Dissertation submitted in partial compliance with the requirements for the
Master’s Degree in Technology: Chiropractic, Durban University of Technology, 2012. / Aim: To evaluate the normal selected cervical spine radiographic parameters i.e. the
cervical lordosis (CL), sagittal canal diameter (SCD), interpedicular distance (IPD) and
cervical gravity line (CGL) in asymptomatic young to middle-aged females across four
ethnic groups (Black, White, Indian and Coloured) in Durban, KwaZulu Natal, South
Africa.
Participants: Eighty apparently healthy females between the ages of 18 and 45 years
from the Black, Indian, Coloured and White ethnic groups in Durban, KwaZulu Natal.
Methodology: Written informed consent was obtained from each participant. A case
history, physical examination and an orthopaedic assessment of the cervical spine was
conducted for each participant. Study specific data such as ethnicity, age, height and
weight was recorded. A lateral and an A-P radiograph of the cervical spine were taken for
each participant. The selected radiographic parameters viz. cervical lordosis (CL), sagittal
canal diameter (SCD), interpedicular distance (IPD) and cervical gravity line (CGL) were
evaluated according to methods described previously. SPSS version 15.0 (SPSS Inc.,
Chicago, Illinois, USA) was used for data analysis. Coefficients of variation were
calculated within ethnic groups to assess intra-group variation. Inter-group variation was
assessed using ANOVA testing with Bonferroni-adjusted post-hoc tests in the case of a
significant ANOVA test. Pearson’s chi square test was used to assess the association
between ethnic groups and position of the CGL. T-tests were used to compare mean CL
between those with anterior and normally placed CGL within each ethnic group.
Results:
The mean ± SD of the CL in South African females by ethnic group using the C1-C7 and C2-
C7 methods
CERVICAL LORDOSIS (mean ± SD) (°)
ETHNICITY
C1-C7 C2-C7
Black 42.1° (±13.4) 16.3° (±8.3)
White 37.4° (±10.3) 9.9° (±4.8)
Indian 33.7° (±9.7) 6.9° (±4.8)
Coloured 42.5°(±10.9) 12.1° (±9.5)
The mean ± SD of the SCD in South African females by ethnic group
SAGITTAL CANAL DIAMETER (mean ±SD)(mm)
ETHNICITY
Black
White
Indian
Coloured
SCDC2 SCDC3 SCDC4 SCDC5 SCDC6 SCDC7
20.2 (±1.7) 17.4 (±1.4) 17.2 (±1.4) 17.0 (±1.4) 17.6 (±1.3) 17.5 (±1.4)
20.8 (± 2.2) 17.9 (±1.6) 17.6 (±1.6) 17.4 (±1.6) 17.6 (±1.4) 21.0 (±2.0) 18.2 (±1.7) 17.5 (±1.5) 17.4 (±1.7) 17.6 (±1.6) 17.1 (±1.5)
20.3 (±1.6) 17.5 (±1.8) 17.4 (±1.5) 17.7 (±1.2) 17.6 (±1.3) 16.9 (±1.2)
16.9 (±1.4)
The mean ± SD of the IPD in South African females by ethnic group
INTERPEDICULAR DISTANCE (mean ±SD)(mm)
ETHNICITY IPDC3 IPDC4 IPDC5 IPDC6 IPDC7
Black
27.0 (±2.8) 27.6 (±3.2) 28.2 (±4.0) 28.9 (±4.2) 27.5 (±3.5)
White 28.4 (±2.6) 28.8 (±2.2) 29.5 (±2.3) 29.3 (±2.5) 28.2 (±2.9)
Indian 27.2 (±1.8) 27.5 (±1.8) 27.9 (±1.6) 27.9 (±1.6) 27.5 (±2.0)
Coloured 27.9 (±2.3) 27.8 (±2.3) 28.3 (±2.2) 28.4 (±1.8) 28.2 (±1.7)
The placement of the CGL in South African females in each ethnic group
CERVICAL GRAVITY LINE
ETHNICITY PLACEMENT OF CGL
Black 70% anterior placement
White 70% anterior placement
Indian 60% anterior placement
Coloured 60% anterior placement
The C1-C7 measurements and the C2-C7 CL measurements were significantly different
amongst the ethnic groups. For the C2-C7 method, Blacks differed significantly from both
Whites (p = 0.037) and Indians (p = 0.001; Bonferroni adjusted post-hoc test); with the
values for the Blacks being higher than both Whites and Indians. There was no correlation
between CL and BMI amongst any of the selected ethnic groups. There were no
significant differences in the mean SCD and IPD amongst the ethnic groups (p > 0.05;
ANOVA test). There was no significant association between any ethnic group and the
position of the CGL (p = 0.830; Pearson’s chi square test). In Black females, those with a
normally positioned CGL had significantly higher C2-C7 CL measurements (p = 0.008; T-
tests). There was no correlation between the CL and anterior placing of the CGL in any of
the ethnic groups.
Conclusion:
No individual differences were observed in the CL amongst the ethnic
groups when using the C1-C7 method. However, significant differences were observed
when the C2-C7 method was used. There were no significant differences observed in the
mean SCD and IPD amongst the ethnic groups. In Black females, those with a normally
positioned CGL had significantly higher C2-C7 CL measurements. The trends observed in
this research study and the differences in the findings to those of previous studies lay the
platform for a larger population-based study across South Africa to establish normative
reference values for each radiographic parameter specific for gender and ethnicity.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:dut/oai:localhost:10321/937 |
| Date | 13 November 2013 |
| Creators | Naicker, Janeene Tamara |
| Contributors | Shaik, Junaid |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | 82 p |
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