An Investigation of 3D Spinal Alignment in Cervicogenic Headache

Authors

• Ibrahim M. Moustafa, PT, PhD
• Tamer M. Shousha, PT, PhD
• Deed E. Harrison, DC

Publication

Musculoskeletal Science and Practice 2021 Feb;51:102284.

Article Link

An Investigation of 3D Spinal Alignment in Cervicogenic Headache

Abstract

Background: There is a growing interest in the impact of body posture influences on outcome measures of cervicogenic headache (CGH).
Objective: To evaluate differences in the 3D spinal alignment in cases suffering from chronic CGH compared to a group of strictly matched control participants without CGH.
Design: A single-blinded, comparative cohort design
Methods: 100 participants suffering from frequent headaches for at least 3 months who fulfilled the CHISG criteria for CGH were match by age and sex to 100 asymptomatic control group participants. A 4D Formetric device was used to assess participants’ posture variables of: 1) thoracic kyphosis max (ICT-ITL in degrees); 2) trunk lateral imbalance (VP-DM in mm); 3)
Trunk anterior inclination (VP-DM in mm); 4) lumbar lordotic angle (ITL-ILS max in degrees); 5) Vertebral rotation (rms) in degrees. A matched-pairs binary logistic regression was used to determine whether measurements of posture demonstrated an association with the likelihood of the presence of CGH.
Results: There were statistically significant differences between the CGH and control group for all posture variables indicating larger posture displacements in the CGH group: ICT-ITL (p< .001), Lateral VP-DM (p< .001), Sagittal VP-DM (p< .001), ITL-ILS (p< .001), RMS (p< .001). Logistic regression revealed that as posture displacement increased, a statistically significant increased likelihood of having CGH occurred: (ICT-ITL (max) (p<0.001); Trunk imbalance VPDM (p<0.004); Trunk inclination VP-DM (p<.001); and vertebral rotation (RMS) (p=.007). No such relationship was found for Lumbar Lordosis ITL-ILS max.
Conclusions: Participants with CGH exhibited increased magnitudes of thoracolumbar posture displacements which corresponded to an increased odds of suffering from CGH compared to matched control participants.