Department of Orthopedics and Traumatology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkiye.
Department of Physical Medicine and Rehabilitation, Istanbul Physical Therapy and Rehabilitation Training and Research Hospital, Istanbul, Turkiye.
Clin Neurol Neurosurg. 2024 Oct;245:108458. doi: 10.1016/j.clineuro.2024.108458. Epub 2024 Jul 18.
To elucidate the role of cervical sagittal alignment in the pathophysiology of cervical myofascial pain syndrome(MFPS) and its impact on pain levels and disability status among patients.
This prospective cross-sectional study included participants aged 18-64 years experiencing neck pain for more than 3 months and diagnosed with MFPS. Cervical sagittal parameters (C0-2 cervical lordosis(CL) angle, C2-7 CL angle, cervical sagittal vertical axis (cSVA), T1 slope, T1 slope minus CL mismatch(T1S-CL), and cervical tilt) were measured using Surgimap software by an expert physiatrist. Pain levels were assessed using the Numerical Pain Rating Scale(NRS), and neck disability was evaluated using the Neck Bournemouth Questionnaire(NBQ).
Out of 200 initially assessed participants with cervical MFPS, 133 were included after excluding ineligible individuals. The mean age of the participants was 35.3±8.2 years. Participants categorized by pain severity (moderate vs. severe) showed no significant differences in cervical range of motion, C0-2 angle, cSVA, T1 slope and T1S-CL. However, significant differences were observed in C2-7 angle (p=0.008), cervical tilt (p=0.006), and NBQ scores (p<0.001) between the two pain severity groups. Grouping based on T1S-CL compliance showed no significant differences in pain and disability effects. Correlation analysis revealed weak negative correlations between pain levels and C2-7 Cobb angle (p=0.009, r=0.226) as well as cervical tilt (p=0.005, r=0.243). No correlations were found between cervical sagittal parameters and NBQ scores.
Decreased C2-7 CL angle and cervical tilt angle are associated with increased pain levels; however, cervical sagittal alignment was not found to be associated with disability.
阐明颈椎矢状位排列在颈肌筋膜疼痛综合征（MFPS）病理生理学中的作用及其对患者疼痛程度和残疾状况的影响。
本前瞻性横断面研究纳入了年龄在 18-64 岁之间、患有颈痛超过 3 个月且被诊断为 MFPS 的患者。由一位经验丰富的理疗医师使用 Surgimap 软件测量颈椎矢状位参数（C0-2 颈椎前凸角（CL）、C2-7 CL 角、颈椎矢状垂直轴（cSVA）、T1 斜率、T1 斜率与 CL 不匹配（T1S-CL）和颈椎倾斜）。使用数字疼痛评分量表（NRS）评估疼痛程度，使用颈部 Bournemouth 问卷（NBQ）评估颈部残疾。
在最初评估的 200 名患有颈 MFPS 的参与者中，排除不符合条件的个体后，有 133 名被纳入研究。参与者的平均年龄为 35.3±8.2 岁。根据疼痛严重程度（中度与重度）进行分类的参与者，在颈椎活动度、C0-2 角、cSVA、T1 斜率和 T1S-CL 方面无显著差异。然而，在 C2-7 角（p=0.008）、颈椎倾斜（p=0.006）和 NBQ 评分（p<0.001）方面，两组之间存在显著差异。根据 T1S-CL 顺应性进行分组，在疼痛和残疾效果方面无显著差异。相关性分析显示，疼痛水平与 C2-7 Cobb 角（p=0.009，r=0.226）和颈椎倾斜（p=0.005，r=0.243）呈弱负相关。颈椎矢状位参数与 NBQ 评分之间无相关性。
C2-7 CL 角和颈椎倾斜角度减小与疼痛程度增加相关，而颈椎矢状位排列与残疾状况无关。
