Cervical Spine Movement Sequencing During Flexion-Extension

2011 ◽  
Author(s):  
William J. Anderst ◽  
Michelle Schafman ◽  
William F. Donaldson ◽  
Joon Y. Lee ◽  
James D. Kang
Keyword(s):  
Cervical Spine ◽  
Range Of Motion ◽  
Daily Living ◽  
X Rays ◽  
Clinical Tool ◽  
Normal Range ◽  
Kinematic Data ◽  
Flexion Extension ◽  
Functional Movements ◽  
Spine Movement

Static flexion-extension x-rays are the most common clinical tool used to assess abnormal motion of the cervical spine. Despite their widespread use (over 168,000 cases per year), the clinical efficacy of flexion-extension radiographs of the cervical spine has yet to be proven1. Limitations of static flexion-extension x-rays include data collection during static positions that may not accurately represent dynamic behavior, and the fact that data is collected at end range of motion positions, not in more frequently encountered mid-range positions. Consequently, static x-rays may not reveal movement abnormalities that occur during activities of daily living and lead to pain and degeneration. Therefore, it may be advantageous to analyze cervical spine kinematic data collected during dynamic, functional movements performed through an entire range of motion (not just the endpoints). Furthermore, the literature confirms there is substantial variability in “normal” range of motion and translation during flexion-extension1, making it difficult to reliably identify abnormal motion. Therefore, it may also be beneficial to evaluate alternative motion parameters that may reliably identify abnormal motion.

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. 

Remaining Cervical Spine Movement Under Different Immobilization Techniques

2020 ◽  
Vol 35 (4) ◽  
pp. 382-387 ◽  
Author(s):  
Davut D. Uzun ◽  
Matthias K. Jung ◽  
Jeronimo Weerts ◽  
Matthias Münzberg ◽  
Paul A. Grützner ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Standard Procedure ◽  
Human Motion ◽  
Cervical Collar ◽  
Vacuum Mattress ◽  
Flexion Extension ◽  
Immobilization Techniques ◽  
Spine Board ◽  
Spine Movement ◽  
Belt System

AbstractBackground:Immobilization of the cervical spine by Emergency Medical Services (EMS) personnel is a standard procedure. In most EMS, multiple immobilization tools are available.The aim of this study is the analysis of residual spine motion under different types of cervical spine immobilization.Methods:In this explorative biomechanical study, different immobilization techniques were performed on three healthy subjects. The test subjects’ heads were then passively moved to cause standardized spinal motion. The primary endpoints were the remaining range of motion for flexion, extension, bending, and rotation measured with a wireless human motion detector.Results:In the case of immobilization of the test person (TP) on a straight (0°) vacuum mattress, the remaining rotation of the cervical spine could be reduced from 7° to 3° by additional headblocks. Also, the remaining flexion and extension were reduced from 14° to 3° and from 15° to 6°, respectively. The subjects’ immobilization was best on a spine board using a headlock system and the Spider Strap belt system (MIH-Medical; Georgsmarienhütte, Germany). However, the remaining cervical spine extension increased from 1° to 9° if a Speedclip belt system was used (Laerdal; Stavanger, Norway). The additional use of a cervical collar was not advantageous in reducing cervical spine movement with a spine board or vacuum mattress.Conclusions:The remaining movement of the cervical spine is minimal when the patient is immobilized on a spine board with a headlock system and a Spider Strap harness system or on a vacuum mattress with additional headblocks. The remaining movement of the cervical spine could not be reduced by the additional use of a cervical collar.

scholarly journals Comparison of the efficacy of three cervical collars in restricting cervical range of motion: A randomized study

2018 ◽  
Vol 27 (1) ◽  
pp. 24-29 ◽  
Author(s):  
Jae Guk Kim ◽  
Sung Hwan Bang ◽  
Gu Hyun Kang ◽  
Yong Soo Jang ◽  
Wonhee Kim ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Range Of Motion ◽  
Cervical Spine Injury ◽  
Axial Rotation ◽  
The Other ◽  
Spine Injury ◽  
Cervical Range Of Motion ◽  
Flexion Extension ◽  
Cervical Immobilization ◽  
The Difference

