Correlation between loss of cervical lordosis and the degree of cervical disc herniation

Background: Chronic neck pain is a common health problem and is increasingly relevant in health-related quality of life, not only in industrialized countries. The etiology of neck pain is very complex and may be associated with disc herniation, facet joints, muscles, and ligaments that cervical stability will gradually decrease and can cause damage and lead to loss of cervical lordosis. However, studies rarely report the correlation between cervical lordosis and cervical herniation in patients with neck pain. The purpose of this study was to determine the profile of cervical lordosis curves in patients with chronic neck pain and prove the correlation between the degree of cervical disc herniation with loss of cervical lordosis. Method: This study was designed as an analytic study with a retrospective cross-sectional approach. Cervical lordosis curves are measured from mid sagittal cervical MRI while the degree of cervical disc herniation is evaluated using a herniation score. The Spearman correlation test and a simple linear regression test were performed to assess the relationship between loss of cervical lordosis and cervical herniation severity. Multivariate analysis was performed to adjust for the effect of confounding variables. Result: A total of 67 study samples, 64.2% male and 35.8% female, with an average age of 54.7 ± 12.5. Cervical lordosis angle was found not normal (86.6%), most are in the form of hypolordosis (41.8%) and kyphosis (43.3%). The most herniation was in protrusion stage (47.8%). There was a significant correlation between the loss of the cervical lordosis and the degree of disc herniation (r -0.259, and p-value 0.034), each increase of one cervical disc herniation score affects the angle of the lordosis curve by -1.9 degrees, with a coefficient value of B = -1,914 (95% CI, p = 0.026). Conclusion: there is a significant correlation between loss of cervical lordosis and cervical disc herniation (p <0.05).