Inversion of cervical curvature: What to do? (conventional and surgical treatment)

Contents

La cervical spine normally presents a curvature (called cervical lordosis) allowing the support of the head on the trunk. In some situations, one can observe a reversal of cervical curvature.

This can cause neck pain, stiffness and headaches.

Is this condition serious? What are its manifestations in daily life? Can we fix it? We talk about it in this article.

Cervical spine, short anatomical reminder

La column vertebral, also called spine, consists of 33 vertebrae stacked on top of each other vertically:

  • 7 cervical vertebrae, numbered from C1 to C7,
  • 12 dorsal or thoracic vertebrae, from D1 to D12,
  • 5 lumbar vertebrae, from L1 to L5,
  • 5 sacral vertebrae fused together forming the sacrum,
  • 3 to 5 (usually 4) fused vertebrae forming the terminal part of the spine: the coccyx.

In a normal situation, the spine presents a succession of three physiological curvatures giving it a general “S” appearance:

  • Cervical lordosis: anterior physiological curvature of the cervical spine (concave or indented).
  • A dorsal curvature: posterior physiological curvature of the dorsal spine. When it is exaggerated, it is called "dorsal kyphosis" (convex or bump).
  • A lumbar lordosis : anterior physiological curvature of the Lumbar spine (natural arch).

The cervical spine is therefore naturally curve, in lordosis. When this lordosis turns into kyphosis, we then speak of reversal of curvature of the cervical spine.

This condition is also called cervical kyphosis.

Cervical Spine Curvature Inversion: Causes and Symptoms

There is no specific cause that would explain the inversion of curvature of the cervical spine. Scientific studies attempt to demonstrate the role of spasms muscle in the genesis of this pathology.

Anyway, we know that there are a number of factors that favor thereversal of cervic lordosisale. For example, we can cite:

  • to unsuitable postures (rare)
  • certain bone pathologies such as osteoporosis et osteoarthritis cervical.
  • following surgery (such as a cervical laminectomy)
  • trauma (fall, whiplash, etc.)
  • at birth (congenital)
  • etc.

The different symptoms ofreversal of cervical curvature can be the following:

  • Neck pain.
  • Contractures and muscle tension in the neck area.
  • Limitation of mobility of the cervical spine, with difficulty in performing certain movements.
  • Headaches (headaches) and migraines.
  • Paraesthesias and weakness in the upper limbs

It should be noted, however, that some cases are asymptomatic, that is to say that the patient does not feel any pain despite the presence of an inversion of curvature of the cervical spine.

This is probably due to an adaptive capacity of the body which was able to adjust to the curve inversion. Also, an absence of inflammation or nerve irritation often allows the body to feel pain free.

How to make the diagnosis?

Usually a profile x-ray (in the sagittal plane) is sufficient to observe an inversion of curvature of the cervical spine.

In some cases, more advanced imaging tests (such as an MRI) may be done. This will allow the soft tissues around the cervical region to be observed, and see if there is any disc or nerve damage associated with the condition.

In addition to medical imaging, it is important to perform a complete clinical examination. This will highlight the impact of symptoms in daily life. Also, we can observe the associated stiffness, weakness and muscular tension.

What to do to treat the condition and get relief?

Once the diagnosis is made, the treatment will consist of taking medications painkillers associated with some steps Additional such as massage, application of heat, adjustment of posture during sleep, etc.

It should be understood that these methods will not necessarily correct the curvature as such in the majority of cases. Rather, we want to reduce the inflammatory process related to the condition, as well as the nervous pressure if indicated.

Also, we want to restore range of motion and maximize the strength of the stabilizing muscles in the cervical region. Finally, a relaxation of muscle tension will allow the patient to suffer less on a daily basis.

Medical treatment

To relieve pain associated with reversal of cervical curvature (when symptomatic), simple analgesics such as anti-inflammatory ou paracetamol are usually sufficient.

Frequently used are treatments producers by the application of ointments containing active ingredients with a pain-relieving effect. This makes it possible to combine the relaxing effect of massage and the analgesic effect of the drug to achieve effective pain reduction.

Massage sessions

The Massages provided by a physiotherapist, an osteopath or other are very effective in relieving pain caused by condition. They allow to relax the muscles of the neck, to remove tensions and contractures. As mentioned, it should be noted that these modalities will not necessarily address the cause of the problem.

Some tools and accessories will reduce your pain in the comfort of your home. The recommended products are:

Physiotherapy (physiotherapy)

Besides passive treatments, you should consult a medical professional such as a physical therapist (physiotherapist). He will prescribe stretching and muscle strengthening movements adapted to your condition to relieve your symptoms and improve your function.

Here is an example of an exercise prescribed in physiotherapy to restore cervical lordosis:

Here is a series of exercises from the Mckenzie method for the cervical spine that a specialized therapist can test in your case:

Applying heat

The application of heat to the neck, through hot water bottles, is effective in reducing neck pain after a long day at work.

It is also possible to use collars cervical heated, or patches heated which have a very interesting relaxing and decontracting effect.

Adjusting your position while sleeping

The bad positions during sleep participate in modifying the conformation of the spine in the long term, more particularly the cervical spine. It can aggravate or promote the straightness of the cervical spine.

Moreover, once the straightness of the cervical spine is installed, it will result in unrest du sleep. So it's a vicious circle!

To break this vicious circle, it is recommended to Modify de bedding. There are comfortable mattresses and pillows (like a memory foam orthopedic pillow), specially designed to prevent neck pain.

Here are some tips to prevent or avoid worsening cervical spine deformities through small adjustments to your sleeping position:

  • Dorsal position: it is considered the best position for good recovery, as it promotes complete muscle relaxation. The three curvatures of the spine are respected, provided that the cushion is well positioned against the neck. Attention, the cushion should not be thick!
  • Lateral position: if you sleep on your side, opt for a thick pillow to fill the space between the shoulder and the neck (always with the aim of stabilizing the cervical region).
  • Ventral position: with this position, you have to turn your head, which sometimes accentuates muscle tension in many individuals. If you can't change position, opt for a thin, memory foam cushion.

surgery

If the deformity is fixed (i.e. it does not worsen over time) and the nerves are not affected, then surgery will not be automatically recommended to correct an inversion of curvature of the cervical spine. Indeed, it is quite an invasive procedure and a serious operation.

On the other hand, the operation will be indicated (and sometimes even urgently) when the condition is associated with neurological disorders.

Today, surgery to treat this condition usually involves spinal fusion combined with a metal rod to maintain proper neck alignment and straightening. An osteotomy is sometimes part of the surgical procedure in certain cases (for example, in the presence of ankylosing spondylitis).

As this is a complex operation, the medical team will have to weigh the pros and cons, based on factors such as:

  • the progression of the deformation
  • the severity of the deformation
  • the importance of pain and other symptoms

When indicated, early surgery usually gives better results, and may also prevent the progression of the deformity. When the operation is not indicated, the patient still benefits from close follow-up to monitor the evolution and prevent serious problems.

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