From the Research
Cervical curve correction can lead to decreased cervicothoracic junction pain in some patients, as evidenced by the most recent and highest quality study available, which suggests that pedicle subtraction osteotomy (PSO) provides the most powerful correction for cervical sagittal vertical alignment and cervical lordosis, resulting in improved patient outcomes 1.
Key Points to Consider
- The goal of cervical curve correction is to restore the normal lordotic curve of the cervical spine, which may reduce mechanical stress at the cervicothoracic junction and alleviate pain.
- Treatment typically involves a multimodal approach, including spinal manipulation, targeted exercises, postural correction training, and sometimes specialized cervical traction devices.
- The biomechanical rationale is that improving cervical alignment redistributes forces more evenly throughout the spine, potentially reducing abnormal loading at the cervicothoracic junction.
- Individual responses vary significantly, and cervical curve correction should be part of a comprehensive treatment plan rather than viewed as a standalone solution for cervicothoracic pain.
Evidence-Based Recommendations
- The most recent and highest quality study available suggests that PSO provides the most powerful correction for cervical sagittal vertical alignment and cervical lordosis, resulting in improved patient outcomes 1.
- Other studies have shown that cervicothoracic junction manual therapy can improve cervical alignment, cervical mobility, and muscle recruitment ability in subjects with forward head posture 2.
- Surgical techniques, such as PSO, can be effective in correcting cervicothoracic sagittal imbalance, but also present significant risks, and careful surgical planning is necessary based on patient-specific deformities and risk factors 1.
Clinical Implications
- Cervical curve correction should be considered as part of a comprehensive treatment plan for patients with cervicothoracic junction pain.
- A multimodal approach, including spinal manipulation, targeted exercises, postural correction training, and sometimes specialized cervical traction devices, may be effective in reducing mechanical stress at the cervicothoracic junction and alleviating pain.
- Surgical techniques, such as PSO, may be considered for patients with severe cervicothoracic sagittal imbalance, but careful surgical planning is necessary to minimize risks and optimize outcomes.