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
All authors declare that they have no competing interests.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Cervical lordosis: the effect of age and gender.Spine J. 2017 Jun;17(6):880-888. doi: 10.1016/j.spinee.2017.02.007. Epub 2017 Feb 27. Spine J. 2017. PMID: 28254673
Is more lordosis associated with improved outcomes in cervical laminectomy and fusion when baseline alignment is lordotic?Spine J. 2016 Aug;16(8):982-8. doi: 10.1016/j.spinee.2016.04.009. Epub 2016 Apr 11. Spine J. 2016. PMID: 27080410
Relationship between T1 slope and loss of lordosis after laminoplasty in patients with cervical ossification of the posterior longitudinal ligament.Spine J. 2016 Feb;16(2):219-25. doi: 10.1016/j.spinee.2015.10.042. Epub 2015 Oct 30. Spine J. 2016. PMID: 26523967
Which parameters are relevant in sagittal balance analysis of the cervical spine? A literature review.Eur Spine J. 2018 Feb;27(Suppl 1):8-15. doi: 10.1007/s00586-018-5462-y. Epub 2018 Jan 13. Eur Spine J. 2018. PMID: 29332239 Review.
[Measurement and clinical significance of cervical lordosis].Zhongguo Gu Shang. 2014 Dec;27(12):1062-4. Zhongguo Gu Shang. 2014. PMID: 25638900 Review. Chinese.
Cited by 2 articles
Differences of Spinal Curvature, Thoracic Mobility, and Respiratory Strength Between Chronic Neck Pain Patients and People Without Cervical Pain.Ann Rehabil Med. 2020 Feb;44(1):58-68. doi: 10.5535/arm.2020.44.1.58. Epub 2020 Feb 29. Ann Rehabil Med. 2020. PMID: 32130839 Free PMC article.
Correlation between cervical lordosis and cervical disc herniation in young patients with neck pain.Medicine (Baltimore). 2019 Aug;98(31):e16545. doi: 10.1097/MD.0000000000016545. Medicine (Baltimore). 2019. PMID: 31374017 Free PMC article.