Functional Radiographic Examination of the Cervical Spine in Patients with Post-Traumatic Headache

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Abstract
The segmental extension-flexion motion of the cervical spine and the overall C1–C7 motion were measured on functional X-rays in 19 patients with post-traumatic headache and 19 age-and sex-matched controls. The extension-flexion C1–C7 motion was reduced in patients with post-traumatic headache due to reduced motion in three segments: C2–C3, C5–C6 (p < 0.05), and C6–C7 (p < 0.01). In both groups a negative correlation between the C1–C7 motion and age was found, but the regression coefficients were different. Only in the control group could a negative correlation between segmental motion and age be demonstrated. In the patients with post-traumatic headache a statistically significant negative correlation between the log(pain index) and the age-corrected C1–C7 motion was found (p < 0.04). On the segmental level a negative correlation between the log (pain index) and the age-corrected C1–C2 and C5–C6 motion could be demonstrated (p < 0.05). Regarding C6–C7 there was a tendency to negative correlation. Furthermore, a negative correlation between the frequency of associated symptoms (dizziness, visual disturbances and ear symptoms) and the age-corrected C5–C6 motion was found. Consequently the decrement of motion primarily affected C2–C3, C5–C6, and C6–C7, whereas the analysis of correlation with pain index indicated C1–C2 and C5–C6 (C6–C7) as the most important segments involved.