Osteophytes on the zygapophyseal (facet) joints of the cervical spine ( C3 –C7): A skeletal study

Tropism, or asymmetry, of facet joints in the cervical spine has been found to be related to degenerative changes of the joints and discs. Clinicians often assume that differences in segmental mobility are related to tropism. The aims of this study were to determine the relationship between asymmetry of facet joints in the sub-axial cervical spine and (1) segmental mobility and (2) spinal levels perceived by therapists to have limited mobility. Eighteen participants with idiopathic neck pain had MRIs of their cervical spine in neutral and at the end of active rotation. Angular movement and translational movement of each motion segment was calculated from 3D segmentations of the vertebrae. A plane was fitted to the facet on each side. Tropism was considered to be the difference in the orientation of the facet planes and ranged from 1 to 30° with a median of 7.7°. No relationships were found between the extent of tropism and either segmental movement or locations deemed to be symptomatic. Tropism in the sub-axial cervical spine does not appear to be related to segmental mobility in rotation or to levels deemed to be symptomatic.

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Imaging Occult Lesions in the Cervical Spine Facet Joints

American Journal of Forensic Medicine & Pathology ◽

10.1097/paf.0b013e318187de9a ◽

2009 ◽

Vol 30 (2) ◽

pp. 142-147 ◽

Cited By ~ 7

Author(s):

Lars Uhrenholt ◽

Edith Nielsen ◽

Annie Vesterby Charles ◽

Ellen Hauge ◽

Markil Gregersen

Keyword(s):

Cervical Spine ◽

Facet Joints

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Analysis of the uncinate processes of the cervical spine: an anatomical study

Journal of Neurosurgery Spine ◽

10.3171/2011.12.spine11541 ◽

2012 ◽

Vol 16 (4) ◽

pp. 402-407 ◽

Cited By ~ 18

Author(s):

R. Shane Tubbs ◽

Olivia J. Rompala ◽

Ketan Verma ◽

Martin M. Mortazavi ◽

Brion Benninger ◽

...

Keyword(s):

Cervical Spine ◽

Anatomical Study ◽

Axial Rotation ◽

Intervertebral Discs ◽

Uncinate Process ◽

Surgical Approaches ◽

Intervertebral Foramen ◽

Facet Joints ◽

Vertebral Level ◽

Arthritic Changes

Object Although the uncovertebral region is neurosurgically relevant, relatively little is reported in the literature, specifically the neurosurgical literature, regarding its anatomy. Therefore, the present study aimed at further elucidation of this region's morphological features. Methods Morphometry was performed on the uncinate processes of 40 adult human skeletons. Additionally, range of motion testing was performed, with special attention given to the uncinate processes. Finally, these excrescences were classified based on their encroachment on the adjacent intervertebral foramen. Results The height of these processes was on average 4.8 mm, and there was an inverse relationship between height of the uncinate process and the size of the intervertebral foramen. Degeneration of the vertebral body (VB) did not correlate with whether the uncinate process effaced the intervertebral foramen. The taller uncinate processes tended to be located below C-3 vertebral levels, and their average anteroposterior length was 8 mm. The average thickness was found to be 4.9 mm for the base and 1.8 mm for the apex. There were no significant differences found between vertebral level and thickness of the uncinate process. Arthritic changes of the cervical VBs did not necessarily deform the uncinate processes. With axial rotation, the intervertebral discs were noted to be driven into the ipsilateral uncinate process. With lateral flexion, the ipsilateral uncinate processes aided the ipsilateral facet joints in maintaining the integrity of the ipsilateral intervertebral foramen. Conclusions A good appreciation for the anatomy of the uncinate processes is important to the neurosurgeon who operates on the spine. It is hoped that the data presented herein will decrease complications during surgical approaches to the cervical spine.

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Development of differentiated surgical technique for treating patients with multilevel degenerative diseases of cervical spine

Innovative medicine of Kuban ◽

10.35401/2500-0268-2019-16-4-47-54 ◽

2019 ◽

pp. 47-54

Author(s):

V. A. Byvaltsev ◽

A. A. Kalinin ◽

M. A. Aliyev ◽

V. V. Shepelev ◽

B. R. Yusupov ◽

...

