Active Range of Motion as an Indicator for Ligament and Membrane Lesions in the Upper Cervical Spine after a Whiplash Trauma

2007 ◽  
Vol 24 (4) ◽  
pp. 713-721 ◽  
Author(s):  
Bertel Rune Kaale ◽  
Jostein Krakenes ◽  
Grethe Albrektsen ◽  
Knut Wester
Keyword(s):  
Cervical Spine ◽  
Range Of Motion ◽  
Upper Cervical Spine ◽  
Active Range Of Motion ◽  
Upper Cervical ◽  
Whiplash Trauma

scholarly journals Does isolated atlantoaxial fusion result in better clinical outcome compared to occipitocervical fusion?

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Katharina E. Wenning ◽  
Martin F. Hoffmann
Keyword(s):  
Cervical Spine ◽  
Clinical Outcome ◽  
Range Of Motion ◽  
Rating Scale ◽  
Neck Disability Index ◽  
Upper Cervical Spine ◽  
Occipitocervical Fusion ◽  
Atlantoaxial Fusion ◽  
Upper Cervical

Abstract Background The C0 to C2 region is the keystone for range of motion in the upper cervical spine. Posterior procedures usually include a fusion of at least one segment. Atlantoaxial fusion (AAF) only inhibits any motion in the C1/C2 segment whereas occipitocervical fusion (OCF) additionally interferes with the C0/C1 segment. The purpose of our study was to investigate clinical outcome of patients that underwent OCF or AAF for upper cervical spine injuries. Methods Over a 5-year period (2010–2015), consecutive patients with upper cervical spine disorders were retrospectively identified as having been treated with OCF or AAF. The Numeric Pain Rating Scale (NPRS) and the Neck Disability Index (NDI) were used to evaluate postoperative neck pain and health restrictions. Demographics, follow-up, and clinical outcome parameters were evaluated. Infection, hematoma, screw malpositioning, and deaths were used as complication variables. Follow-up was at least 6 months postoperatively. Results Ninety-six patients (male = 42, female = 54) underwent stabilization of the upper cervical spine. OCF was performed in 44 patients (45.8%), and 52 patients (54.2%) were treated with AAF. Patients with OCF were diagnosed with more comorbidities (p = 0.01). Follow-up was shorter in the OCF group compared to the AAF group (6.3 months and 14.3 months; p = 0.01). No differences were found related to infection (OCF 4.5%; AAF 7.7%) and revision rate (OCF 13.6%; AAF 17.3%; p > 0.05). Regarding bother and disability, no differences were discovered utilizing the NDI score (AAF 21.4%; OCF 37.4%; p > 0.05). A reduction of disability measured by the NDI was observed with greater follow-up for all patients (p = 0.01). Conclusion Theoretically, AAF provides greater range of motion by preserving the C0/C1 motion segment resulting in less disability. The current study did not show any significant differences regarding clinical outcome measured by the NDI compared to OCF. No differences were found regarding complication and infection rates in both groups. Both techniques provide a stable treatment with comparable clinical outcome.

scholarly journals Concurrent validity and reliability of measuring range of motion during the cervical flexion rotation test with a novel digital goniometer

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Kerstin Luedtke ◽  
Thomas Schoettker-Königer ◽  
Toby Hall ◽  
Christine Reimer ◽  
Maike Grassold ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Neck Pain ◽  
Range Of Motion ◽  
Head And Neck ◽  
Concurrent Validity ◽  
Reliability And Validity ◽  
Upper Cervical Spine ◽  
Rater Reliability ◽  
Rotation Test ◽  
Upper Cervical

Abstract Background Headache is a common and costly health problem. Although the pathogenesis of headache is heterogeneous, reported contributing factors are dysfunctions of the upper cervical spine. The flexion rotation test (FRT) is a commonly used diagnostic test to detect upper cervical movement impairment. A digital goniometer may support precise measurement of movement impairment in the upper cervical spine. However, its reliability and validity is not assessed, yet. The aim of this study was to investigate the reliability and validity of the digital goniometer compared to an ultrasound-based movement analysis system. Methods Two separate cross-sectional studies were conducted using the digital goniometer EasyAngle (Meloq AB, Stockholm, Sweden) for a) investigating the concurrent validity of upper cervical range of motion (ROM) during the FRT and b) determining the inter- and intra-rater reliability in the target population of patients with head and neck pain. Sixty-two participants, 39 with and 23 without head and neck pain, were recruited for the concurrent validity study. For the reliability study, a total of 50 participants were recruited. Intraclass correlation coefficients (ICC) and Bland Altmann plots were used to assess validity and ICC values, Bland Altmann plots as well as Kappa coefficients were used for estimating intra-rater and inter-rater reliability. Results Concurrent validity was strong with an ICC (2,1) of 0.97 for ROM to either side (95%CI = 0.95–0.98). Bland Altman Plots revealed a mean difference between measurement systems of 0.5° for the left and 0.11° for the right side. The inter-rater ICC (2,1) was 0.66 (95%CI 0.47–0.79, p <  0.001, SEM 6.6°), indicating good reliability. The limits of agreement were between 10.25° and − 11.89°, the mean difference between both raters was − 0.82°. Intra-rater reliability for the measurement of ROM during the FRT was between 0.96 (ICC 3,1) for rater 1 and 0.94 (ICC 3,1) for rater 2. Conclusions The digital goniometer demonstrated strong concurrent validity and good to strong reliability and can be used in clinical practice to accurately determine movement impairment in the upper cervical spine. Trial registration German Registry of Clinical Trials DRKS00013051.

