Sagittal Balance
A Normal Sagittal Spinal Configuration: A Desirable Clinical Outcome
PUBLISHED: J Manipulative Physiol Ther. 1996 Jul-Aug;19(6):398-405. Pub Med: https://www.ncbi.nlm.nih.gov/pubmed/8864971
AUTHORS: Harrison DD, Troyanovich SJ, Harrison DE, Janik TJ, Murphy DJ.
CONCLUSION: The usual, typical or normal configuration of the cervical spine in the sagittal dimension is a lordosis with a range of 16.5-66 degrees when measured as tangent lines along the cervical curve of the posterior vertebral body margins of C2 and C7.
An analysis of stresses and strains supports this claim, as do studies from the scientific literature that attempt to measure and classify average cervical configuration from large population bases.
The use of normative data as a gauge against which to measure patients’ structural health and as an outcome of the degree of success or failure of chiropractic interventions seem to be logical consequences of these findings.
Increase in Cerebral Blood Flow indicated by increased Cerebral Arterial area and pixel intensity on brain magnetic resonance angiogram following correction of Cervical Lordosis.
PUBLISHED: Brain Circ. 2019 Jan-Mar;5(1):19-26. doi: 10.4103/bc.bc_25_18. Epub 2019 Mar 27. Pub Med: https://www.ncbi.nlm.nih.gov/pubmed/31001596
AUTHORS: Katz EA1, Katz SB1, Fedorchuk CA2, Lightstone DF2, Banach CJ1, Podoll JD3.
RESULTS: Pixel intensity increased 23.0%-225.9%, and a Student’s t-test determined that the increase was significant (P < 0.001). Regression analysis of the change in pixel intensity versus the cervical lordosis showed that as the deviation from a normal cervical lordosis increases, percentage change in pixel intensity on MRA decreases.
CONCLUSION: These results indicate that correction of cervical lordosis may be associated with an immediate increase in cerebral blood flow.
Cervical Spine Sagittal Alignment and clinical outcome after Anterior Cervical Discectomy and Fusion
PUBLISHED: Am J Orthop (Belle Mead NJ). 2012 Jun;41(6):E81-4. Referenced Pub Med: https://www.ncbi.nlm.nih.gov/pubmed/22837996
AUTHORS: Gum JL1, Glassman SD, Douglas LR, Carreon LY.
RESULTS: Receiver operating characteristic curve analysis showed that a postoperative cervical lordosis of at least 6° predicted achievement of MCID for NDI (8 point change in NDI).
This suggests that maintenance or restoration of overall cervical lordosis is important in achieving a successful result after Anterior Cervical Discectomy and Fusion (ACDF).
