In vivo three-dimensional intervertebral kinematics of the subaxial cervical spine during seated axial rotation and lateral bending via a fluoroscopy-to-CT registration approach
In vivo three-dimensional intervertebral kinematics of the subaxial cervical spine during seated axial rotation and lateral bending via a fluoroscopy-to-CT registration approach
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DOI：
10.1016/j.jbiomech.2014.08.014
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发表时间：
2014-10-17
影响因子：
2.4
通讯作者：
Shih, Ting-Fang
中科院分区：
文献类型：
--
作者：
Lin, Cheng-Chung;Lu, Tung-Wu;Shih, Ting-Fang
准确测量椎间耦合运动有助于了解相关疾病的病因、诊断和评估后续治疗。没有研究报告在坐位主动轴向旋转（AR）和侧弯（LB）过程中颈椎的体内动态和三维（3D）椎间运动。目前的研究填补了差距，通过测量耦合椎间运动的轴下颈椎在10个无症状的年轻成年人在直立坐姿在积极的头部LB和AR使用体积模型为基础的二维到三维配准方法，通过双平面荧光透视。个体椎骨的受试者特定模型来自每个受试者的CT数据，并与荧光透视图像配准，以确定用于获得椎间运动学的轴下椎骨的3D姿态。AR期间C3/C4、C4/C5、C5/C6和C6/C7的单侧平均活动度（ROM）分别为4.2度、4.6度、3.0度和1.3度。LB期间的相应值分别为6.4度、5.2度、6.1度和6.1度。椎间LB（ILB）在颈椎的AR和LB任务中均发挥重要作用，其ROM大于椎间AR（IAR）（耦合运动比（IAR/ILB）：LB为0.23-0.75，LB为0.34-0.95）。在AR中）。与AR任务相比，LB任务期间的ILB范围在C5/6显著更大（p = 0.008）和C6/7（p = 0.001），但C4/5的IAR范围显著较小（p = 0.02），导致C4/5（p = 0.0013）、C5/6（p < 0.001）和C6/7（p = 0.0037）的耦合运动比率显著较小。观察到的椎间运动学的耦合特征与先前研究中在仰卧位无负重的离散静态条件下的椎间运动学的耦合特征不同，这表明测试条件可能影响下颈椎的运动学。虽然由于技术限制未包括C1和C2，但目前的结果仍然提供了生理条件下无症状年轻受试者下颈椎椎间运动的基线数据，这可能有助于进一步研究脊柱生物力学。(C)2014爱思唯尔有限公司版权所有。
Accurate measurement of the coupled intervertebral motions is helpful for understanding the etiology and diagnosis of relevant diseases, and for assessing the subsequent treatment. No study has reported the in vivo, dynamic and three-dimensional (3D) intervertebral motion of the cervical spine during active axial rotation (AR) and lateral bending (LB) in the sitting position. The current study fills the gap by measuring the coupled intervertebral motions of the subaxial cervical spine in ten asymptomatic young adults in an upright sitting position during active head LB and AR using a volumetric model-based 2D-to-3D registration method via biplane fluoroscopy. Subject-specific models of the individual vertebrae were derived from each subject's CT data and were registered to the fluoroscopic images for determining the 3D poses of the subaxial vertebrae that were used to obtain the intervertebral kinematics. The averaged ranges of motion to one side (ROM) during AR at C3/C4, C4/C5, C5/C6, and C6/C7 were 4.2 degrees, 4.6 degrees, 3.0 degrees and 1.3 degrees, respectively. The corresponding values were 6.4 degrees, 5.2 degrees, 6.1 degrees and 6.1 degrees during LB. Intervertebral LB (ILB) played an important role in both AR and LB tasks of the cervical spine, experiencing greater ROM than intervertebral AR (IAR) (ratio of coupled motion (IAR/ILB): 0.23-0.75 in LB, 0.34-0.95. in AR). Compared to the AR task, the ranges of ILB during the LB task were significantly greater at C5/6 (p = 0.008) and C6/7 (p = 0.001) but the range of IAR was significantly smaller at C4/5 (p = 0.02), leading to significantly smaller ratios of coupled motions at C4/5 (p = 0.0013), C5/6 (p < 0.001) and C6/7 (p = 0.0037). The observed coupling characteristics of the intervertebral kinematics were different from those in previous studies under discrete static conditions in a supine position without weight-bearing, suggesting that the testing conditions likely affect the kinematics of the subaxial cervical spine. While C1 and C2 were not included owing to technical limitations, the current results nonetheless provide baseline data of the intervertebral motion of the subaxial cervical spine in asymptomatic young subjects under physiological conditions, which may be helpful for further investigations into spine biomechanics. (C) 2014 Elsevier Ltd. All rights reserved.