Roentgenographic findings in the cervical spine in asymptomatic persons: a ten-year follow-up

The lateral roentgenographic findings in 159 initially asymptomatic persons were reviewed at a 10-year interval. A questionnaire was used at the time of the last roentgenogram to determine the incidence of pain.

To identify the number of persons who experienced pain during that 10-year period, describe the roentgenographic changes, and determine the association between the development of symptoms and roentgenographic findings.

It is well established that degenerative changes of the cervical spine increase with age and may occur in asymptomatic persons. However, it is unknown whether pain is more likely to develop in persons with degenerative changes than in those with normal roentgenograms.

Lateral cervical roentgenograms were obtained in 200 asymptomatic persons, 100 women and 100 men, to obtain normal values of cervical lordosis and degenerative changes in persons aged 20-65 years. Ten years later, 159 participants had repeat roentgenograms and were administered a questionnaire regarding the presence or absence of pain.

There was an increase in the number of subluxations and an increase in degenerative changes. Pain developed in 15% of participants in the 10-year interval. The presence of degenerative changes at C6-C7 on the initial roentgenogram was a statistically significant predictor of pain.

With age, there is an increase in the number of subluxations and the incidence and severity of degenerative changes. Pain is more likely to develop in persons with degenerative changes at C6-C7.