Abstract

Background: Reversed cervical lordosis (RCL) is a pathological condition characterized by a reversal of the normal cervical spine curvature, resulting in kyphosis. This deformity is frequently associated with chronic neck pain, neurological deficits, and functional limitations. Despite its clinical relevance, research regarding standardized diagnostic criteria, clinical manifestations, imaging features, and therapeutic outcomes remains scattered.
Objective: This systematic review aims to comprehensively synthesize current evidence on the clinical presentations, radiological characteristics, and both conservative and surgical treatment outcomes in patients diagnosed with reversed cervical lordosis.
Methods: A thorough search was conducted across PubMed, Scopus, Embase, and Web of Science databases for studies published between January 2000 and December 2023. Eligible studies included randomized controlled trials, cohort studies, and case series with at least five patients, focusing on human subjects diagnosed with RCL. Data extracted encompassed patient demographics, diagnostic parameters such as Cobb angle measurements, clinical symptoms, treatment modalities, outcome measures including pain and disability indices, and follow-up durations. The methodological quality of included studies was appraised using established assessment tools.
Results: Fifteen studies encompassing 645 patients met the inclusion criteria. Common clinical findings included persistent neck pain, limited cervical mobility, and radicular symptoms in some cases. Radiologically, RCL was primarily identified by a negative Cobb angle on lateral cervical radiographs. Conservative management approaches, such as physical therapy and cervical traction, demonstrated modest benefits in symptom relief and alignment correction over short to medium-term follow-up. Surgical interventions, notably anterior cervical discectomy and fusion (ACDF) and posterior fusion procedures, provided significant improvements in cervical alignment and clinical outcomes, particularly among patients with severe or refractory symptoms.
Conclusion: Reversed cervical lordosis represents a clinically significant deformity that necessitates early recognition and appropriate management. While both conservative and surgical treatments offer benefits, surgical correction may yield superior radiological and functional outcomes in selected patients. Further high-quality research is needed to establish uniform diagnostic criteria and to evaluate long-term treatment efficacy.