Is the Sagittal Configuration of the Cervical Spine Changed in Women with Chronic Whiplash Syndrome? A Comparative Computer-assisted Radiographic Assessment

This section is compiled by Frank M. Painter, D.C.
Send all comments or additions to:   Frankp@chiro.org

FROM:   J Manipulative Physiol Ther 2002 (Nov);   25 (9):   550–555

Kristjansson E, Jonsson H Jr

PhD candidate in Health Science at the Faculty of Medicine, University of Iceland, Reykjavik, Iceland., Chief Orthopaedic Surgeon at Landspitalinn, University Hospital, Reykjavik, Iceland.

SEE ALSO: Sagittal Alignment of Cervical Flexion and Extension: Lateral Radiographic Analysis

OBJECTIVE:   To reveal whether women with chronic whiplash-associated disorder (WAD) symptoms, grade I-II, demonstrate regional and/or segmental radiographic signs of altered cervical lordosis.

DESIGN:   Case-control study.

SETTING:   Radiography department at a university hospital.

PARTICIPANTS:   Three age-balanced groups comprising 120 women. The case group included women with chronic whiplash syndrome (n = 41), and the control group included women with chronic insidious onset neck pain (n = 39) and an asymptomatic group (n = 40), who were given baseline data. The sample was referred from informed doctors and physiotherapists.

INTERVENTION:   The women sat in a standardized sitting position and radiographs were taken in a lateral position with fluoroscopic control for alignment.

OUTCOME MEASURES:   Two distinct measurements were taken; 1 of the angles of the upper and lower cervical curvatures, respectively, and 1 of the angles between the inferior borders of each pair of vertebrae in the lower cervical spine. The 3 groups were compared on the ratio of the lower to upper cervical spine angles and on the mean angular values for each segment in the cervical spine.

RESULTS:   The whiplash group showed a decreased ratio between the lower versus upper cervical spine but comparisons between groups were not statistically significant. The whiplash group was in a significantly more flexed position at the C4-C5 level compared with the asymptomatic group (P =.007). The reliability measures have to be strengthened to render these results definitely conclusive.

CONCLUSION:   The whiplash group exhibited a different configuration of cervical lordosis. This is clinically important and needs to be studied more closely.

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