: 10.1007/s00590-012-0966-3. Epub 2012 Mar 10.


The normal sagittal alignment of the cervical spine is lordotic and is affected by the posture of the head and neck. The question of whether loss of cervical lordosis is the result of muscle spasm after injury or a normal variation, and the clinical significance of such changes in sagittal profile of the cervical spine has been an issue of several studies. The purpose of this paper is to study the incidence of normal cervical lordosis and its changes after neck injury compared to the healthy population. We studied the lateral radiographs of the cervical spine of 60 patients with neck injury compared to 100 patients without a neck injury. Lateral radiographs were obtained in the standing or sitting position, and the curvature of the cervical spine was measured using the angle formed between the inferior end plates of the C2 and C7 vertebrae. In the patients without neck injury, lordotic and straight cervical spine sagittal alignment was observed in 36.5% each, double curvature in 17%, and kyphotic in 10%. In the patients with neck injury, lordotic sagittal alignment was observed in 36%, straight in 34%, double curvature in 26% and kyphotic in 4%. No significant difference between the two groups regarding all types of sagittal alignment of the cervical spine was found (p > 0.100). The alterations in normal cervical lordosis in patients with neck injury must be considered coincidental. These alterations should not be associated with muscle spasm caused by neck pain.

MeSH terms

  • Adult
  • Arthrometry, Articular
  • Cervical Vertebrae / anatomy & histology
  • Cervical Vertebrae / injuries*
  • Cervical Vertebrae / pathology
  • Female
  • Greece
  • Humans
  • Male
  • Neck Injuries* / complications
  • Neck Injuries* / diagnostic imaging
  • Neck Injuries* / physiopathology
  • Neck Pain / etiology
  • Outcome Assessment, Health Care
  • Patient Positioning
  • Radiography
  • Retrospective Studies
  • Spasm / etiology
  • Spinal Curvatures* / diagnostic imaging
  • Spinal Curvatures* / etiology
  • Spinal Curvatures* / physiopathology