Glossary: “lordosis” - the normal curvature of the neck and low back, ideally 40o
“cervicogenic” - coming from the neck (“cervical”) “kyphosis” - the normal curve of the midback, ideally 37o
“hyperkyphosis” - abnormal mid-back curvature, too much thoracic spine curve with resultant forward head posture
“sagittal” - referring to the body when viewed from the side “SMT” - spinal manual therapy, chiropractic spinal corrections
PAPERS: 1. Determining the relationship between cervical lordosis and neck complaints.
McAviney J, et al. JMPT 2005 Mar-Apr;28(3):187-93
“RESULTS: Patients with lordosis of 20 degrees or less were more likely to have cervicogenic symptoms. The association between cervical pain and lordosis of 0 de- grees or less was significant. The odds that a patient with cervical pain had a lordo- sis of 0 degrees or less was 18 times greater than for a patient with a noncervical complaint. Patients with cervical pain had less lordosis.”
2. Prediction of osteoporotic spinal deformity.
Keller TS et al Spine 2003 Mar 1;28(5):455-62.
“CONCLUSIONS: These predictions suggest that postural forces are responsible for initiation of osteoporotic spinal deformity in elderly subjects. Vertebral deformities are exacerbated by anterior translation of the upper spinal column, which increases compressive loads in the thoracolumbar region of the spine.”
In essence: The results suggest that an increase in the upper back curve is responsible for the initiation of osteoporotic spinal deformity in elderly subjects.
3. Hyperkyphotic posture and risk of future osteoporotic fractures: the Rancho Bernardo study. Huang et al J Bone Miner Res. 2006 Mar;21(3):419-23. Epub 2005 Dec 5.
“(The) findings suggest that hyperkyphotic posture itself may be an important risk fac- tor for future fractures, independent of low bone mass density or fracture history.”
4. The impact of positive sagittal balance in adult spinal deformity. Glassman et al Spine. 2005 Sep 15;30(18):2024-9.
“RESULTS: All measures of health status showed significantly poorer scores as C7 plumb line deviation increased. Patients with relative kyphosis in the lumbar region had significantly more disability than patients with normal or lordotic lumbar sagittal Cobb measures.”
“CONCLUSIONS: This study shows that although even mildly positive sagittal bal- ance is somewhat detrimental, severity of symptoms increases in a linear fashion with progressive sagittal imbalance. The results also show that kyphosis is more fa- vorable in the upper thoracic region but very poorly tolerated in the lumbar spine.”
In essence: The results show that an increase in the upper back curve or loss of lower back curve results in decreased general health status.
5. Hyperkyphotic posture and risk of injurious falls in older persons: the Rancho Bernardo Study. Kado et al J Gerontol A Biol Sci Med Sci. 2007 Jun;62(6):652-7.
“CONCLUSIONS: Moderate hyperkyphotic posture may signify an easily identifiable independent risk factor for injurious falls in older men, with the association being less pronounced in older women.”
6. Hyperkyphotic posture and poor physical functional ability in older community- dwelling men and women: the Rancho Bernardo study. Kado et al J Gerontol A Biol Sci Med Sci. 2005 May;60(5):633-7.
“CONCLUSIONS: Older persons with hyperkyphotic posture are more likely to have physical functional difficulties.”
7. Hyperkyphotic posture predicts mortality in older community-dwelling men and women: a prospective study. Kado et al J Am Geriat Soc 2004 Oct;52(10):1662-7
“In cause-specific mortality analyses, hyperkyphotic posture was specifically associ- ated with an increased rate of death due to atherosclerosis.”
“Older men and women with hyperkyphotic posture have higher mortality rates.”
8. Hyperkyphosis Predicts Mortality Independent of Vertebral Osteoporosis in Older Women Kado et al Annals of In Med 19 May 2009 Vol150 Issue 10 pp 681-687
“Conclusion: In older women with vertebral fractures, hyperkyphosis predicts an in- creased risk for death, independent of underlying spinal osteoporosis and the extent and severity of vertebral fractures.”
9. Dizziness and unsteadiness following whiplash injury: characteristic features and relationship with cervical joint position error. Treleaven J, Jull G, Sterling M. J Rehabil Med. 2003 Jan;35(1):36-43.
“Cervical mechanoreceptor dysfunction is a likely cause of dizziness in whiplash- associated disorder.”
10. A Randomized Controlled Trial of Chiropractic Spinal Manipulative Therapy for Migraine Tuchin PJ et al JMPT. 2000 Feb;23(2):91-5
“22% (n = 18) of the treatment group reported a greater than 90% reduction of their migraines as a consequence of the 2 months of SMT. A further 49% (n = 41) reported significant improvement in the morbidity of each episode. An additional finding was that 73 (59%) participants reported no neck pain as a consequence of the 2 months of SMT.”
11. Scoliosis treatment using a combination of manipulative and rehabilitative ther- apy: a retrospective case series Morningstar, MW BMC Musculoskeletal Disorders 2004, 5:32
“... the combined use of manipulative and neuromuscular rehabilitation seemed to reduce scoliotic curvatures in 19 subjects by an average of 17°. This reduction took place within a 4 to 6-week period.“