Natural Cervical Lordosis in Healthy Individuals
Yes, a natural cervical lordosis is present in healthy individuals, with the normal cervical spine having a lordotic curve (forward curve when viewed from the side). 1
Normal Cervical Lordosis Characteristics
- The cervical spine naturally exhibits a lordotic curve in healthy individuals, which is a physiological curvature of the cervical spine 2
- In healthy adults, approximately 51% have a lordotic cervical spine, 41% have a straight spine, and less than 10% have either a double curve or kyphotic spine 1
- In children, the distribution differs with 71% having a lordotic cervical spine, 23% having a straight spine, and less than 6% having a double curve spine 1
Measurement and Normal Values
- Using the Cobb C2-C7 method, a normal cervical lordotic angle can be measured from the inferior endplates of C2 and C7 vertebrae 2
- Research suggests a "clinically normal" range for cervical lordosis is between 31° to 40° 3
- Patients with lordosis of 20° or less are more likely to have cervicogenic symptoms (P < .001) 3
Variations by Age and Gender
- Total cervical lordosis (FM-C7) remains similar between age groups, but the internal architecture changes significantly 1
- Males tend to have smaller upper cervical lordosis (FM-C3) and higher lower cervical lordosis (C3-C7) compared to females 1
- Males have a larger median cervical lordosis than females (20° vs 14°) 3
- Gender differences are apparent even in children, with girls having higher upper cervical lordosis than boys 1
Clinical Significance
- Neck pain and disability is often associated with cervical lordosis malalignment 1
- The odds of a patient with cervical pain having a lordosis of 0° or less is 18 times greater than for a patient without cervical complaints 3
- Alterations in normal cervical lordosis in patients with neck injury should be considered coincidental rather than associated with muscle spasm caused by neck pain 4
- Lordosis of the cervical spine can affect functional outcomes, such as swallowing in elderly patients 2
Imaging Considerations
- Radiographs are useful in diagnosing cervical spine alignment, but therapy is rarely altered by radiographic findings in the absence of red flag symptoms 5
- MRI is the most sensitive test for detecting soft tissue abnormalities but has a high rate of abnormalities in asymptomatic individuals 5
- Spondylotic changes on radiographs and MRI are common in patients over 30 years of age and correlate poorly with the presence of neck pain 5
Treatment Implications
- Maintenance of a lordosis in the range of 31° to 40° could be a clinical goal for chiropractic treatment 3
- Surgical procedures involving cervical lordosis stabilization or restoration must consider age and gender differences in cervical lordosis architecture 1
- In cases where lordotic curvature adversely affects function in the elderly, rehabilitation to manage the lordosis may be beneficial 2