Increase in Cerebral Blood Flow Indicated by Increased Cerebral Arterial Area and Pixel Intensity on Brain Magnetic Resonance Angiogram Following Correction of Cervical Lordosis
Brain Circulation January-March 2019; Vol. 5; No. 1; pp. 19-26
Evan A Katz, Seana B Katz, Curtis A Fedorchuk, Douglas F Lightstone, Chris J Banach, Jessica D Podoll
Introduction:
The relationship between cervical lordosis and cerebral blood flow has been a subject of growing interest in the field of healthcare. A recent study aimed to evaluate the changes in cerebral blood flow using brain magnetic resonance angiogram (MRA) in patients with loss of cervical lordosis before and after correction using the Cervical DennerollTM Spinal Orthotic. This article summarizes the key findings and implications of this study.
Key Findings:
Definition of Cervical Lordosis:
Cervical lordosis is defined as the angle between the lines tangent to the posterior aspect of C2 and C7 vertebral bodies. The study focused on patients with a variety of cervical curves, ranging from 19° kyphotic to 13° lordotic, with the ideal being 42° lordotic.
Causes and Consequences of Loss of Cervical Lordosis:
Loss of cervical lordosis can occur gradually due to poor posture and ergonomics or more rapidly due to trauma such as whiplash. The study highlights that this condition is associated with decreased vertebral artery hemodynamics, increased spinal cord and nerve root tension, pain, disability, and various skeletal changes.
Relationship Between Cervical Lordosis and Cerebral Blood Flow:
The hypothesis of the study posited that correcting cervical hypolordosis would lead to increased cerebral artery hemodynamics and circulation. This is based on the anatomical relationship between the cervical spine, vertebral arteries, and cerebral vasculature.
Methodology:
The study involved seven patients, and cervical lordosis was measured on lateral cervical x-rays. Initial and post-correction MRAs were performed to analyze and quantify pixel intensities representing cerebral blood flow.
Immediate Increase in Cerebral Blood Flow:
The results of the study demonstrated a significant increase in cerebral blood flow by 23.0%–225.9% with improved cervical lordosis. Conversely, as cervical lordosis decreased, blood flow on MRA also decreased.
Implications for Neurological Conditions:
Correction of cervical lordosis was associated with improved cerebral artery parameters, indicating an immediate increase in blood flow in the brain. Clinical trials have shown that this correction may positively impact various neuromusculoskeletal and visceral conditions.
Future Research Directions:
The study suggests that further research, using perfusion-weighted magnetic resonance imaging or computed tomography perfusion scans, would be warranted to explore the potential benefits of cervical lordosis correction for conditions such as dementia, Alzheimer’s disease, cervicogenic headaches, and traumatic brain injury.
Conclusion:
The study provides valuable insights into the intricate relationship between cervical lordosis and cerebral blood flow. The immediate increase in cerebral blood flow following correction of cervical lordosis underscores the importance of biomechanics in influencing physiology. These findings open avenues for future research and potential clinical applications in addressing neurological conditions associated with altered cerebral blood flow.