An investigation of 3D spinal alignment in cervicogenic headache

Musculoskelet Sci Pract. 2021 Feb;51:102284. doi: 10.1016/j.msksp.2020.102284. Epub 2020 Nov 2.


Background: There is a growing interest in the impact of body posture influences on outcome measures of cervicogenic headache (CGH).

Objective: To evaluate differences in the 3D spinal alignment in cases suffering from chronic CGH compared to a group of strictly matched control participants without CGH.

Design: A single-blinded, comparative cohort design.

Methods: 100 participants suffering from frequent headaches for at least 3 months who fulfilled the CHISG criteria for CGH were match by age and sex to 100 asymptomatic control group participants. A 4D Formetric device was used to assess participants' posture variables of: 1) thoracic kyphosis max (ICT-ITL in degrees); 2) trunk lateral imbalance (VP-DM in mm); 3) Trunk anterior inclination (VP-DM in mm); 4) lumbar lordotic angle (ITL-ILS max in degrees); 5) Vertebral rotation (rms) in degrees. A matched-pairs binary logistic regression was used to determine whether measurements of posture demonstrated an association with the likelihood of the presence of CGH.

Results: There were statistically significant differences between the CGH and control group for all posture variables indicating larger posture displacements in the CGH group: ICT-ITL (p < .001), Lateral VP-DM (p < .001), Sagittal VP-DM (p < .001), ITL-ILS (p < .001), RMS (p < .001). Logistic regression revealed that as posture displacement increased, a statistically significant increased likelihood of having CGH occurred: (ICT-ITL (max) (p < .001); Trunk imbalance VP-DM (p < .004); Trunk inclination VP-DM (p < .001); and vertebral rotation (RMS) (p = .007). No such relationship was found for Lumbar Lordosis ITL-ILS max.

Conclusions: Participants with CGH exhibited increased magnitudes of thoracolumbar posture displacements which corresponded to an increased odds of suffering from CGH compared to matched control participants.

Keywords: Cervicogenic; Headache; Posture.

MeSH terms

  • Case-Control Studies
  • Humans
  • Kyphosis*
  • Lordosis*
  • Post-Traumatic Headache*
  • Posture
  • Spine