All About Cervical Curves- Zabdi S.

Original Picture
Original Picture

Vertabend has currently been tackling the biomedical and engineering research components of our second deliverable. During class our team has also started on a interpreted needs list that consists of customer statements supporting a specific need or want and the possible metrics for each solution. Each “need” was ranked in order of importance. My main contribution to the team has been the acquisition of information centered on neck structure, and how current orthosis (braces) solve the problem of neck pain.

The most exciting findings throughout my research has been learning all about our cervical curve. I will start off with a brief overview with the anatomy of the neck. The cervical spine is composed of the first seven vertebrates. It begins right below the head and ends right on the thoracic spine. Our neck is also much more flexible than the rest of the spine as we need to freely move our head in different angles. The reason for this flexibility is due to two vertebrates, the atlas (the first vertebra that rests between the neck and spine) and the axis (the second vertebra) which allow for rotation. The “ideal” position of the neck is known as a lordotic curve (a backward C-shape), which has been accepted as the physiological form. Although there isn’t an exact and perfect curve of the neck, the overall “normal” curvature is a range between 20 degrees and 35 degrees in humans. Other defined measurements of neck curvature are straight and kyphotic forms. An individual with kyphotic (forward curve) or straight curvature can be consider as abnormal however studies have found that even with these shapes of the neck, a few individuals do not experience any pain or health problems. Overall, this background knowledge will allow us to be aware of how to develop our neck support pillow, since we want to maintain the best neck posture while sleeping.

Cervical Spine Alignment
http://janesvillechiropractic.com/wp-content/uploads/2014/01/cbp-chart-04.png

An interesting study that I found came from the  European Spine Journal which had an article describing the association between cervical spine curvature and neck pain (D. Grob, H. Frauenfelder, and A. F. Mannion, 2007). This study was quite different since it asserted that degenerative changes of the neck (different curvatures) did not cause pain in individuals. The article also referenced a previous study by Harrison (another article publisher on neck curvature) that did find a causative relationship between curvature and neck pain, stating that it was flawed due to improper group sampling, incorrect positioning of x-ray scans and other factors. However, there was a follow up report (Letter to the editor: “The association between cervical spine curvature and neck pain (D.Grob et al.) Deed E. Harrison and Donald Harrison, 2007) by Harrison declaring that those assumptions are incorrect, and that the main differences between both of their studies was that Grob’s targeted elderly patients. This was quite surprising as I was excited to read an informative article yet I found another journal discussing the problems with the unique results found by Grob. I still want to find more specific information on what exactly causes mild neck pain in individuals while sleeping, since through our interviews people complained about a stiff neck in the morning. At the same time, this study has still provided a lot of information on the curvature of the neck which will definitely play a role for a neck support pillow.

The association between cervical spine curvature and neck pain D. Grob, H. Frauenfelder, and A. F. Mannion
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2213543/

Another study that I found concentrated on the effectiveness of commonly known spinal orthoses at restricting spinal motion which would allow the user to recover from neck pain quickly. The study analyzed the effectiveness of the Miami J Advanced, Miami J, Aspen, Philadelphia, and VIsta  collars. The findings of the effectiveness of each device varied in great amounts. In conclusion, the article summarized that the Aspen collar was superior in restricting movement compared to the other collars in the study. The Vista collar was found to be the least effective device. Although the article provides the public with information on which collar is most restrictive in movement, it does not go into depth of how beneficial it is for the neck. We can still assume that less movement would be better, which might play into how confining and tight our neck support pillow must be in order to prevent neck discomfort. On the other hand, highly restrictive collars are usually for more serious injuries.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3578513/#!po=5.55556
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3578513/#!po=5.55556

In conclusion, I found many good sources of information about the biomedical aspect of the neck and current cervical collars. I still hope to find more concrete studies on how a cervical collar aligns the neck. I also want to analyze how effective are specific neck pillows in preventing neck discomfort as well as why the pillows are a certain shape and structure. I might even look into how the rest of the spine affects the neck overall. These are the goals for the rest of my week and for our second deliverable.

Citations:

D. Grob, H. Frauenfelder, A. F. Mannion, “The association between cervical spine curvature and neck pain,” Eur Spine J. 2007 May; 16(5): 669–678. Published online 2006 November 18. Access: October 10, 2014. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2213543/

Deed E. Harrison, Donald Harrison, Letter to the editor: “The association between cervical spine curvature and neck pain (D.Grob et al.) Deed E. Harrison and Donald Harrison, 2007,” Eur Spine J. 2007 October; 16(10): 1739–1740. Published online 2007 May 8. Access: October 10, 2014. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2078313/
Nicholas Rhys Evans, Georgina Hooper, Rachel Edwards, Gemma Whatling, Valerie Sparkes, Cathy Holt, Sashin Ahuja, “A 3D motion analysis study comparing the effectiveness of cervical spine orthoses at restricting spinal motion through physiological ranges.” Eur Spine J. 2013 March; 22(Suppl 1): 10–15. Published online 2013 January 4. Access: October 10, 2014. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3578513/
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