THE CORRELATION BETWEEN SURFACE MEASUREMENT OF HEAD AND NECK POSTURE AND THE ANATOMIC POSITION OF THE UPPER CERVICAL-VERTEBRAE

Study Design. Repeated measurements were made of surface postural angl es registering the relative positions of the head and neck in photogra phs and of angles of the upper cervical vertebrae recorded in lateral cephalometric radiographs in the same subjects. For all registrations, subjects assumed the natural head rest position. Objectives. To exami ne the correlation between external measurement of head and neck postu re and the anatomic positions of the upper four cervical vertebrae. Su mmary of Background Data. Interpretation of surface cervical posture m easurement is confounded by lack of knowledge about the extent of the underlying compensatory adjustments among the upper cervical vertebrae that may accompany variation in head and neck posture. The correlatio n between surface measurement and postural characteristics of the uppe r cervical spine has not been reported to date. Methods. The associati on between a set of angles describing the anatomic position of the fou r upper cervical vertebrae on lateral cephalometric radiographs and a surface measurement of head and neck posture, the craniovertebral angl e, was studied in 34 young adult women aged between 17.2 and 30.5 year s, mean age, 24.5 years. Anatomic positions of the upper four cervical vertebrae were expressed by angles relative to the true vertical or h orizontal, Surface angles registering head and neck position for each subject were obtained from photographs recorded on two occasions. Resu lts. No strong correlation could be established between the angles tak en from the lateral cephalometric radiographs measuring the extent of upper cervical lordosis, orientation of the atlas, vertebral inclinati on, or odontoid process tilt and surface angles recording head and nec k position. This finding was attributed principally to the much greate r positional variability demonstrated within the upper cervical spine when compared with the surface measurements of head and neck position. Conclusion. Anatomic alignment of the upper cervical vertebrae cannot be inferred from variation in surface measurement of head and neck po sture. This is the case even in those people identified with more extr eme head and neck postural tendencies.