title: Chronic neck pain in young adults: perspectives on anatomic differences.
abstract: BACKGROUND
  Neck pain (NP) is a common musculoskeletal disorder, but little is known about the associated risk factors.
  
  
  OBJECTIVE
  We compared anatomic differences in the neck and trunk area of young adult patients with chronic NP and control subjects without NP to identify risk factors and predictors.
  
  
  METHODS
  This is an age-, sex-, and body mass index-matched retrospective case-control study of a consecutive sample.
  
  
  METHODS
  Patients with axial NP for longer than 6 months (23 males and 25 females) and pain-free volunteers (23 males and 25 females) were included.
  
  
  METHODS
  Outcome measures were linear and angular dimensions of the cervicothoracic junction.
  
  
  METHODS
  Midsagittal magnetic resonance imaging scans of the cervicothoracic spine were obtained. Four linear and four angular parameters were identified and measured. These parameters included depth of the T1-manubrium arch (T1AD), depth of the thoracic cage (TXD), tangential height of T1 (T1H1), relative height of T1 (T1H2), T1 slope (T1S), thoracic inlet inclination (TiI), T1-manubrium arch inclination (T1AI), and the angular difference between TiI and T1AI (TiI-T1AI). The measurements were taken by two neurosurgeons.
  
  
  RESULTS
  Depth of the T1-manubrium arch and TiI were identified as predictors for NP in the binary logistic regression analysis. Each millimeter increase in T1AD lessened the probability of NP with an adjusted odds ratio (OR) of 0.823 (95% confidence interval [CI], 0.701-0.966) in females and 0.809 (95% CI, 0.681-0.959) in males. Each degree increase in TiI was associated with the probability of NP with an adjusted OR of 1.247 (95% CI, 1.060-1.466) in males.
  
  
  CONCLUSIONS
  Measurement of cervicothoracic junctional structures is a reliable and feasible method of estimating potential predictor of chronic NP in young adults. Forward inclination of the thoracic inlet in males and a shallow thoracic cage in females were identified as important predictors.
authors.affiliation: Department of Neurosurgery, Korea University Guro Hospital, 80 Guro-dong, Guro-ku, Seoul 152-050, Republic of Korea.
authors.forename: Ji-Hye
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Neurosurgery, Korea University Guro Hospital, 80 Guro-dong, Guro-ku, Seoul 152-050, Republic of Korea. Electronic address: ykapa76@yahoo.co.kr.
authors.forename: Youn-Kwan
authors.initials: YK
authors.lastname: Park
authors.affiliation: Department of Neurosurgery, Korea University Guro Hospital, 80 Guro-dong, Guro-ku, Seoul 152-050, Republic of Korea.
authors.forename: Joo-Han
authors.initials: JH
authors.lastname: Kim
mesh_terms: D000328:Adult; D015992:Body Mass Index; D016022:Case-Control Studies; D002574:Cervical Vertebrae / Q000473:pathology*; D059350:Chronic Pain / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D009333:Neck / Q000473:pathology*; D019547:Neck Pain / Q000473:pathology*; D013904:Thoracic Vertebrae / Q000473:pathology*; D055815:Young Adult
keywords: Gender differences; Neck pain; Radiologic study; Thoracic cage dimension; Thoracic inlet inclination; Young adult