Abstract
BackgroundCervical 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.MethodsA 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.ResultsIn 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.ConclusionMajority of the asymptomatic individuals possesses lordotic cervical curvature which is higher in males than in females but have no relationship with age or symptoms.
Highlights
Cervical lordosis has important clinical and surgical implications
In the meta-regression analyses, age was not significantly associated with lordotic cervical curvature but was significantly associated with the percentage of individuals with lordotic cervical curvature. This meta-analytical review finds that most asymptomatic individuals possess lordotic cervical curvature which averages at about 18° when measured with C2–C7 posterior tangent method
Cobb C2–C7 method may underestimate as we have found that use of this method led to an average of about 13° of lordotic cervical angle
Summary
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. Curvature of the cervical spine has important clinical implications [2, 3]. Attainment of moderate cervical lordotic curvature is found to be associated with better surgical outcomes in patients with neurologic deficits [4,5,6]. Reattainment of cervical lordosis after a surgical intervention is considered important as compression of nervous tissue may cause injury otherwise [7]. Cervical spine in asymptomatic individuals generally attains lordotic alignment but up to 35% of cases exhibit kyphosis [10]. Cervical spine distributes the compressive load differently as compared with the rest of the spine; 36% of the compressive load is absorbed by the anterior column and 64% by the posterior facet joints [13, 14]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
