title: Postural changes of the cervical spine in patients with nontoxic goiter.
abstract: OBJECTIVE
  To investigate differences in cervical spine posture and range of motion and self-reported neck pain and headache between patients with nontoxic goiter compared with a matched control group.
  
  
  METHODS
  An observational, controlled, blinded study.
  
  
  METHODS
  The ambulatory outpatient facility of a university hospital.
  
  
  METHODS
  Twenty-five nontoxic goiter patients and 25 matched nongoiterous control subjects from the Department of Endocrinology.
  
  
  METHODS
  Participants were X-rayed from a lateral position in neutral, full flexion and full extension, and the radiographs were evaluated by a blinded examiner for anterior head carriage, maximal flexion, maximal extension and the extent and severity of any degenerative changes in the cervical spine. The degree of postural neck muscle tenderness was evaluated by a blinded rheumatologist using a validated Total Tenderness Score system. In addition, the two groups were compared for their self-reported frequency of neck pain and headaches.
  
  
  RESULTS
  A significant increase in anterior head carriage was found among the goiter patients (p = .01), together with a corresponding decrease in flexion (p = .01), whereas the corresponding increase in extension was not statistically significant (p = .16). A higher prevalence of headaches was found in the goiter group (p = .06), but there was no difference in neck muscle tenderness (p = .40) or frequency of neck problems (p = .40) between the groups. The severity of degenerative changes in the cervical spine (p = .22) and the number of vertebral levels with degenerative changes (p = .13) were similar in the two groups.
  
  
  CONCLUSIONS
  Goiters of > 100 g seem to alter the posture of the cervical spine, possibly resulting in a tendency for more frequent headaches. The changes do not seem to cause more neck pain, muscle tenderness or degeneration of the cervical spine.
authors.affiliation: Center for Biomechanics, Faculty of Health Sciences, University of Odense, Denmark.
authors.forename: E
authors.initials: E
authors.lastname: Gökpinar
authors.forename: N
authors.initials: N
authors.lastname: Nilsson
authors.forename: P B
authors.initials: PB
authors.lastname: Anderson
authors.forename: J
authors.initials: J
authors.lastname: Beyer
authors.forename: L
authors.initials: L
authors.lastname: Hegedüs
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001696:Biomechanical Phenomena; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000503:physiopathology*; D003627:Data Interpretation, Statistical; D005260:Female; D006042:Goiter / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006261:Headache / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000209:etiology; D011187:Posture; D011859:Radiography; D011795:Surveys and Questionnaires