scholarly journals Biomechanics of the upper cervical spine ligaments in axial rotation and flexion-extension: Considerations into the clinical framework

2020 ◽  
Vol 11 (3) ◽  
pp. 217
Author(s):  
Pierre-Michel Dugailly ◽  
Benoît Beyer ◽  
VÉronique Feipel
Keyword(s):  
Cervical Spine ◽  
Axial Rotation ◽  
Upper Cervical Spine ◽  
Flexion Extension ◽  
Upper Cervical

In vitro 3D-kinematics of the upper cervical spine: helical axis and simulation for axial rotation and flexion extension

2009 ◽  
Vol 32 (2) ◽  
pp. 141-151 ◽  
Author(s):  
Pierre-Michel Dugailly ◽  
Stéphane Sobczak ◽  
Victor Sholukha ◽  
Serge Van Sint Jan ◽  
Patrick Salvia ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Axial Rotation ◽  
Helical Axis ◽  
Upper Cervical Spine ◽  
3D Kinematics ◽  
Flexion Extension ◽  
Upper Cervical

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

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.

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. 

In vivo 3D kinematic changes in the cervical spine after laminoplasty for cervical spondylotic myelopathy

2014 ◽  
Vol 21 (3) ◽  
pp. 417-424 ◽  
Author(s):  
Yukitaka Nagamoto ◽  
Motoki Iwasaki ◽  
Tsuyoshi Sugiura ◽  
Takahito Fujimori ◽  
Yohei Matsuo ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Cervical Spondylotic Myelopathy ◽  
Head Rotation ◽  
Upper Cervical Spine ◽  
Registration Method ◽  
Flexion Extension ◽  
Upper Cervical ◽  
Head Flexion ◽  
Age Range

Object Cervical laminoplasty is an effective procedure for decompressing the spinal cord at multiple levels, but restriction of neck motion is one of the well-known complications of the procedure. Although many authors have reported on cervical range of motion (ROM) after laminoplasty, they have focused mainly on 2D flexion and extension on lateral radiographs, not on 3D motion (including coupled motion) nor on precise intervertebral motion. The purpose of this study was to clarify the 3D kinematic changes in the cervical spine after laminoplasty performed to treat cervical spondylotic myelopathy. Methods Eleven consecutive patients (6 men and 5 women, mean age 68.1 years, age range 57–79 years) with cervical spondylotic myelopathy who had undergone laminoplasty were included in the study. All patients underwent 3D CT of the cervical spine in 5 positions (neutral, 45° head rotation left and right, maximum head flexion, and maximum head extension) using supporting devices. The scans were performed preoperatively and at 6 months after laminoplasty. Segmental ROM from Oc–C1 to C7–T1 was calculated both in flexion-extension and in rotation, using a voxel-based registration method. Results Mean C2–7 flexion-extension ROM, equivalent to cervical ROM in all previous studies, was 45.5° ± 7.1° preoperatively and 35.5° ± 8.2° postoperatively, which was a statistically significant 33% decrease. However, mean Oc–T1 flexion-extension ROM, which represented total cervical ROM, was 71.5° ± 8.3° preoperatively and 66.5° ± 8.3° postoperatively, an insignificant 7.0% decrease. In focusing on each motion segment, the authors observed a statistically significant 22.6% decrease in mean segmental ROM at the operated levels during flexion-extension and a statistically insignificant 10.2% decrease during rotation. The most significant decrease was observed at C2–3. Segmental ROM at C2–3 decreased 24.2% during flexion-extension and 21.8% during rotation. However, a statistically insignificant 37.2% increase was observed at the upper cervical spine (Oc–C2) during flexion-extension. The coupling pattern during rotation did not change significantly after laminoplasty. Conclusions In this first accurate documentation of 3D segmental kinematic changes after laminoplasty, Oc–T1 ROM, which represented total cervical ROM, did not change significantly during either flexion-extension or rotation by 6 months after laminoplasty despite a significant decrease in C2–7 flexion-extension ROM. This is thought to be partially because of a compensatory increase in segmental ROM at the upper cervical spine (Oc–C2).

scholarly journals Posterior Resection via Atlantoaxial Lamina Space Without Internal Fixation for C1-C2 Intraspinal Tumors: A Novel Approach

2020 ◽  
Author(s):  
Beiping Ouyang ◽  
Xiaobao Zou ◽  
Ling Ni ◽  
Su Ge ◽  
Yuyue Chen ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Internal Fixation ◽  
Statistical Significance ◽  
Tumor Resection ◽  
Neck Disability Index ◽  
Upper Cervical Spine ◽  
One Stage ◽  
Flexion Extension ◽  
Upper Cervical

