Cervical spine geometry correlated to cervical degenerative disease in a symptomatic group

Abstract

Objective To investigate whether a statistical correlation exists between lateral cervical geometry and cervical pathology, as identified on neutral anteroposterior (AP) and lateral radiographs within a symptomatic group; describe the cervical pathology and determine its location and frequency; and identify the subject’s age, sex, and chief complaint. Setting Department of radiology at a chiropractic college. Methods One hundred eighty-six consecutive pairs of AP and lateral cervical radiographs were reviewed for pathology. A 5-category severity scale was used to describe degenerative joint disease, the most common pathological finding. The subject’s age, sex, and symptoms were recorded. Geometric analysis was focused on vertebral position, alignment, and gravitational loading acquired from the neutral lateral cervical radiograph. Results Regression and discriminant analysis identified 5 geometric variables that correctly classified pathology subjects from nonpathology subjects 79% of the time. Those variables were: (1) forward flexion angle of the lower cervical curve; (2) gravitational loading on the C5 superior vertebral end plate; (3) horizontal angle of C2 measured from its inferior vertebral end plate; (4) disk angle of C3; and (5) posterior disk height of C5. Degenerative joint disease was the most common pathological finding identified within discrete age, sex, and symptom groups. Conclusion We identified 5 geometric variables from the lateral cervical spine that were predictive 79% of the time for cervical degenerative joint disease. There were discrete age, sex, and symptom groups, which demonstrated an increased incidence of degenerative joint disease.