This 20 year longitudinal study compared initial MRIs and follow-up MRIs of healthy asymptomatic volunteers. Subjects were grouped by being either lordotic or non-lordotic in their cervical sagittal alignment.

After 20 years they concluded that non-lordotic cervical alignment was related to the progression of disc degeneration at C7-T1 but not at any of the other levels.

However, most importantly, they found that cervical alignment was NOT at all associated with the development of neck pain, stiff shoulders, or arm numbness.

So when a health care provider claims that a patient’s symptom can be explained by looking at neck alignment based on an x-ray, they are frankly full of B.S.! They are what I call performing BARF (Brainless Application of Radiological Findings).

If you already have a VOMIT poster, great; but if you don’t, you may download it for free on the “Pain Education” section of and print it off as a poster yourself.

The poster is now available in 7 languages.

You may certainly still order the poster for $20 which I consider an essential educational tool to have in every clinic.

Reference: Okada E et al Twenty-year Longitudinal Follow-up MRI Study of Asymptomatic Volunteers: The Impact of Cervical Alignment on Disk Degeneration. Clin Spine Surg. 2018 Dec;31(10):446-451.

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