Keyword(s):

Cervical Spine ◽

Disease Duration ◽

Intervertebral Discs ◽

Adverse Outcomes ◽

Neurological Symptoms ◽

Cervical Region ◽

Degenerative Diseases ◽

Facet Joints ◽

On Line ◽

Surgical Tactics

Background. Currently, there is no uniform tactics for the differentiated use of dorsal decompressive-stabilizing techniques for multilevel degenerative diseases of the cervical spine, and the results of these technologies application are largely controversial.Aim. Analysis of the unsatisfactory outcomes of dorsal decompressive-stabilizing interventions in the treatment of patients with multilevel degenerative diseases of the cervical spine and development of a clinicalinstrumental algorithm for differentiated surgical tactics.Material and methods. A retrospective study included 112 patients with degenerative diseases of the cervical spine at two levels or more due to hernias of intervertebral discs, yellow ligament hypertrophy and arthrosis of facet joints, which in 2007-2014 underwent dorsal decompressive-stabilizing interventions in the volume of laminotomy with laminoplasty (LP) and laminectomy with fixation for lateral masses (LF). A correlation analysis of clinical parameters with anamnestic data, instrumental parameters, a feature of accepted surgical tactics and postoperative adverse effects.Results. In the analysis, it was established that «satisfactory» postoperative outcomes of LP are associated with a neutral or lordotic configuration of the cervical spine, the preservation of segmental movements without clinical and instrumental signs of instability; In addition, the use of LF is possible with mobile kyphotization of the cervical spine and the presence of translational instability of the cervical segments. The «unsatisfactory» postoperative results of the LP and LF are in direct correlation with the duration of the disease, the presence of myelopathic focus and rigid kyphosis of the cervical region.Conclusion. Differential use of dorsal decompressive-stabilizing techniques based on a comprehensive assessment of disease duration, configuration of the cervical spine, spinal cord condition and volume of segmental movements allows to reduce neurological symptoms, improve the level of pain and improve the functional status of patients, as well as significantly reduce the number of adverse outcomes associated with the progression of kyphotic deformity, deterioration of neurological symptoms and revision on-line decompressive-stabilizing interventions.

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Association between Cervical Spine Degeneration and the Presence of Dens Fractures

Zeitschrift für Orthopädie und Unfallchirurgie ◽

10.1055/a-0853-8046 ◽

2019 ◽

Vol 158 (01) ◽

pp. 46-50

Author(s):

Marcel Betsch ◽

Sabina Blizzard ◽

Bala Krishnamoorthy ◽

Jung Yoo

Keyword(s):

Cervical Spine ◽

Retrospective Cohort ◽

Odontoid Process ◽

Case Series ◽

Facet Joints ◽

Relative Risks ◽

Increased Risk ◽

Dens Fracture ◽

Spine Degeneration ◽

Dens Fractures

Abstract Purpose Results of a small case series indicate an increased risk of dens fractures in patients with osteoarthritis. The purpose of this retrospective cohort study was to analyze the relative risks associated with degeneration of the cervical spine in the occurrence of dens fractures in older patients. Methods We performed a retrospective CT study of 1,794 patients > 55 years of age with and without dens fractures for signs of osteoarthritis (OA). Results OA of the atlanto-dens interval (AdI) was present in 75.9% of fracture patients, whereas 63.5% of non-fracture patients had OA of the AdI (p = 0.04). In cases of osteoarthritis of the facet joints, we did find a significant increase (p < 0.05) in the dens fracture risk in patients with OA. Conclusions This study indicates an association between OA of the cervical spine and the risk of sustaining a dens fracture. OA can lead to a reduction in the range of motion of the cervical spine. As a consequence, a relatively low-energy trauma can induce a forced sagittal motion, which will produce a torque at the base of the odontoid process resulting in a fracture.

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A BIOMECHANICAL STUDY OF THE EFFECTS OF FLEXION ANGLE ON THE INDUCTION MECHANISM OF CERVICAL SPONDYLOSIS

Journal of Mechanics in Medicine and Biology ◽

10.1142/s0219519421500536 ◽

2021 ◽

pp. 2150053

Author(s):

FU CAO ◽

RONGCHANG FU ◽

WENYUAN WANG

Keyword(s):

