Does Improvement towards a Normal Cervical Sagittal Configuration Aid in the Management of Lumbosacral Radiculopathy: A Randomized Controlled Trial

Abstract

A randomized controlled study with a six-month follow-up was conducted to investigate the effects of sagittal head posture correction on 3D spinal posture parameters, back and leg pain, disability, and S1 nerve root function in patients with chronic discogenic lumbosacral radiculopathy (CDLR). Participants included 80 (35 female) patients between 40 and 55 years experiencing CDLR with a definite hypolordotic cervical spine and forward head posture (FHP) and were randomly assigned a comparative treatment control group and a study group. Both groups received TENS therapy and hot packs, additionally, the study group received the Denneroll cervical traction orthotic. Interventions were applied at a frequency of 3 x per week for 10 weeks and groups were followed for an additional 6-months. Radiographic measures included cervical lordosis (CL) from C2–C7 and FHP; postural measurements included: lumbar lordosis, thoracic kyphosis, trunk inclination, lateral deviation, trunk imbalance, surface rotation, and pelvic inclination. Leg and back pain scores, Oswestry Disability Index (ODI), and H-reflex latency and amplitude were measured. Statistically significant differences between the groups at 10 weeks were found: for all postural measures, CL (p = 0.001), AHT (p = 0.002), H-reflex amplitude (p = 0.007) and latency (p = 0.001). No significant difference for back pain (p = 0.2), leg pain (p = 0.1) and ODI (p = 0.6) at 10 weeks were identified. Only the study group’s improvements were maintained at the 6-month follow up while the control groups values regressed back to baseline. At the 6-month follow-up, it was identified in the study group that improved cervical lordosis and reduction of FHP were found to have a positive impact on 3D posture parameters, leg and back pain scores, ODI, and H-reflex latency and amplitude.