ANALYSIS OF CERVICAL SAGITTAL BALANCE IN PATIENTS NECK PAIN AND NO NECK PAIN

Lima, Vania Maria; Reis, Marcio Cley Fernandes dos; Olivares, Nilson Mozas; Toller, Guilherme Reiff; Castro, Daniel Jose Mazzo Bedran de; Madrid, Orlando Rafael de Andrade

doi:10.1590/S1808-185120222202265303

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Original Article, Degenerative • Coluna/Columna 22 (2) • 2023 • https://doi.org/10.1590/S1808-185120222202265303 copy

ANALYSIS OF CERVICAL SAGITTAL BALANCE IN PATIENTS NECK PAIN AND NO NECK PAIN

ANÁLISE DO EQUILÍBRIO SAGITAL CERVICAL EM PACIENTES COM E SEM CERVICALGIA

ANÁLISIS DEL EQUILIBRIO SAGITAL CERVICAL EN PACIENTES CON Y SIN CERVICALGIA

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Introduction:

Sagittal balance was measured by Hardacker`s et al. using the occipital method COBB C1-C2, C2-C3, C3-C4, C4-C5, C5-C6, C6-C7 in a sample of asymptomatic patients without neck and shoulder pain. In other recent studies, measurements of cervical sagittal balance included several radiographic parameters.

Objective:

To compare the cervical sagittal balance in groups of patients with and without neck pain submitted to cervical radiography with the upper limbs in flexion.

Methods:

This is a cross-sectional, quantitative, prospective, descriptive study with radiographic analysis of 50 adults aged between 30 to 70 years old. The group was divided into Group 1: without neck pain, and Group 2: with neck pain. All answered a questionnaire about age and the presence or absence of neck pain. Exclusion criteria were: inadequate X-Ray image, deformity or previous spine surgery, limited shoulder mobility, and individuals younger than 30 and older than 70. The radiographic parameters evaluated were: COBB, TIA ( THORACIC INLET ANGLE), T1 SLOPE, NECKTILT, and COG-C7 with no neck pain. α = 5% (significance when p <0.05).

Results:

The MANN WHITNEY nonparametric test showed no significant differences between Cobb GROUPS (p= 0.7452), T1 SLOPE GROUPS (p=0.1410), NECKTILT GROUPS (p=0.0852) and GROUPS THORACIC INLET ANGLE (p=0.1789).

Conclusion:

There was a significant difference only between COG-C7 GROUPS (cm) (p=0.0013). The analysis of the obtained data showed statistical significance in the variation in the COG-C7 groups.

Level of Evidence II; Prospective comparative study.

Keywords:
Postural balance; Radiography; Neck pain

		Mean ± SD.		Minimum Value		Q1		Median		Q3		Maximum Value
Variable	n	No neck pain	Neck pain	No neck pain	Neck pain	No neck pain	Neck pain	No neck pain	Neck pain	No neck pain	Neck pain	No neck pain	Neck pain	p
COBB (cm)	25	35,44±4,5	34,88±4,9	30	22	32	32	34	34	40	40	42	40	0,7452
COG C0-C7 (cm)	25	11,28±0,9	10,52±0,7	9	9	11	10	11	10	12	11	12	11,5	0,0013*
Neck tilt (cm)	25	39,4±3,3	40,88±3,1	32	32	38	39	40	40	42	43	46	48	0,0852
Thoracic Inlet Angle	25	78,24±6	76,72±4,4	65	70	75	72	80	76	82	81	88	84	0,1789
T1 Slope	25	20,8±2,2	22,24±2,9	16	18	19	20	22	22	22	24	24	28	0,1410

Variable	Total Count	Mean	St Dey	Minimum	Q1	Median	Q3	Maximum
COBB	25	35,440	491	30,000	32,000	34,000	40,000	42,000
COG-C7 (cm)	25	11,280	0,879	9,000	11,000	11,000	12,000	12,500
Necktilt	25	39,400	3,291	32,000	38,000	40,000	42,000	46,000
Thoracic Inlet Angle	25	78,24	5,99	65,00	75,00	80,00	82,00	88,00
T1 Slope	25	20,800	2,236	16,000	19,000	22,000	22,000	24,000

Variable	Total Count	Mean	St Dey	Minimum	Q1	Median	Q3	Maximum
COBB	25	34,880	4,868	22,000	32,000	34,000	40,000	40,000
COG-C7 (cm)	25	10,520	0,653	9,000	10,000	10,500	11,000	11,500
Necktilt	25	40,880	3,113	32,000	39,000	40,000	43,000	48,000
Thoracic Inlet Angle	25	76,720	4,430	70,000	72,000	76,000	81,000	84,000
T1 Slope	25	22,240	2,905	18,000	20,000	22,000	24,000	28,000

Patients	COBB	COG-C7	Necktilt T	Thoracic Inlet Angle	T1 Slope
1	32	10,5 cm	38	72	18
2	22	9.5 cm	40	74	20
3	32	10,5 cm	38	82	22
4	40	10 cm	40	82	20
5	40	11,5 cm	42	84	22
6	40	10,5 cm	44	72	24
7	38	9 cm	38	72	20
8	34	11 cm	38	78	28
9	32	11 cm	38	80	20
10	40	11,5 cm	32	72	22
11	40	11 cm	40	76	28
12	40	11 cm	44	78	28
13	34	10 cm	48	84	24
14	32	11,5 cm	40	72	24
15	30	10,5 cm	42	72	20
16	40	10,5 cm	44	76	20
17	38	10,5 cm	42	80	22
18	40	11 cm	42	82	20
19	38	11 cm	44	76	22
20	34	10 cm	44	72	22
21	32	10,5 cm	40	76	24
22	28	10 cm	42	70	20
23	36	10 cm	40	82	18
24	30	9.5 cm	40	80	22
25	30	11 cm	42	74	26

Patients	COBB	COG-C7	Necktilt T	Thoracic Inlet Angle	T1 Slope
1	30	9 cm	32	88	24
2	32	11 cm	36	68	18
3	34	11,5 cm	38	74	24
4	40	10 cm	44	80	20
5	34	10 cm	46	83	20
6	40	10,5 cm	40	65	24
7	30	11 cm	34	82	22
8	42	10,5 cm	38	76	24
9	32	11 cm	40	78	22
10	42	12 cm	44	84	22
11	34	12,5 cm	40	82	20
12	32	12,5 cm	36	84	22
13	36	11 cm	40	82	22
14	42	12,5 cm	42	78	22
15	34	12 cm	38	82	18
16	38	11 cm	44	82	22
17	30	12 cm	38	72	18
18	40	11 cm	39	82	18
19	40	12 cm	42	82	22
20	42	11 cm	38	68	22
21	38	12 cm	40	78	16
22	30	12 cm	42	76	20
23	32	12 cm	36	68	18
24	32	11 cm	38	82	20
25	30	11 cm	40	80	20

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E-mail: coluna.columna@uol.com.br

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[1] Correspondence: Vania Maria Lima. 1745, Ave. Paulista. Conj. 1213, São Paulo, SP, Brazil. 01311-200. colunavania@gmail.com.