An Analysis of the State of Cervical Disc Herniation According to Cervical Lordosis and Age

Article information

Acupunct. 2015;32(3):107-115
Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Kyung Hee University
*Corresponding author : Department of Acupuncture & Moxibustion Medicine, Kangnam Korean, Hospital Kyung Hee University, 225, Yeongdong-daero, Gangnam-gu, Seoul, 06283, Republic of Korea, Tel : +82-2-3457-9014, E-mail : ackys@hanmail.net
Received 2015 August 12; Revised 2015 August 27; Accepted 2015 August 31.

Abstract

Objectives:

The aim of this study is to investigate the state of cervical disc herniation according to the degree of cervical lordosis and age.

Methods:

67 records of inpatients who were diagnosed with herniated intervertebral disc(HIVD) of the cervical spine were analyzed. Cobb’s method, Jochumsen method and the Ishihara index were used to measure the degree of cervical lordosis. The state of the cervical disc was identified using magnetic resonance imaging(MRI) of the cervical spine. Then correlations among cervical lordosis, age and cervical disc herniation were analyzed.

Results:

Disc bulging was associated with hypolordosis and disc protrusion was associated with hyperlordosis and age. Disc extrusion was not associated with either cervical lordosis or age. The number of disc herniations in the cervical spine was correlated with age significantly, but not with cervical lordosis.

Conclusions:

Cervical disc herniation had a tendency to correlate with age and cervical lordosis, although this is not definite. Future studies that analyze more radiographic images of patients with HIVD of the cervical spine might be necessary to identify the influence of cervical lordosis on cervical disc herniation.

Fig. 1

Flowchart of data collection

Fig. 2

Cobb’s method[C1–C7]

Fig. 3

Jochumsen method

Fig. 4

Ishihara index

Age Distribution of All Subjects

Means of Cobb’s Angle According to the Degree of Cervical Lordosis

Means of The Value of Jochumsen Method According to The Degree of Cervical Lordosis

Means of the Value of Ishihara Index According to the Degree of Cervical Lordosis

Correlation between Cervical Lordosis and the Number of Herniated Intervertebral Disc

The p-value of Kruskal-Wallis Test Showing Differences of The Number of Herniated Intervertebral Disc among Each Groups Divided by The Degree of Cervical Lordosis

Correlation between Age and the Number of Herniated Intervertebral Disc

Correlation between Age and Cervical Lordosis

Age Controlled Partial Correlations between Cervical Lordosis and The Number of Herniated Intervertebral Disc

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Article information Continued

Fig. 1

Flowchart of data collection

Fig. 2

Cobb’s method[C1–C7]

Fig. 3

Jochumsen method

Fig. 4

Ishihara index

Table 1

Age Distribution of All Subjects

Age Male Female Total
20~29 2 4 6
30~39 4 7 11
40~49 4 15 19
50~59 7 14 21
60~69 1 4 5
70~79 1 4 5

Total 19 48 67

Table 2

Means of Cobb’s Angle According to the Degree of Cervical Lordosis

n Cobb’s angle
Hypolordosis 28 30.34 ± 5.28
Normal 19 39.22 ± 2.97
Hyperlordosis 20 49.61 ± 4.94

Total 67 38.61 ± 9.31

Table 3

Means of The Value of Jochumsen Method According to The Degree of Cervical Lordosis

n value
Kyphosis 3 −3.81 ± 0.50
Straightened 25 −0.48 ± 0.98
Normal 38 3.78 ± 1.88
Hyperlordosis 1 9.65

Total 67 1.93 ± 2.98

Table 4

Means of the Value of Ishihara Index According to the Degree of Cervical Lordosis

n Value
Kyphosis 10 −6.93 ± 5.18
Hypolordosis 19 2.57 ± 1.53
Normal 38 14.81 ± 5.42
Hyperlordosis 0 N/A

Total 67 8.10 ± 9.47

Table 5

Correlation between Cervical Lordosis and the Number of Herniated Intervertebral Disc

Cobb’s angle Jochumsen met hod Ishihara index
Bulging −0. 178
p=0.15
−0.196
p=0. 1 12
−0. 059
p=0.636
Protrusion 0.142
p=0.251
0.235
p=0.055
0.143
p=0.247
Extrusion 0.086
p=0.489
−0.022
p=0.863
−0.097
p=0.434

Protrusion + extrusion 0.184
p=0.135
0.187
p=0. 1 30
0.053
p=0.669

Total 0.033
p=0.792
0.017
p=0.892
0.001
p=0.991

The values are Pearson’s correlation coefficient.

