COMPARISON OF NECK LENGTH WITH THE INCIDENCE OF CERVICAL SPONDYLOSIS

Abstract

BACKGROUND Cervical spondylosis is a disc degenerative disease commonly presenting in the middle aged to ageing population. It manifests as a syndrome causing degeneration of intervertebral discs and vertebral bodies leading to compression of spinal cord, its vessels and spinal nerve roots. It has been considered as an epidemic by World Health Organization. The disease has an insidious onset, progresses stealthily and causes syndromes of radiculopathy, myelopathy and axial joint pain. OBJECTIVES The objectives of the study were to correlate short neck length with the increased incidence of cervical spondylosis, and to compare neck length, relative neck length, height and weight with incidence of cervical spondylosis and evaluate the demographics, patient characteristics as well as radiographic changes in the subjects of cervical spondylosis. SUBJECTS, MATERIALS AND METHODS It was a comparative study conducted at Patel hospital, Karachi after obtaining approval of synopsis (Appendix A) and ethical approval from BUMDC and Patel hospital (Appendix B). It enrolled 88 cases and 88 controls using convenient sampling technique. The cases were recruited from the Orthopedic outpatient department (OPD) and Radiology Department, on the basis of history and physical examination while controls were enrolled from hospital premises, as healthy individuals accompanying the patients. Those individuals who met the inclusion criteria and signed the informed consent (Appendix C) were included in the research project. These participants were subjected to cervical spine radiography (lateral view) with the help of Agfa Fuji CR 35-X system. The neck length was measured on a software Synapse, as a perpendicular distance from the external occipital protuberance to the C7 spinous process. The height and weight of the cases were measured with the help of stadiometer. The relative neck length was calculated by dividing the neck length with the height of the individual. Their history, 2

height, weight, demographics and other characteristics were recorded in a subject evaluation form (Appendix D). RESULTS A total of 176 subjects were evaluated and it was established that the disease was prevalent in the middle age to elderly population ranging from 40 to 60 years. The neck length and relative neck length of the cases showed insignificant decrease with the disease while the short height had a significant association with the disease. The neck length, height and weight also showed significant differences with respect to the disease within males and females. The disease was found to be more prevalent in the pre-obese and obese cases. It showed significant association with the occupation, being most frequent in the female home makers and male outdoor workers having a working duration of more than 8 hours. The disease had increased incidence in mobile users of more than 4-hour duration. The degenerative radiographic changes observed were also severe in relation to the increase in age demonstrating significant association of degenerative changes with respect to the age. CONCLUSION The present study concluded that the prevalence of cervical spondylosis was more in middle aged to elderly population. There was a significant association of height which showed that the short height individuals were more prone to develop cervical spondylosis. The Body Mass Index (BMI), occupation, working hours and mobile use were also significant risk factors. The results delineated the parameters and factors involved in the disease process. These results should be considered by health care providers while assessing the disease. Short height individuals must adapt good posture and healthy lifestyle factors to prevent the disease