Background: The cervical collar has been used as a common device for the initial stabilization of the cervical spine. Although many cervical collars are commercially available, there is no consensus on which offers the greatest protection, with studies showing considerable variations in their ability to restrict cervical range of motion. The use of the XCollar (Emegear, Carpinteria, CA) has been known to decrease the risk of spinal cord injury by minimizing potential cervical spinal distraction. We compared XCollar with two other cervical collars commonly used for adult patients with cervical spine injury to evaluate the difference in effectiveness between the three cervical collars to restrict cervical range of motion. Objectives: This study aimed to evaluate the difference between the three cervical collars in their ability to restrict cervical range of motion. Method: A total of 30 healthy university students aged 21–25 years participated in this study. Participants with any cervical disease and symptoms were excluded. Three cervical collars were tested: Philadelphia® Collar, Stifneck® Select™ Collar, and XCollar. A digital camera and an image-analysis technique were used to evaluate cervical range of motion during flexion, extension, bilateral bending and bilateral axial rotation. Cervical range of motion was evaluated in both the unbraced and braced condition. Results: XCollar permitted less than a mean of 10° of movement during flexion, extension, bilateral bending and bilateral axial rotation. This was less than the movement permitted by the other two cervical collars. Conclusion: XCollar presented superior cervical immobilization compared to the other two commonly used cervical collars in this study. Thus, when cervical collar is considered for an adult patient with cervical spine injury, XCollar might be one of the considerate options as a cervical immobilization device.

DETECTION OF PEDIATRIC CERVICAL SPINE INJURY

Neurosurgery ◽  
2008 ◽  
Vol 62 (3) ◽  
pp. 700-708 ◽  
Author(s):  
Hugh J.L. Garton ◽  
Matthew R. Hammer
Keyword(s):  
Cervical Spine ◽  
Young Children ◽  
Cervical Spine Injury ◽  
Diagnostic Yield ◽  
Plain Film ◽  
Spine Injury ◽  
Lower Sensitivity ◽  
X Rays ◽  
Flexion Extension ◽  
National Emergency

Abstract OBJECTIVE In evaluating the pediatric cervical spine for injury, the use of adult protocols without sufficient sensitivity to pediatric injury patterns may lead to excessive radiation doses. Data on injury location and means of detection can inform pediatric-specific guideline development. METHODS We retrospectively identified pediatric patients with codes from the International Classification of Diseases, 9th Revision, for cervical spine injury treated between 1980 and 2000. Collected data included physical findings, radiographic means of detection, and location of injury. Sensitivity of plain x-rays and diagnostic yield from additional radiographic studies were calculated. RESULTS Of 239 patients, 190 had true injuries and adequate medical records; of these, 187 had adequate radiology records. Patients without radiographic abnormality were excluded. In 34 children younger than 8 years, National Emergency X-Radiography Utilization Study criteria missed two injuries (sensitivity, 94%), with 76% of injuries occurring from occiput–C2. In 158 children older than 8 years, National Emergency X-Radiography Utilization Study criteria identified all injured patients (sensitivity, 100%), with 25% of injuries occurring from occiput–C2. For children younger than 8 years, plain-film sensitivity was 75% and combination plain-film/occiput–C3 computed tomographic scan had a sensitivity of 94%, whereas combination plain-film and flexion-extension views had 81% sensitivity. In patients older than 8 years, the sensitivities were 93%, 97%, and 94%, respectively. CONCLUSION Younger children tend to have more rostral (occiput–C2) injuries compared with older children. The National Emergency X-Radiography Utilization Study protocol may have lower sensitivity in young children than in adults. Limited computed tomography from occiput–C3 may increase diagnostic yield appreciably in young children compared with flexion-extension views. Further prospective studies, especially of young children, are needed to develop reliable pediatric protocols.

scholarly journals Examining the Range of Motion of the Cervical Spine: Utilising Different Bedside Instruments

2021 ◽  
Vol 28 (2) ◽  
pp. 100-105
Author(s):  
Aiman Asyraf Ahmad Sukari ◽  
Sarwinder Singh ◽  
Muhammad Hafiz Bohari ◽  
Zamzuri Idris ◽  
Abdul Rahman Izaini Ghani ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Range Of Motion ◽  
Clinical Examination ◽  
Lateral Flexion ◽  
Range Of Movement ◽  
Cervical Range Of Motion ◽  
Accuracy And Precision ◽  
Flexion Extension ◽  
Measuring Tape ◽  
Examination Techniques

