Hyperplastic Articular Pillars and Cervical Lordosis
Cervical lordosis can serve as an indicator of many traumatic and degenerative clinical conditions. Although it is generally assumed that a number of factors may affect lordosis, the potential link between cervical lordosis and hyperplastic articular pillars has yet to be evaluated.
Researchers analyzed normal, neutral lateral cervical radiographs in a study designed to assess three variables: the reliability of determining articular hyperplasia; the prevalence of the condition; and differences in lordosis measurements between patients with and without hyperplasia of the cervical articular pillars.
Results are presented as follows:
* Interexaminer reliability for determining presence/absence of cervical spine articular pillar hyperplasia ranged from 75-92% (considered fair-to-substantial agreement beyond chance).
* Overall, 46% of patients demonstrated hyperplastic articular pillars of at least one cervical level, with C6 and C5 most commonly affected.
* Both measurement techniques demonstrated significant differences in lordosis between patients with and without pillar hyperplasia.
The authors conclude that "on the basis of these results, cervical pillar hyperplasia should be considered a normal variant unless proved otherwise" and that pillar architecture be evaluated when attempting to restore cervical lordosis.
Peterson CK, Kirk RJ, Isdahl M, et al. Prevalence of hyperplastic articular pillars in the cervical spine and relationship with cervical lordosis. Journal of Manipulative and Physiological Therapeutics
, July/ August 1999:22(6), pp390-94.
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