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Cervical spine and neurovascular findings in 84 patients with hypermobile Ehlers–Danlos Syndrome: a retrospective study

Review written by Dr Xiaoqi Chen info

Key Points

  1. Across 84 self-referred patients with hEDS, cervical structural abnormalities (forward head, C1–C2 ligamentous instability, reduced lordosis) and reduced internal jugular vein and vagus nerve cross-sectional area were highly prevalent, affecting more than 90% of the cohort, and the authors propose these as possible contributors to the multisystem symptoms of hEDS.
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BACKGROUND & OBJECTIVE

Hypermobile Ehlers–Danlos syndrome (hEDS) is a heritable connective tissue disorder characterized by generalized joint hypermobility, chronic musculoskeletal pain, and a wide range of systemic features that frequently include cardiovascular, neurological, gastrointestinal, and autonomic complaints (1). Because the connective tissue laxity that defines the condition may also affect the cervical spine, upper cervical instability has long been raised as a possible contributor to the broader symptom picture, yet it has rarely been examined systematically alongside adjacent neurovascular structures (2).

The aim of this study was to describe cervical spine and neurovascular findings in a cohort of patients with hEDS attending an outpatient neck clinic (see Figure 1), in order to generate hypotheses about structural and autonomic mechanisms that might underpin the multisystem symptomatology seen in this population.

Hypermobile Ehlers–Danlos syndrome (hEDS) is a heritable connective tissue disorder characterized by generalized joint hypermobility, chronic musculoskeletal pain, and a wide range of systemic features.
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Keep management individualized, active, education-led rehabilitation that builds cervical and global strength, addresses postural habits, paces activity, and coordinates care across disciplines where autonomic or pain-related features are prominent.

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METHODS

This was a single-center, retrospective, descriptive observational study. The authors reviewed the clinical records of 84 consecutive patients aged 20–50 years who met the 2017 international diagnostic criteria for hEDS and who presented to a private outpatient neck clinic between

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