Background: This paper outlines a summary of examination technique to identify the range of movement of the cervical spine. Due to common difficulties in obtaining tools for cervical examination within the district, a standardised compilation of easy-to-replicate examination techniques are provided using different tools. Methods: Bedside instruments that can be used includes a measuring tape, compass, goniometer, inclinometer and cervical range of motion (CROM) instrument. Discussion: Cervical flexion-extension, lateral flexion and rotation will be assessed with bedside instruments. This would aid in increasing accuracy and precision of objective measurement while conducting clinical examination to determine the cervical range of motion.

scholarly journals Optimal Assessment of Cervical Spine Trauma in Critically Ill Patients: A Prospective Evaluation

1998 ◽  
Vol 26 (5) ◽  
pp. 487-491 ◽  
Author(s):  
A. E. Ajani ◽  
D. J. Cooper ◽  
C. D. Scheinkestei ◽  
J. Laidlaw ◽  
D. V. Tuxen
Keyword(s):  
Cervical Spine ◽  
Critically Ill ◽  
Trauma Centre ◽  
Trauma Patients ◽  
X Rays ◽  
Cervical Spine Injuries ◽  
Flexion Extension ◽  
Unstable Cervical Spine ◽  
Cervical Spine Fractures ◽  
Tissue Trauma

There is no uniformly accepted protocol for the radiological assessment of the cervical spine in critically ill trauma patients. The Alfred Trauma Centre receives about 40% of Victorian patients with major trauma. A protocol was developed for cervical spine evaluation, comprising three plain X-rays and a swimmer's view added when necessary to visualize C7-T1, CT and/or MRI for abnormal regions, and functional (flexion/extension) X-rays to exclude cervical spine instability due to soft tissue trauma. Functional X-rays were performed “actively” in conscious patients and “passively” in unconscious patients. One hundred consecutive patients were prospectively evaluated and 91 survived to complete data collection. Six (6.6%) had unstable cervical spine injuries—five detected with plain X-rays and one (1.1%) detected only with passive functional X-rays. Static cervical X-rays cost $93.00 per patient. Functional cervical X-rays added $42.00 per patient and were uncomplicated. Collar complications were common when collars remained on for more than 72 hours. This low detection rate is clinically important because of the enormous potential social and economic costs of missed unstable cervical spine fractures.

scholarly journals CORRELATION BETWEEN CERVICAL MORPHOLOGY, PAIN, FUNCTIONALITY, AND ROM IN INDIVIDUALS WITH CERVICALGIA

2019 ◽  
Vol 18 (2) ◽  
pp. 101-105
Author(s):  
Mateus Alves Aimi ◽  
Eduardo Gonçalves Raupp ◽  
Emanuelle Francine Detogni Schmit ◽  
Adriane Vieira ◽  
Cláudia Tarragô Candotti
Keyword(s):  
Cervical Spine ◽  
Pain Intensity ◽  
Range Of Motion ◽  
Functional Disability ◽  
Sagittal Plane ◽  
Neck Disability Index ◽  
X Rays ◽  
Level Of Evidence ◽  
Spine Curvature ◽  
The Right

ABSTRACT Objective: To verify if there is a correlation between the morphology of the cervical spine curvature, pain intensity, functional disability, and range of motion in individuals with cervicalgia. Methods: Thirty-nine individuals were evaluated using x-rays in the right sagittal plane (Cobb C1-C7 two-line method), visual analogue scale, Neck Disability Index questionnaire, and fleximeter. Descriptive statistical analysis (percentage, mean and standard deviation) and inferential (independent t-test and Pearson product-moment correlation coefficient, α=0.05) were performed. Results: There were significant correlations, ranging from moderate to high, between functional capacity and pain intensity (r=0.637, p<0.001), and total range of motion (r=-0.568, p<0.001), and extension (r=-0.610, p<0.001), and between pain intensity and range of motion (r=-0.422, p=0.007). Regarding the morphology of the cervical spine curvature, none of the variables showed a significant correlation. Conclusions: Cervical morphology, more specifically related to the curvature in the sagittal plane, does not seem to interfere alone with pain, functionality, and range of motion. In contrast, it is possible to affirm that higher levels of pain generate a smaller range of cervical movement, especially of extension, which, in turn, results in greater functional losses in individuals with neck pain. Level of Evidence II; Prognostic Studies - Investigating the Effect of a Patient Characteristic on the Outcome of Disease.

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