SYMPTOMS OF THE CERVICAL-SPINE IN TEMPOROMANDIBULAR AND CERVICAL-SPINE DISORDERS

This study was performed to assess the prevalence of signs and symptom s related to cervical spine disorders (CSD) in subgroups of patients w ith temporomandibular disorders (TMD) and to compare TMD patients and CSD patients with regard to the results of orthopaedic cervical spine tests. One hundred and eleven consecutive patients with TMD and 103 co nsecutive patients with signs and symptoms of CSD were examined. The r esults indicated that there is a considerable overlap in the signs and symptoms of patients with TMD and patients with CSD. Signs and sympto ms on neck extension occurred more often in CSD patients than in subgr oups of TMD patients. No significant differences in upper cervical ext ension, neck flexion, and shoulder girdle function were found between CSD patients and subgroups of patients with TMD. Patients with CSD rep orted neck pain during active and passive movements of the neck more o ften than the subgroups of patients with TMD. TMD patients and CSD pat ients did not differ with regard to pain on shoulder girdle function a nd palpation of the shoulder girdle. Logistic regression analyses show ed that orthopaedic tests of the cervical spine are of minor importanc e in discriminating between patients with TMD and patients with CSD. I t is concluded that TMD with a myogenous involvement in contrast to TM D with only an arthrogenous involvement should no longer be viewed as a local disorder of the stomatognathic system. The upper including the stomatognathic system, spine, and shoulder girdle, should be evaluate d in patients with more complex or persistent symptoms in the head and neck region.