Cervical Spine ◽

Cervical Spondylosis ◽

Element Model ◽

Intervertebral Discs ◽

Biomechanical Study ◽

Flexion Angle ◽

Facet Joints ◽

Load Increase ◽

Spine Motion ◽

Wolff’S Law

Lesions in facet joints such as bone hyperplasia and degenerative changes in the intervertebral discs, can compress nerve roots and the spinal cord, leading to cervical spondylosis (CS). Lesions in these parts of the spine are commonly related to abnormal loads caused by bad posture of the cervical spine. This study aimed to understand the potential mechanical effects of load amplitude on cervical spine motion to provide a theoretical basis for the biomechanical causes of CS, and to provide a reference for preventing of the condition. In this study, a finite element model of the normal human cervical spine (C1-C7) was established and validated using an infrared motion capture system to analyze the effects of flexion angle on the stresses experienced by intervertebral discs, the anterior edge of the vertebral body, the pedicle, uncinate and facet joints. Our analysis indicated that the intervertebral disc load increased by at least 70% during the 20∘ to 45∘ flexion of the neck with 121% load increase in the vertebrae. In the intervertebral discs, the stress was largest at C4-C5, and the stress was moderate at C5-C6. These results are consistent with clinical CS prone site research. According to Wolff’s law, when bones are placed under large stresses, hyperplasia can result to allow adaptation to large loads. Increased cervical spine flexion angles caused the proliferation of bone in the above-mentioned parts of the spine and can accelerate accelerating the appearance of CS.

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Numerical investigation on the stability of human upper cervical spine (C1–C3)

Bio-Medical Materials and Engineering ◽

10.3233/bme-211247 ◽

2021 ◽

pp. 1-13

Author(s):

Waseem Ur Rahman ◽

Wei Jiang ◽

Guohua Wang ◽

Zhijun Li

Keyword(s):

Finite Element ◽

Cervical Spine ◽

Axial Rotation ◽

Upper Cervical Spine ◽

Fe Model ◽

Facet Joints ◽

Flexion Extension ◽

Upper Cervical ◽

The Stability

BACKGROUND: The finite element method (FEM) is an efficient and powerful tool for studying human spine biomechanics. OBJECTIVE: In this study, a detailed asymmetric three-dimensional (3D) finite element (FE) model of the upper cervical spine was developed from the computed tomography (CT) scan data to analyze the effect of ligaments and facet joints on the stability of the upper cervical spine. METHODS: A 3D FE model was validated against data obtained from previously published works, which were performed in vitro and FE analysis of vertebrae under three types of loads, i.e. flexion/extension, axial rotation, and lateral bending. RESULTS: The results show that the range of motion of segment C1–C2 is more flexible than that of segment C2–C3. Moreover, the results from the FE model were used to compute stresses on the ligaments and facet joints of the upper cervical spine during physiological moments. CONCLUSION: The anterior longitudinal ligaments (ALL) and interspinous ligaments (ISL) are found to be the most active ligaments, and the maximum stress distribution is appear on the vertebra C3 superior facet surface under both extension and flexion moments.

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188 MORPHOLOGICAL DESCRIPTION OF THE ANATOMY OF CERVICAL SPINE FACET JOINTS BY FACET ORIENTATION

Osteoarthritis and Cartilage ◽

10.1016/s1063-4584(08)60234-4 ◽

2008 ◽

Vol 16 ◽

pp. S92

Author(s):

L. Uhrenholt ◽

E. Hauge ◽

A. Vesterby Charles ◽

M. Gregersen

Keyword(s):

Cervical Spine ◽

Morphological Description ◽

Facet Joints ◽

Facet Orientation

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Cervical facetectomy and its effect on spine strength

Journal of Neurosurgery ◽

10.3171/jns.1985.63.2.0278 ◽

1985 ◽

Vol 63 (2) ◽

pp. 278-282 ◽

Cited By ~ 149

Author(s):

Richard B. Raynor ◽

James Pugh ◽

Ilan Shapiro

Keyword(s):

Cervical Spine ◽

Facet Joint ◽

Fracture Load ◽

Facet Joints ◽

Shear Tests ◽

Content Type ◽

Spine Motion ◽

Vertebral Bodies ◽

The Difference ◽

Anterior Posterior

✓ Fourteen cervical spine motion segments consisting of two adjacent vertebral bodies and their connecting ligaments were tested in shear. Five had intact facet joints, five had bilateral facetectomy of 50% or less, and four had bilateral 70% facetectomy. Three to 5 mm of root could be exposed in the specimens with 50% facetectomy, and 8 to 10 mm in those with 70% facetectomy. Anterior-posterior shear tests were run alternately in compression and distraction. Facetectomy was found to have no effect on compression and distraction stiffness. Failure in the 70% facetectomized specimens was due to fracture of the remaining joint at 159 lbs. In the specimens with 50% facetectomy, a fracture load could not be established since failure of the specimen mounting occurred at 208 lbs, as it did in two of the specimens without facetectomy that were tested to failure. The difference in bone fracture at 159 lbs and mounting failure at 208 lbs is significant at p < 0.05. Bilateral resection of more than 50% of the facet joint significantly compromises the shear strength of a cervical spine motion segment.

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