• E Kristjansson and H Jónsson.
• Faculty of Medicine, University of Iceland, Reykjavík, Iceland. eythork@simnet.is
• J Manipulative Physiol Ther. 2002 Nov 1; 25 (9): 550-5.

ObjectiveTo reveal whether women with chronic whiplash-associated disorder (WAD) symptoms, grade I-II, demonstrate regional and/or segmental radiographic signs of altered cervical lordosis.DesignCase-control study.SettingRadiography department at a university hospital.ParticipantsThree age-balanced groups comprising 120 women. The case group included women with chronic whiplash syndrome (n = 41), and the control group included women with chronic insidious onset neck pain (n = 39) and an asymptomatic group (n = 40), who were given baseline data. The sample was referred from informed doctors and physiotherapists.InterventionThe women sat in a standardized sitting position and radiographs were taken in a lateral position with fluoroscopic control for alignment.Outcome MeasuresTwo distinct measurements were taken; 1 of the angles of the upper and lower cervical curvatures, respectively, and 1 of the angles between the inferior borders of each pair of vertebrae in the lower cervical spine. The 3 groups were compared on the ratio of the lower to upper cervical spine angles and on the mean angular values for each segment in the cervical spine.ResultsThe whiplash group showed a decreased ratio between the lower versus upper cervical spine but comparisons between groups were not statistically significant. The whiplash group was in a significantly more flexed position at the C4-C5 level compared with the asymptomatic group (P =.007). The reliability measures have to be strengthened to render these results definitely conclusive.ConclusionThe whiplash group exhibited a different configuration of cervical lordosis. This is clinically important and needs to be studied more closely.

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