A Natural-Position X-Ray for Evaluating Cervical Vertebra Physiology Curvature Before and After Conservative Treatment

Abstract

BACKGROUND Abnormal physiological curvature is one of the symptoms of early cervical spondylosis. An X-ray taken with the patient standing in a natural position can best reflect the real cervical vertebra physiological curvature. The purpose of this research was to study the value of natural-position X-ray in evaluating cervical vertebra physiology curvature before and after conservative treatment. MATERIAL AND METHODS This study included 135 participants of different ages diagnosed with cervical disease and who received conservative treatment for more than 12 months. The natural- and regular-position X-rays were performed before and after treatment. The positive change of D value in Borden's measurement and C2~7 Cobb angle should be recognized as an improvement of cervical vertebra physiology curvature. RESULTS Before treatment, the C2~7 Cobb angle of the regular-position group was larger than that of natural-position group. After treatment, the C2~7 Cobb angle of the natural-position group was larger than that of the regular-position group, and the D value increased after treatment in both groups. The effective rate of cervical physiological curvature of the natural-position group was higher than that of the regular-position group. CONCLUSIONS Natural-position X-ray has greater accuracy in evaluating cervical vertebra physiology curvature before and after conservative treatment compared with regular-position X-ray.

Conflict of interest statement

Conflict of interest: None declared

Figures

Figure 1

Patient stands in front of the camera frame with his right side close to it, and his back close to the vertical plate. The back side of his head, back, buttocks, legs, and both heels are required to cling to the vertical plate surface, which creates the neutral position of natural standing. The neck is placed in the middle line of the irradiation field, and the central line is vertically rayed into the camera frame through the side of the thyroid cartilage. The filming distance and equipment model are the same as those in regular position.

Figure 2

A device (Invention patent No.: ZL 201920952467.4) for cervical vertebra physiological curvature protection in natural position is applied for traction. Based on information such as the patient’s image data, height, and weight, traction pillows of specific materials and hardness are made for traction to correct the physiological curvature of the cervical spine and to relax the strained cervical muscles.

Figure 3

Regular position. (A) A retroflexion of cervical vertebra was observed. (B) Before treatment, the C2–7 Cobb angle was −11.5°, and the D value was obviously negative. (C) After 12 months’ treatment, the D value was 0.5 mm, which was significantly improved from the previous negative value.

Figure 4

Natural position. (A) Before treatment, a retroflexion of cervical vertebra was observed. The C2–7 Cobb angle was −13.5°. (B) After treatment, significant improvement of cervical physiological curvature was observed. The C2–7 Cobb angle was 12°.