Fatma Nur BOY SOYLU, Feyza ÖZKAN ÜNLÜ, Selda ERDEM, Gülşah ÖZDEMİR, Duygu KÜLCÜ GELER, Pınar AKPINAR, İlknur AKTAŞ

Servikal lordoz açıları ve boyun ağrısı ilişkisinin değerlendirilmesi

Amaç: Kronik boyun ağrısında servikal lordozun Cobb, Tanjant ve efektif servikal lordoz yöntemlerinin değerlendirilmesi ve bu parametrelerin boyun ağrısı ile ilişkisinin araştırılması. Hastalar ve Yöntem: Bu çalışmada boyun ağrısı ile hastanemize başvuran 44 hasta değerlendirildi. Klinik muayenede VAS gündüz ve gece skorları ile sağ rotasyon, sol rotasyon, fleksiyon, ekstansiyon, sağ lateral fleksiyon ve sol lateral fleksiyon açıları not edildi. Hastaların lateral servikal grafilerinde Cobb and Tanjant açıları hesaplandı ve efektif lordoz varlığı değerlendirildi. İstatistiksel analizde bulguların korelasyonu Spearman testi ile değerlendirildi. Bulgular: Cobb ve Tanjant metodları arasında pozitif yönlü yüksek korelasyon bulundu (r=0,92, p<0,01).Cobb ve efektif lordoz metodları arasında orta düzeyli (r=0,60, p<0,01), Tanjant ile efektif lordoz metodları arasında ise yüksek düzeyli korelasyon saptandı (r=0,71, p<0,01). VAS skorları ile Cobb, Tanjant açıları ve efektif lordoz arasında istatistiksel olarak anlamlı ilişki bulunmadı. Sağ rotasyon, sol rotasyon, sağ lateral fleksiyon ve sol lateral fleksiyon açıları ile Cobb, Tanjant açıları ve efektif lordoz arasında istatistiksel olarak anlamlı ilişki bulunmadı. Sonuç: Tanjant metodunun efektif lordoz ile ilişkisinin Cobb metoduna göre daha yüksek olması ve ölçüm tekniğinin daha pratik olması nedeniyle, servikal lordoz ölçümünde Tanjant metodu kolaylıkla ve güvenilirlikle kullanılabilir. Araştırmamızda boyun ağrısı ile servikal lordoz açıları arasında anlamlı ilişki bulunmamıştır.

Anahtar Kelimeler:

Servikal lordoz, Cobb metodu, Direkt grafi, Efektif servical lordoz, Tanjant metodu

Evaluation of cervical lordosis and its relation to cervical pain

Objective: To evaluate cervical lordosis with Cobb, Tangent and effective cervical lordosis methods and the correlation of these parameters with chronic neck pain. Patients and Methods: Forty-four patients who applied to the outpatient clinic with the complaint of chronic neck pain were included. Neck pain was evaluated by visual analogue scale (VAS) and cervical rotation, flexion, extention, and right and left lateral flexion angles were noted. Cobb and Tangent angles were measured and effective lordosis was evaluated with lateral cervical roentgenogram. The correlation analysis was made with Spearman’s test. Results: High correlations were found between the Cobb and Tangent methods (r=0.92, p<0.01). The correlation between the Cobb and effective lordosis methods was moderate (r=0.60, p<0.01). High correlation was noted between the Tangent and effective lordosis methods (r=0.71, p<0.01). No correlation was found between the VAS scores and the Cobb, Tangent and effective lordosis methods. Also, no correlations were found between rotation, flexion, extension, right and left lateral flexions and the Cobb, Tangent and effective lordosis methods. Conclusion: Since the Tangent method is more practical than the Cobb method and has a higher correlation with effective lordosis, the Tangent method can be used to measure cervical lordosis easily and reliably. We found no correlation between neck pain and cervical lordosis.

Keywords:

Cervical lordosis, Cobb method, Direct graphy, Effective cervical lordosis, Tangent method,

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1. McAviney J, Schulz D, Bock R, Harrison DE, Holland B. Determining the relationship between cervical lordosis and neck complaints. J Manipulative Physiol Ther 2005;28:187-93.
2. Grob D, Frauenfelder H, Mannion AF. The association between cervical spine curvature and neck pain. Eur Spine J 2007;16: 669– 78. doi: 10.1007/s00586-006-0254-1
3. Helliwell PS, Evans PF, Wright V. The straight cervical spine: does it indicate muscle spasm? J Bone Joint Surg Br 1994;76:103-6.
4. Gore DR, Sepic SB, Gardner GM. Roentgenographic findings of the cervical spine in asymptomatic people. Spine 1986;11:521–4.
5. Harrison DD, Janik TJ, Troyanovich SJ, Holland B. Comparisons of lordotic cervical spine curvatures to a theoretical ideal model of the static sagittal cervical spine. Spine 1996;21:667–75.
6. Cobb JR. Outlines for the study of scoliosis. Instructional Course Lectures. Vol 5. Ann Arbor, Michigan: American Academy of Orthopedic Surgeons, 1948: 261- 75.
7. Harrison DE, Harrison DD, Cailliet R, Troyanovich SJ, Janik TJ, Holland B. Cobb method of Harrison posterior tangent method: which to choose for lateral cervical radiographic analysis. Spine 2000;25:2072–8.
8. Gwinn DE, Iannotti CA, Benzel EC, Steinmetz MP. Effective lordosis: analysis of sagittal spinal canal alignment in cervical spondylotic myelopathy. J Neurosurg Spine 2009; 11:667-72. doi: 10.3171/ 2009.7.SPINE08656
9. Kumagai G, Ono A, Numasawa T, et al. Association between roentgenographic findings of the cervical spine and neck symptoms in a Japanese community population. J Orthop Sci 2014; J Orthop Sci 2014; 19:390-7. doi: 10.1007/s00776-014-0549-8
10. Harrison DD, Harrison DE, Janik TJ, 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; 29:2485–92. doi:10.1097/01.brs.0000144449.90741.7c
11. Harrison DE, Jones EW, Janik TJ, Harrison DD. Evaluation of axial and flexural stresses in the vertebral body cortex and trabecular bone in lordosis and two sagittal cervical translation configurations with an elliptical shell model. J Manipulative Physiol Ther 2002; 25:391–401.
12. Harrison DE, Harrison DD, Janik TJ, William Jones E, Cailliet R, Normand M Comparison of axial and flexural stresses in lordosis and three buckled configurations of the cervical spine. Clin Biomech 2001; 16:276–84.
13. Gay RE. The curve of the cervical spine: variations and significance. J Manipulative Physiol Ther 1993; 16:591–4.