Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
, 13 (1), 147

Cervical Lordosis in Asymptomatic Individuals: A Meta-Analysis

Affiliations
Meta-Analysis

Cervical Lordosis in Asymptomatic Individuals: A Meta-Analysis

Guang-Ming Guo et al. J Orthop Surg Res.

Abstract

Background: Cervical lordosis has important clinical and surgical implications. Cervical spine curvature is reported with considerable variability in individual studies. The aim of this study was to examine the existence and extent of cervical lordosis in asymptomatic individuals and to evaluate its relationship with age and gender.

Methods: A comprehensive literature search was conducted in several electronic databases. Study selection was based on pre-determined eligibility criteria. Random effects meta-analyses were performed to estimate the proportion of asymptomatic individuals with lordosis and the effect size of cervical lordotic curvature in these individuals which followed metaregression analysis to examine the factors affecting cervical lordosis. Data from 21 studies (15,364 asymptomatic individuals, age 42.30 years [95% confidence interval 36.42, 48.18], 54.2% males) were used in the present study.

Results: In this population, 63.99% [95% confidence interval 44.94, 83.03] individuals possessed lordotic curvature. Degree of lordotic curvature differed by method of measurement; 12.71° [6.59, 18.84] with Cobb C2-C7 method and 18.55° [14.48, 22.63] with posterior tangent method. Lordotic curvature was not significantly different between symptomatic and asymptomatic individuals but was significantly higher in males in comparison with females. Age was not significantly associated with lordotic cervical curvature.

Conclusion: Majority of the asymptomatic individuals possesses lordotic cervical curvature which is higher in males than in females but have no relationship with age or symptoms.

Keywords: Age; Asymptomatic; Cervical spine; Gender; Lordosis.

Conflict of interest statement

Ethics approval and consent to participate

Not applicable.

Competing interests

All authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
A flowchart of study screening and selection process
Fig. 2
Fig. 2
A forest graph showing the percentage of asymptomatic individuals with lordotic cervical curvature and the overall effect size
Fig. 3
Fig. 3
A forest graph showing the cervical lordotic angles reported by individual studies and the overall effect size as well as the effect sizes of two methods used to measure the cervical curvature
Fig. 4
Fig. 4
A forest graph showing no significant difference between symptomatic and asymptomatic individuals in the cervical lordotic angles
Fig. 5
Fig. 5
A forest graph showing a significant difference in the cervical lordotic angles between male and female asymptomatic individuals
Fig. 6
Fig. 6
A metaregression scatterplot showing the relationship between age and the percentage of individuals with lordotic curvature in cervical spine

Similar articles

See all similar articles

Cited by 2 articles

References

    1. Been E, Shefi S, Soudack M. Cervical lordosis: the effect of age and gender. Spine J. 2017;17(6):880–888. doi: 10.1016/j.spinee.2017.02.007. - DOI - PubMed
    1. Kawakami M, Tamaki T, Yoshida M, Hayashi N, Ando M, Yamada H. Axial symptoms and cervical alignments after cervical anterior spinal fusion for patients with cervical myelopathy. J Spinal Disord. 1999;12:50–56. doi: 10.1097/00002517-199902000-00008. - DOI - PubMed
    1. Nightingale RW, McElhaney JH, Richardson WJ, Best TM, Myers BS. Experimental impact injury to the cervical spine: relating motion of the head and the mechanism of injury. J Bone Joint Surg Am. 1996;78:412–421. doi: 10.2106/00004623-199603000-00013. - DOI - PubMed
    1. Baba H, Uchida K, Maezawa Y, Furusawa N, Azuchi M, Imura S. Lordotic alignment and posterior migration of the spinal cord following en bloc open-door laminoplasty for cervical myelopathy: a magnetic resonance imaging study. J Neurol. 1996;85:626–632. doi: 10.1007/BF00878657. - DOI - PubMed
    1. Swank ML, Sutterlin CE, Bossons CR, Dials BE. Rigid internal fixation with lateral mass plates in multilevel anterior and posterior reconstruction of the cervical spine. Spine. 1997;22:274–282. doi: 10.1097/00007632-199702010-00009. - DOI - PubMed

Publication types

Feedback