The Correlation Between Surface Measurement of Head and Neck Posture and the Anatomic Position of the Upper Cervical Vertebrae

Study Design. Repeated measurements were made of surface postural angles registering the relative positions of the head and neck in photographs and of angles of the upper cervical vertebrae recorded in lateral cephalometric radiographs in the same subjects. For all registrations, subjects assumed the natural head rest position. Objectives. To examine the correlation between external measurement of head and neck posture and the anatomic positions of the upper four cervical vertebrae. Summary of Background Data. Interpretation of surface cervical posture measurement is confounded by lack of knowledge about the extent of the underlying compensatory adjustments among the upper cervical vertebrae that may accompany variation in head and neck posture. The correlation between surface measurement and postural characteristics of the upper cervical spine has not been reported to date. Methods. The association between a set of angles describing the anatomic position of the four upper cervical vertebrae on lateral cephalometric radiographs and a surface measurement of head and neck posture, the craniovertebral angle, was studied in 34 young adult women aged between 17.2 and 30.5 years, mean age, 24.5 years. Anatomic positions of the upper four cervical vertebrae were expressed by angles relative to the true vertical or horizontal. Surface angles registering head and neck position for each subject were obtained from photographs recorded on two occasions. Results. No strong correlation could be established between the angles taken from the lateral cephalometric radiographs measuring the extent of upper cervical lordosis, orientation of the atlas, vertebral inclination, or odontoid process tilt and surface angles recording head and neck position. This finding was attributed principally to the much greater positional variability demonstrated within the upper cervical spine when compared with the surface measurements of head and neck position. Conclusion. Anatomic alignment of the upper cervical vertebrae cannot be inferred from variation in surface measurement of head and neck posture. This is the case even in those people identified with more extreme head and neck postural tendencies.

[1]  J. T. Bryant,et al.  Method for Determining Vertebral Body Positions in the Sagittal Plane Using Skin Markers , 1989, Spine.

[2]  S. Wei,et al.  Intersex differences in craniocervical morphology and posture in southern Chinese and British Caucasians. , 1988, American journal of physical anthropology.

[3]  B. Solow,et al.  Craniocervical morphology and posture in Australian aboriginals. , 1982, American journal of physical anthropology.

[4]  S. Bohrer,et al.  Some Upper Cervical Spine Norms , 1987, Spine.

[5]  Coenraad F. A. Moorrees,et al.  Natural head position, a basic consideration in the interpretation of cephalometric radiographs , 1958 .

[6]  Fc Barker.  The 12C(a,?)16O Cross Section at Stellar Energies , 1987 .

[7]  D. Watson,et al.  Cervical Headache: An Investigation of Natural Head Posture and Upper Cervical Flexor Muscle Performance , 1993, Cephalalgia : an international journal of headache.

[8]  M. Polansky,et al.  The Influence of Different Sitting Positions on Cervical and Lumbar Posture , 1996, Spine.

[9]  J. Fleiss,et al.  Intraclass correlations: uses in assessing rater reliability. , 1979, Psychological bulletin.

[10]  S. Raine,et al.  Posture of the head, shoulders and thoracic spine in comfortable erect standing. , 1994, The Australian journal of physiotherapy.

[11]  J. Huggare.  A natural head position technique for radiographic cephalometry. , 1993, Dento maxillo facial radiology.

[12]  B. Solow,et al.  Craniocervical postural relations and craniofacial morphology in 30 blind subjects. , 1986, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[13]  K. Grimmer.  The Relationship Between Cervical Resting Posture and Neck Pain , 1996 .

[14]  B. Braun.  Postural differences between asymptomatic men and women and craniofacial pain patients. , 1991, Archives of physical medicine and rehabilitation.

[15]  The Relationship Between Surface Contour and Vertebral Body Measures of Upper Spine Curvature , 1994, Spine.

[16]  H. Epstein,et al.  THE CERVICAL SPINE: TRANSFORMATION OF THE NORMAL LORDOTIC PATTERN INTO A LINEAR PATTERN IN THE NEUTRAL POSTURE. , 1963, The Journal of bone and joint surgery. American volume.

[17]  B Solow,et al.  Natural head position in standing subjects. , 1971, Acta odontologica Scandinavica.

[18]  C. Oatis,et al.  Incidence of common postural abnormalities in the cervical, shoulder, and thoracic regions and their association with pain in two age groups of healthy subjects. , 1992, Physical therapy.

[19]  S. Matteson,et al.  A simple method for taking natural-head-position cephalograms. , 1983, American journal of orthodontics.