Cervical Vertebral Axis Flattening: Demographics and Causes

ABSTRACT Objective The neck is an important region that connects the head and body with the vital structures it contains. Pain originating from the cervical vertebral axis constitutes a significant part of the pain in this region and is the most common musculoskeletal problem after low back pain. Deviations such as decreased cervical lordosis or the development of kyphosis are associated with pain and disability. Although cervical axis flattening is a very common condition, there is not enough data on its causes. This study aimed to reveal the underlying causes of cervical lordosis straightening. Material and method Cervical radiographs of the cases were taken in the neutral position and the cervical axis angle was measured between C2-C7 by the Cobb method. A regional detailed physical examination was performed for the locomotor system and the Beck Depression and Beck Anxiety scales were filled in. A cervical MRI was performed in all cases. Three months later, regional detailed physical examinations and radiography were performed again. Cases in which lordosis flattening continued in the last cervical radiographs were considered chronic. The cases were divided into two groups: acute and chronic phases. Results 25% of the acute cases were diagnosed with fibromyalgia syndrome (FMS),45% of them with tension-type headache (TTHA), 45% of them cervical spondylosis (CS), 30% of them with cervical disc herniation (CDH), 15% of them with myofascial pain syndrome (MPS), 10% of them with anxiety, and 10% of them with depression. In cases with chronic phases, 60% of them were diagnosed with FMS, 45% of them with TTHA, 22.5% of them with CS, 55% of them with CDH, 17.5% of them with MPS, 30% of them with anxiety, 7.5% of them with depression and 20% of them with migraine. Conclusion Since cervical region pain has a very complex cause, regional diseases related to this region and problems such as FMS, TTH, depression, and anxiety should be differentiated in the diagnosis. This study will make an important contribution to the literature as a guide.