Comparative clinical and imaging features of chronic nonspecific neck pain and degenerative cervical spondylosis: A retrospective propensity score-matched analysis.

BACKGROUND

Cervical spine degeneration affects sagittal alignment, muscle morphology, intervertebral discs, and bone quality. Chronic nonspecific neck pain (CNSNP) may represent an early stage of degenerative cervical spondylosis (DCS), yet their differences remain unclear. This study intends to compare these features between CNSNP and DCS patients.

METHOD: The clinical data and radiological characteristics of 55 patients with CNSNP and 754 patients with DCS were reviewed. Propensity score matching (PSM) was used to adjust for sex, age, and BMI between the two groups. Cervical alignment, muscle morphology, DD, and bone quality were assessed via MRI. Statistical analyses were conducted to compare the two groups.

RESULTS

Compared with the CNSNP group, the DCS group had a larger adjusted cross-sectional area (aCSA), a higher fat infiltration ratio (FI%), and a smaller functional cross-sectional area (fCSA) (p < 0.05). The cranial tilt was significantly greater in the DCS group (p < 0.05), whereas the cervical sagittal vertical axis (cSVA) was significantly greater in the CNSNP group (p < 0.05). FI% correlated positively with cranial tilt across all muscle groups (p < 0.05) and with DD in the average DEs (ADEs), average SEs (ASEs), and average DFs (ADFs) (p < 0.01).

CONCLUSIONS

Patients with DCS showed significant differences compared to those with CNSNP in terms of cervical paraspinal muscle morphology, sagittal parameters, and disc degeneration. These findings suggested that increased FI%, reduced fCSA, and elevated aCSA in paraspinal muscles, together with sagittal imbalance and disc degeneration, are significant factors in the analysis of potential degenerative patterns in CNSNP and DCS.