Table 6

The p-value of Kruskal-Wallis Test Showing Differences of The Number of Herniated Intervertebral Disc among Each Groups Divided by The Degree of Cervical Lordosis

Cobb’s angle* Jochumsen method Ishihara index
Bulging 0.425 0.327 0.077
Protrusion 0.508 0.385 0.257
Extrusion 0.430 0.520 0.797

Protrusion, extrusion 0.069 0.416 0.244

Total 0.527 0.694 0.626
*

divided into three groups; hypolordosis, normal, hyperlordosis.

divided into four groups; kyphosis, straightened, normal, hyperlordosis.

divided into three groups; kyphosis, hypolordosis, normal.

Table 7

Correlation between Age and the Number of Herniated Intervertebral Disc

Age Bulging Protrusion Extrusion Protrusion + extrusion Total
20–29 1.50 ± 1.38 1.33 ± 1.37 0.33 ± 0.52 1.67 ± 1.51 3.17 ± 1.33
30–39 1.36 ± 1.57 1.73 ± 1.19 0.73 ± 0.79 2.45 ± 1.44 3.82 ± 1.17
40–49 1.16 ± 1.01 1.79 ± 1.18 1.11 ± 1.10 2.89 ± 1.29 4.05 ± 1.13
50–59 1.76 ± 1.34 1.81 ± 1.47 0.71 ± 0.90 2.52 ± 1.54 4.29 ± 1.06
60–69 2.00 ± 1.58 1.40 ± 0.55 2.00 ± 1.87 3.40 ± 2.07 5.40 ± 1.34
70–79 0.80 ± 0.84 2.90 ± 0.84 0.20 ± 0.45 3.00 ± 0.71 3.80 ± 1.10

Pearson’s correlation coefficient 0.022
p=0.859
0.165
p=0.182
0.061
p=0.624
0.193
p=0.118
0.248
p=0.043

The number of each cervical discs was presented as mean ± standard deviation.

Table 8

Correlation between Age and Cervical Lordosis

Age Cobb’s angle Jochumsen method Ishihara index
20~29 37.90 ± 3.66 0.91 ± 3.66 5.09 ± 3.20
30~39 33.52 ± 5.19 0.44 ± 1.68 4.73 ± 7.57
40~49 39.14 ± 10.47 1.70 ± 3.31 8.97 ± 9.53
50~59 37.86 ± 9.06 2.34 ± 3.01 8.13 ± 11.33
60~69 40.97 ± 8.96 2.64 ± 3.04 10.42 ± 8.05
70~79 49.44 ± 11.52 4.93 ± 3.47 13.30 ± 10.96

Pearson’s correlation coefficient 0.295
p=0.015
0.334
p=0.006
0.223
p=0.07

The Degree of cervical lordosis was presented as mean ± standard deviation.

Table 9

Age Controlled Partial Correlations between Cervical Lordosis and The Number of Herniated Intervertebral Disc

Cobb’s angle Jochumsen method Ishihara index
Bulging −0.193
p=0.12
−0.216
p=0. 082
−0.065
p=0.602
Protrusion 0.099
p=0.428
0.194
p=0. 119
0.11 1
p=0.375
Extrusion 0.071
p=0. 569
-0.045
p=0.722
−0.114
p=0. 362

Protrusion, extrusion 0.138
p=0.269
0.135
p=0.28
0.012
p=0.922

Total −0. 044
p=0.729
−0.072
p=0.564
−0.057
p=0.649

The values are partial correlation coefficient.