Affiliations: [a] Department of Physiotherapy, College of Health Sciences, University of Sharjah, UAE | [b] Basic Science Department, Faculty of Physical Therapy, Cairo University, Egypt | [c] CBP NonProfit (a Spine Research Foundation) and Private Practice, Eagle, ID, USA
Correspondence:
[*]
Corresponding author: Ibrahim Moustafa Moustafa, 7 Mohamed Hassan, El Gamal Street, Abbas El Akaad, Nacer, Egypt. E-mail:ibrahiem.mostafa@pt.cu.edu.eg
Abstract: OBJECTIVE: To test the hypothesis that improvement of cervical
lordosis in cervical spondylotic radiculopathy (CSR) will improve cervical
spine flexion and extension end range of motion kinematics in a population
suffering from CSR. METHODS: Thirty chronic lower CSR patients with cervical lordosis
< 25° were included. IRB approval and informed consent were
obtained. Patients were assigned randomly into two equal groups, study (SG)
and control (CG). Both groups received stretching exercises and
infrared; the SG received 3-point bending cervical extension traction.
Treatments were applied 3 × per week for 10 weeks, care was terminated and
subjects were evaluated at 3 intervals: baseline, 30 visits, and 3-month
follow-up.
Radiographic neutral lateral cervical absolute rotation angle (ARA C2-C7)
and cervical segmental (C2-C7 segments) rotational and translational
flexion-extension kinematics analysis were measured for all patients at the
three intervals. The outcome were analyzed using repeated measures one-way
ANOVA. Tukey's post-hoc multiple comparisons was implemented when necessary.
Pearson correlation between ARA and segmental translational and rotational
displacements was determined. RESULTS: Both groups demonstrated statistically significant
increases in segmental motion at the 10-week follow up; but only the SG
group showed a statistically significant increase in cervical lordosis (p <
0.0001). At 3-month follow up, only the SG improvements in segmental
rotation and translation were maintained. CONCLUSION: Improved lordosis in the study group was associated
with significant improvement in the translational and rotational motions of
the lower cervical spine. This finding provides objective evidence that
cervical flexion/extension is partially dependent on the posture and
sagittal curve orientation. These findings are in agreement with several
other reports in the literature; whereas ours is the first post treatment
analysis identifying this relationship.
Keywords: Cervical spine, lordosis, flexion and extension, traction, spondylotic radiculopathy
