Comparison of Radiographic Cervical Sagittal Alignment Parameters in Patients With Nonspecific Neck Pain, Degenerative Neck Pain, and Healthy Individuals.

BACKGROUND Cervical spine imbalance can lead to neck pain and abnormal posture. However, the relationship between global cervical sagittal balance and different neck pain subtypes remains unclear. Therefore, this retrospective study aimed to compare radiographic cervical sagittal alignment parameters, including the sagittal vertical axis (SVA), spino-cranial angle (SCA), and intervertebral disc height, among 25 patients with nonspecific neck pain, 20 patients with degenerative neck pain, and 25 asymptomatic healthy controls. MATERIAL AND METHODS This retrospective observational study included 70 participants enrolled between January 2023 and January 2025, categorized into 3 groups: patients with nonspecific neck pain, patients with degenerative neck pain (structural pathology), and asymptomatic healthy controls. Using cervical radiographs, 3 cervical alignment parameters were evaluated: SVA, SCA, and disk height. Differences between groups were analyzed using one-way analysis of variance. RESULTS SVA and SCA differed significantly between the nonspecific neck pain group and both the degenerative neck pain group (P<0.05) and healthy controls (P<0.05), whereas no significant differences were observed between the degenerative neck pain group and healthy controls. Intervertebral disc height did not differ significantly among the 3 groups (P>0.05). CONCLUSIONS Nonspecific neck pain is associated with changes in global cervical sagittal alignment, including greater anterior translation and altered lordosis. These patterns differ from those observed in patients with degenerative neck pain and asymptomatic controls, supporting the use of global rather than segmental alignment in clinical assessment.