title: Is the sagittal configuration of the cervical spine changed in women with chronic whiplash syndrome? A comparative computer-assisted radiographic assessment.
abstract: OBJECTIVE
  To reveal whether women with chronic whiplash-associated disorder (WAD) symptoms, grade I-II, demonstrate regional and/or segmental radiographic signs of altered cervical lordosis.
  
  
  METHODS
  Case-control study.
  
  
  METHODS
  Radiography department at a university hospital.
  
  
  METHODS
  Three age-balanced groups comprising 120 women. The case group included women with chronic whiplash syndrome (n = 41), and the control group included women with chronic insidious onset neck pain (n = 39) and an asymptomatic group (n = 40), who were given baseline data. The sample was referred from informed doctors and physiotherapists.
  
  
  METHODS
  The women sat in a standardized sitting position and radiographs were taken in a lateral position with fluoroscopic control for alignment.
  
  
  METHODS
  Two distinct measurements were taken; 1 of the angles of the upper and lower cervical curvatures, respectively, and 1 of the angles between the inferior borders of each pair of vertebrae in the lower cervical spine. The 3 groups were compared on the ratio of the lower to upper cervical spine angles and on the mean angular values for each segment in the cervical spine.
  
  
  RESULTS
  The whiplash group showed a decreased ratio between the lower versus upper cervical spine but comparisons between groups were not statistically significant. The whiplash group was in a significantly more flexed position at the C4-C5 level compared with the asymptomatic group (P =.007). The reliability measures have to be strengthened to render these results definitely conclusive.
  
  
  CONCLUSIONS
  The whiplash group exhibited a different configuration of cervical lordosis. This is clinically important and needs to be studied more closely.
authors.affiliation: Faculty of Medicine, University of Iceland, Reykjavík, Iceland. eythork@simnet.is
authors.forename: E
authors.initials: E
authors.lastname: Kristjansson
authors.forename: H
authors.initials: H
authors.lastname: Jónsson
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008141:Lordosis / Q000000981:diagnostic imaging*; D019547:Neck Pain / Q000000981:diagnostic imaging*; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods; D016059:Range of Motion, Articular; D012399:Rotation; D014911:Whiplash Injuries / Q000000981:diagnostic imaging* / Q000503:physiopathology