Quantifying the effects of age, gender, degeneration, and adjacent level degeneration on cervical spine range of motion using multivariate analyses.
Level 4 - case-series / case-control
Retrospective cross-sectional analysis of patient radiographs
PubMed 18197104 · doi:10.1097/BRS.0b013e31816044e8
What was done
Flexion/extension cervical spine radiographs from 195 patients (133 females, 62 males; age range 15–93 years) were retrospectively analyzed. Segmental range of motion (ROM) and Kellgren score (KS) of degeneration were measured from C2 to C7. Multivariate linear analyses evaluated the associations between segmental ROM and five independent variables: index-level KS, KS at the level above, KS at the level below, age, and gender (significance at P < 0.05).
What was found
Interobserver reliability was ICC 0.81 for KS and ICC 0.72 for segmental ROM. Multivariate analysis showed: - Age was independently associated with a 5° decrease in subaxial cervical ROM every 10 years (significant at C2–C3, C3–C4, C4–C5, and C5–C6). - Index-level degeneration was negatively associated with ROM at all subaxial levels (C2–C7), with a 1.2° decrease in ROM per 1-point increase in KS. - Degeneration at the inferior segment was positively associated with ROM at C2–C3, C3–C4, and C4–C5, reflecting a 0.8° increase in ROM at the level above for every 1-point increase in KS below. - Gender was significantly associated with ROM only at C2–C3.
Why it matters
This study separates the independent mechanical contributions of normal aging from degenerative disc disease on cervical mobility, providing quantified benchmarks for age-related loss and compensatory hypermobility adjacent to degenerate levels.
Limits
The retrospective cross-sectional design cannot establish longitudinal progression within individual patients. Clinical symptoms, pain, indications for imaging, and prior treatments were not reported in the abstract. Plain flexion/extension radiographs assess motion only in the sagittal plane and do not evaluate axial rotation or lateral bending.
Cited by
- supports Human joint range of motion naturally decreases as people age.