An investigation of 3D spinal alignment in cervicogenic headache.

BACKGROUND

There is a growing interest in the impact of body posture influences on outcome measures of cervicogenic headache (CGH).

OBJECTIVE

To evaluate differences in the 3D spinal alignment in cases suffering from chronic CGH compared to a group of strictly matched control participants without CGH.

DESIGN

A single-blinded, comparative cohort design.

METHODS

100 participants suffering from frequent headaches for at least 3 months who fulfilled the CHISG criteria for CGH were match by age and sex to 100 asymptomatic control group participants. A 4D Formetric device was used to assess participants' posture variables of: 1) thoracic kyphosis max (ICT-ITL in degrees); 2) trunk lateral imbalance (VP-DM in mm); 3) Trunk anterior inclination (VP-DM in mm); 4) lumbar lordotic angle (ITL-ILS max in degrees); 5) Vertebral rotation (rms) in degrees. A matched-pairs binary logistic regression was used to determine whether measurements of posture demonstrated an association with the likelihood of the presence of CGH.

RESULTS

There were statistically significant differences between the CGH and control group for all posture variables indicating larger posture displacements in the CGH group: ICT-ITL (p < .001), Lateral VP-DM (p < .001), Sagittal VP-DM (p < .001), ITL-ILS (p < .001), RMS (p < .001). Logistic regression revealed that as posture displacement increased, a statistically significant increased likelihood of having CGH occurred: (ICT-ITL (max) (p < .001); Trunk imbalance VP-DM (p < .004); Trunk inclination VP-DM (p < .001); and vertebral rotation (RMS) (p = .007). No such relationship was found for Lumbar Lordosis ITL-ILS max.

CONCLUSIONS

Participants with CGH exhibited increased magnitudes of thoracolumbar posture displacements which corresponded to an increased odds of suffering from CGH compared to matched control participants.