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Does cervical lordosis change after spinal manipulation for non-specific neck pain? A prospective cohort study

Overview of attention for article published in Chiropractic & Manual Therapies, December 2015
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Title
Does cervical lordosis change after spinal manipulation for non-specific neck pain? A prospective cohort study
Published in
Chiropractic & Manual Therapies, December 2015
DOI 10.1186/s12998-015-0078-3
Pubmed ID
Authors

Michael Shilton, Jonathan Branney, Bas Penning de Vries, Alan C. Breen

Abstract

The association between cervical lordosis (sagittal alignment) and neck pain is controversial. Further, it is unclear whether spinal manipulative therapy can change cervical lordosis. This study aimed to determine whether cervical lordosis changes after a course of spinal manipulation for non-specific neck pain. Posterior tangents of C2 and C6 were drawn on the lateral cervical fluoroscopic images of 29 patients with subacute/chronic non-specific neck pain and 30 healthy volunteers matched for age and gender, recruited August 2011 to April 2013. The resultant angle was measured using 'Image J' digital geometric software. The intra-observer repeatability (measurement error and reliability) and intra-subject repeatability (minimum detectable change (MDC) over 4 weeks) were determined in healthy volunteers. A comparison of cervical lordosis was made between patients and healthy volunteers at baseline. Change in lordosis between baseline and 4-week follow-up was determined in patients receiving spinal manipulation. Intra-observer measurement error for cervical lordosis was acceptable (SEM 3.6°) and reliability was substantial ICC 0.98, 95 % CI 0.962-0991). The intra-subject MDC however, was large (13.5°). There was no significant difference between lordotic angles in patients and healthy volunteers (p = 0.16). The mean cervical lordotic increase over 4 weeks in patients was 2.1° (9.2) which was not significant (p = 0.12). This study found no difference in cervical lordosis (sagittal alignment) between patients with mild non-specific neck pain and matched healthy volunteers. Furthermore, there was no significant change in cervical lordosis in patients after 4 weeks of cervical spinal manipulation.

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Geographical breakdown

Country Count As %
Denmark 1 1%
Australia 1 1%
Unknown 66 97%

Demographic breakdown

Readers by professional status Count As %
Other 12 18%
Student > Master 9 13%
Student > Postgraduate 8 12%
Student > Doctoral Student 8 12%
Researcher 6 9%
Other 13 19%
Unknown 12 18%
Readers by discipline Count As %
Medicine and Dentistry 27 40%
Nursing and Health Professions 13 19%
Sports and Recreations 4 6%
Engineering 4 6%
Agricultural and Biological Sciences 3 4%
Other 5 7%
Unknown 12 18%