A cross-sectional study correlating cervical radiographic degenerative findings to pain and disability.

Abstract

A cross-sectional design was used to correlate cervical radiographic findings of spinal degeneration to neck pain and disability. The results were correlated to assess the clinical importance of radiographic spinal degeneration. Past investigations suggest little association between clinical findings and radiographic evidence of spinal degeneration. However, changes in activities of daily living and chronicity of complaint have not been investigated. Over a 5-month period, data were collected on 700 consecutive patients referred for cervical radiographic examination as part of their clinical evaluation. While in the radiology department, all subjects completed a visual analog pain scale, neck disability index, and short questionnaire, all of which quantified various aspects of any neck complaint. Relationships between indices of patient complaint and the number of cervical degenerative intervertebral discs were evluated using regression analysis. A significant relationship (P < 0.001) was noted between the number of levels of intervertebral disc degeneration and the chronicity of cervical complaint. No significant relationship was found between cervical degeneration and past trauma (P = 0.904) or gender (P = 0.213). Multiple-regression analysis of visual analog pain scale scores revealed a significant two-way interaction with chronicity and past trauma (P = 0.007) and a significant main effect with gender (P < 0.001). Cervical degeneration was not significant as a main effect or interaction with other factors. Multiple-regression analysis of neck disability index scores demonstrated a significant three-way interaction of chronicity, degeneration, and gender (P = 0.022) and a significant two-way interaction for chronicity and trauma (P = 0.025). No additional information was gathered by multivariate multiple-regression techniques. Increasing levels of spinal degeneration are related to increasing chronicity of patient complaints. Spinal degeneration is not related to past trauma or gender. Women, but not men, report higher disability with increasing levels of degeneration. Subjects with past trauma reported more intense pain and disability. Overall, men reported less neck pain and disability than women.