Abstract
Patients diagnosed with traumatic or non-traumatic spinal pain and idiopathic scoliosis frequently suffer from imbalance. The evaluation of the perception of verticality by means of visual tests emerges as a quick and easy tool for clinical management of the balance disorders. Several studies have assessed the visual perception of verticality in spinal diseases obtaining controversial results. The aim of our study is to analyze the perception of visual verticality in subjects with several spinal diseases in comparison with healthy subjects. A meta-analysis was carried out. PubMed MEDLINE, Scopus, WoS, CINAHL, and SciELO databases were searched until January 2020. The standardized mean difference (SMD) was calculated to analyze differences between patients and healthy controls. Fifteen studies with a total of 2052 patients were included. In comparison with healthy subjects, a misperception of verticality was found in patients with spinal pain when the perception of the verticality was assessed with the rod and frame test (SMD = 0.339; 95% confidence interval (CI) = 0.181, 0.497; p < 0.001). It seems that the perception of visual verticality is not altered in patients with idiopathic scoliosis (p = 0.294). The present meta-analysis shows a misperception of visual verticality only in patients with spinal pain.
Highlights
Spinal diseases include pathologies of the neck, thorax, and the lumbosacral area of the spine [1,2]
Based on the search criteria, 137 references were retrieved from the different databases and 4 additional records were identified in the lists of references of other articles
We suggest that the misperception of visual verticality and related balance disorders observed in patients with neck pain mainly derived from the cervico-ocular pathways alteration, but not from cervico-vestibular impairments
Summary
Spinal diseases include pathologies of the neck, thorax, and the lumbosacral area of the spine [1,2]. The last Global Burden of Disease Study reported that pain related to spinal diseases is the main cause of disability [6,7], work absenteeism [8], and socioeconomic burden worldwide [9]. In the United States, the economic burden of spinal diseases was 87.6 billion dollars in 2013, one of the highest after diabetes, stroke, and ischemic heart disease [12]. For these reasons, it is of paramount importance to establish effective and accessible treatments to promote health and reduce the negative consequences of spinal diseases [13,14]
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