The relationship between chronic type III acromioclavicular joint dislocation and cervical spine pain

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Abstract

Background

This study was aimed at evaluating whether or not patients with chronic type III acromioclavicular dislocation develop cervical spine pain and degenerative changes more frequently than normal subjects.

Methods

The cervical spine of 34 patients with chronic type III AC dislocation was radiographically evaluated. Osteophytosis presence was registered and the narrowing of the intervertebral disc and cervical lordosis were evaluated. Subjective cervical symptoms were investigated using the Northwick Park Neck Pain Questionnaire (NPQ). One-hundred healthy volunteers were recruited as a control group.

Results

The rate and distribution of osteophytosis and narrowed intervertebral disc were similar in both of the groups. Patients with chronic AC dislocation had a lower value of cervical lordosis. NPQ score was 17.3% in patients with AC separation (100% = the worst result) and 2.2% in the control group (p < 0.05). An inverse significant nonparametric correlation was found between the NPQ value and the lordosis degree in the AC dislocation group (p = 0.001) wheras results were not correlated (p = 0.27) in the control group.

Conclusions

Our study shows that chronic type III AC dislocation does not interfere with osteophytes formation or intervertebral disc narrowing, but that it may predispose cervical hypolordosis. The higher average NPQ values were observed in patients with chronic AC dislocation, especially in those that developed cervical hypolordosis.

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Most cited references 21

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Determining the relationship between cervical lordosis and neck complaints.

Jeb McAviney, Dan Schulz, Richard Bock … (2016)

To investigate the presence of a "functionally normal" cervical lordosis and identify if this and the amount of forward head posture are related to neck complaints. Using the posterior tangent method, an angle of cervical lordosis was measured from C2 through C7 vertebrae on 277 lateral cervical x-rays. Anterior weight bearing was measured as the horizontal distance of the posterior superior body of the C2 vertebra compared to a vertical line drawn superiorly from the posterior inferior body of the C7 vertebra. The measurements were sorted into 2 groups, cervical complaint and noncervical complaint groups. The data were then partitioned into age by decades, sex, and angle categories. Patients with lordosis of 20 degrees or less were more likely to have cervicogenic symptoms (P < .001). The association between cervical pain and lordosis of 0 degrees or less was significant (P < .0001). The odds that a patient with cervical pain had a lordosis of 0 degrees or less was 18 times greater than for a patient with a noncervical complaint. Patients with cervical pain had less lordosis and this was consistent over all age ranges. Males had larger median cervical lordosis than females (20 degrees vs 14 degrees) (2-sided Mann-Whitney U test, P = .016). When partitioned by age grouping, this trend is significant only in the 40- to 49-year-old range (2-sided Mann-Whitney U test, P < .01). We found a statistically significant association between cervical pain and lordosis < 20 degrees and a "clinically normal" range for cervical lordosis of 31 degrees to 40 degrees. Maintenance of a lordosis in the range of 31 degrees to 40 degrees could be a clinical goal for chiropractic treatment.

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The Northwick Park Neck Pain Questionnaire, devised to measure neck pain and disability.

Elizabeth Turner, M. J. Cooper, Jeremy A Frank … (1994)

Neck pain is common in rheumatological practice. Assessment of outcome is difficult without objective measures. A neck pain questionnaire using nine five-part sections has been devised to overcome this problem. Forty-four rheumatology out-patients with neck pain were studied. Questionnaires were completed on days 0 and 3-5, and at 1 and 3 months. There was good short-term repeatability (r = 0.84, kappa = 0.62). Mean scores of each of the nine sections tended to rise with that of the pain section showing internal consistency. Questions on duration and intensity of pain were good indicators of a patient's global assessment. The questionnaire is easy for patients to complete, simple to score and provides an objective measure to evaluate outcome in patients with acute or chronic neck pain.

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Rockwood type III acromioclavicular dislocation: surgical versus conservative treatment.

C Gstettner, M. Täuber, W Hitzl … (2015)

The best treatment for Rockwood type III injuries is still controversial. During a retrospective study, 24 patients who were treated surgically with a hook plate and 17 conservatively treated patients were examined with a mean follow-up of 34 months. The Oxford Shoulder Score, Simple Shoulder Test, and Constant score were assessed at the follow-up examination. Stress radiographs of both shoulders were taken, and the coracoclavicular distance, as well as the width of the acromioclavicular joint, was measured. The mean Constant score was 80.7 in the conservatively treated group and 90.4 in the group that underwent surgery. The mean coracoclavicular distance was 15.9 mm in the conservatively treated group and 12.1 mm in the surgically treated group. These differences were significant (P < .05, Mann-Whitney U test and Student t test). In this study, better results were achieved by surgical treatment with the hook plate than by conservative treatment.

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Author and article information

Journal

Journal ID (nlm-ta): BMC Musculoskelet Disord

Title: BMC Musculoskeletal Disorders

Publisher: BioMed Central

ISSN (Electronic): 1471-2474

Publication date Collection: 2009

Publication date (Electronic): 16 December 2009

Volume: 10

Page: 157

Affiliations

[1 ]Department of Orthopaedics and Traumatology, University of Rome "Sapienza". Piazzale Aldo Moro, 5. Rome, Italy

[2 ]Department of Experimental Medicine, University of Rome "Sapienza". Piazzale Aldo Moro, 5. Rome, Italy

Article

Publisher ID: 1471-2474-10-157

DOI: 10.1186/1471-2474-10-157

PMC ID: 2804620

PubMed ID: 20015356

SO-VID: 0fe6efc6-0b2c-440c-ada7-c8187d36cf26

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

The relationship between chronic type III acromioclavicular joint dislocation and cervical spine pain

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Abstract

Background

Methods

Results

Conclusions

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Orthopedics

Most cited references 21

Determining the relationship between cervical lordosis and neck complaints.

The Northwick Park Neck Pain Questionnaire, devised to measure neck pain and disability.

Rockwood type III acromioclavicular dislocation: surgical versus conservative treatment.

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