Abstract Background: Intraspinal upper cervical C1-C2 tumors pose a challenge in resection. Internal fixation has routinely been used to prevent the occurrence of instability after atlantoaxial laminectomy for resection of C1-C2 intraspinal tumors, that sacrifices the motion of upper cervical spine. We therefore present this report to evaluate the efficacy and safety of one-stage posterior resection of these tumors through the atlantoaxial lamina space without internal fixation.Methods: Ten suitably selected patient with C1-C2 intraspinal tumors were included in this study (period January 2016 to January 2018). All the patients underwent one-stage posterior resection through atlantoaxial lamina space without internal fixation. The efficacy of the procedure was documented by comparing postoperative and preoperative outcome scores [The visual analogue scores (VAS), Japanese Orthopedic Association scores (JOA), neck disability index (NDI)], cervical physiological curvature and range of flexion-extension. Safety was assessed by documenting the complications associated with surgery and subsequent sequale. Results: 6 Male and 4 female patients with mean age 36 years (range 17 years to 50 years) underwent total tumor resection through posterior only approach using the atlantoaxial lamina space for the following tumors: 4 neurofibromas, 3 schwannomas and 3 meningiomas. The mean follow-up was 31.2 months (range 24–36 months). These patients’ pathological types included. Postoperative VAS and NDI were lower than those of pre-operation with statistical significance (p < 0.05) while postoperative JOA was higher than that of pre-operation (p < 0.05). The physiological curvature and activity of cervical spine were maintained at latest follow up. Three patients suffered cerebrospinal fluid leakages that was managed consertaviley with no added intervention required. No patient had local recurrence at latest follow-up.Conclusion: One-stage posterior resection through atlantoaxial lamina space without fixation is an effective and safe treatment for the upper cervical intraspinal tumor. In our experience this technique can remove tumor completely and does not cause instability to C1-C2 joint.

A model of the alar ligaments of the upper cervical spine in axial rotation

1991 ◽  
Vol 24 (7) ◽  
pp. 607-614 ◽  
Author(s):  
Joseph J. Crisco ◽  
Manohar M. Panjabi ◽  
Jiri Dvorak
Keyword(s):  
Cervical Spine ◽  
Axial Rotation ◽  
Upper Cervical Spine ◽  
Alar Ligaments ◽  
Upper Cervical

Evaluation of flexion/extension of the upper cervical spine in patients with rheumatoid arthritis: an MRI study with a dedicated positioning device compared to conventional radiographs

2005 ◽  
Vol 46 (1) ◽  
pp. 55-66 ◽  
Author(s):  
J. O. Karhu ◽  
R. K. Parkkola ◽  
S. K. Koskinen
Keyword(s):  
Rheumatoid Arthritis ◽  
Cervical Spine ◽  
Healthy Subjects ◽  
Upper Cervical Spine ◽  
Imaging Method ◽  
Neutral Position ◽  
Segmental Motion ◽  
Flexion Extension ◽  
Upper Cervical ◽  
Positioning Device

Purpose: Using flexion/extension magnetic resonance imaging (MRI) with a dedicated positioning device, our purpose was to analyze pathologic cranio‐vertebral joint anatomy and motion in patients with rheumatoid arthritis in comparison to normal patients, and to compare flexion/extension MRI with conventional radiographs (CRs) in patients with rheumatoid arthritis. Material and Methods: The 31 patients with rheumatoid arthritis and 20 healthy subjects included in the study were imaged in an open MRI scanner during flexion/extension. A dedicated positioning device was used. Additionally, we compared flexion/extension MRI with CRs in patients with rheumatoid arthritis. In MRI, the orientation and segmental motion of C0, C1, and C2 were assessed and structure of the dens and amount of pannus tissue were observed. Configuration of the cerebrospinal fluid space and the cord was evaluated in each position. In both MRI and CRs, anterior atlanto‐axial subluxation and vertical dislocation were assessed and sagittal diameter of the dural sac was measured. Results: In the neutral position, C1 of the patients was oriented in a more flexed position in relation to both C0 and C2 compared to that in healthy subjects. The patients had more extension in the upper cervical spine than did healthy subjects. In flexion, atlanto‐axial subluxation was greater in CRs than in MRI. In MRI, the amount of vertical dislocation did not depend on position. In the patients, there was considerably more cord impingement in flexion than in other positions. Conclusion: Evaluation of the rheumatoid cervical spine is optimized using MR images in the neutral, flexed, and extended positions. Measurements and relationships between structures should be compared in all positions. CRs with flexion‐extension views are recommended as the first imaging method.

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