Range of Motion of the Upper Cervical Spine: flexion, extension, lateral bending, and axial rotation

2020 ◽  
Vol 8 ◽  
Author(s):  
Ana I. Lorente ◽  
César Hidalgo García ◽  
Jacobo Rodríguez Sanz ◽  
Mario Maza Frechín ◽  
Albert Pérez Bellmunt
Keyword(s):  
Cervical Spine ◽  
Range Of Motion ◽  
Axial Rotation ◽  
Upper Cervical Spine ◽  
Lateral Bending ◽  
Normal Range ◽  
Range Of Movement ◽  
Flexion Extension ◽  
Upper Cervical ◽  
Life Threatening

Instability is a serious and life-threatening diagnosis in the upper cervical spine (occiput-atlas-axis), and a depth understanding of normal range of movement is required for clinical manual evaluation. To improve this knowledge, ten upper cervical spine specimens have been tested in flexion, extension, lateral bending, and axial rotation. 

scholarly journals Validity and reliability of two Smartphone applications to measure the lower and upper cervical spine range of motion in subjects with chronic cervical pain

2019 ◽  
Vol 32 (4) ◽  
pp. 619-627 ◽  
Author(s):  
Jacobo Rodríguez-Sanz ◽  
Andoni Carrasco-Uribarren ◽  
Sara Cabanillas-Barea ◽  
César Hidalgo-García ◽  
Pablo Fanlo-Mazas ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Range Of Motion ◽  
Upper Cervical Spine ◽  
Cervical Pain ◽  
Smartphone Applications ◽  
Validity And Reliability ◽  
Upper Cervical

Endonasal Surgery of the Upper Cervical Spine: A Morphometric Analysis

Skull Base ◽  
2008 ◽  
Vol 18 (S 01) ◽  
Author(s):  
Harminder Singh ◽  
Bartosz Grobelny ◽  
Adam Flanders ◽  
Marc Rosen ◽  
Paul Schiffmacher ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Morphometric Analysis ◽  
Upper Cervical Spine ◽  
Endonasal Surgery ◽  
Upper Cervical

A 3D-Printed Model-Assisted Cervical Spine Instrumentation after Tumor Resection in a 4-Year-Old Child: A Case Report

2021 ◽  
pp. 1-7
Author(s):  
Marko Jug
Keyword(s):  
Cervical Spine ◽  
3D Model ◽  
Intraoperative Complications ◽  
Tumor Resection ◽  
Upper Cervical Spine ◽  
Spine Instrumentation ◽  
Cord Injury ◽  
Spinal Navigation ◽  
Upper Cervical ◽  
3D Printed

<b><i>Introduction:</i></b> In the case of tumor resection in the upper cervical spine, a multilevel laminectomy with instrumented fixation is required to prevent kyphotic deformity and myelopathy. Nevertheless, instrumentation of the cervical spine in children under the age of 8 years is challenging due to anatomical considerations and unavailability of specific instrumentation. <b><i>Case Presentation:</i></b> We present a case of 3D-printed model-assisted cervical spine instrumentation in a 4-year-old child with post-laminectomy kyphotic decompensation of the cervical spine and spinal cord injury 1 year after medulloblastoma metastasis resection in the upper cervical spine. Due to unavailability of specific instrumentation, 3D virtual planning was used to assess and plan posterior cervical fixation. Fixation with 3.5 mm lateral mass and isthmic screws was suggested and the feasibility of fixation was confirmed “in vitro” in a 3D-printed model preoperatively to reduce the possibility of intraoperative implant-spine mismatch. Intraoperative conditions completely resembled the preoperative plan and 3.5 mm polyaxial screws were successfully used as planned. Postoperatively the child made a complete neurological recovery and 2 years after the instrumented fusion is still disease free with no signs of spinal decompensation. <b><i>Discussion/Conclusion:</i></b> Our case shows that posterior cervical fixation with the conventional screw-rod technique in a 4-year-old child is feasible, but we suggest that suitability and positioning of the chosen implants are preoperatively assessed in a printed 3D model. In addition, a printed 3D model offers the possibility to better visualize and sense spinal anatomy “in vivo,” thereby helping screw placement and reducing the chance for intraoperative complications, especially in the absence of intraoperative spinal navigation.

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