Intervertebral range of motion characteristics of normal cervical spinal segments (C0-T1) during in vivo neck motions
Intervertebral range of motion characteristics of normal cervical spinal segments (C0-T1) during in vivo neck motions
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DOI：
10.1016/j.jbiomech.2019.109418
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发表时间：
2020-01-02
影响因子：
2.4
通讯作者：
Cha, Thomas
中科院分区：
文献类型：
--
作者：
Zhou, Chaochao;Wang, Haiming;Cha, Thomas
体内椎间运动范围（ROM）是脊柱疾病的重要预测指标。虽然颈椎下轴已被广泛研究，但由于枕-寰椎（C0-1）和寰枢（C1-2）颈椎节段的运动特征报道较少，因为这两个节段的精确成像存在技术困难。在这项研究中，我们使用先前验证的双透视成像和模型配准技术，研究了无症状人类受试者体内功能性颈部运动期间整个颈椎（C0-T1）的椎间活动度，包括最大屈曲-伸展、左右侧向弯曲和左右轴向扭转。在所有颈部运动过程中，C0-1 与 C7-T1 类似，其活动性明显低于其他节段，并且始终贡献不到 10% 的颈椎旋转。在颈部的轴向旋转过程中，C1-2 贡献了 73.2 +/- 17.3% 的颈椎旋转，但其他节段贡献的颈椎旋转不到 10%。在横向弯曲和轴向扭转颈部运动期间，无论是主要运动还是耦合运动，C1-2 的轴向扭转 ROM 均显着大于其横向弯曲 ROM (p < 0.001)，而在轴下节段始终观察到相反的差异。这项研究表明，在体内颈部运动期间，上颈段和下颈段存在不同的运动模式。报告的数据可能有助于开发新的颈椎病理诊断方法和旨在恢复正常颈椎节段运动的新手术技术。 (C) 2019 Elsevier Ltd. 保留所有权利。
The in vivo intervertebral range of motion (ROM) is an important predictor for spinal disorders. While the subaxial cervical spine has been extensively studied, the motion characteristics of the occipito-atlantal (C0-1) and atlanto-axial (C1-2) cervical segments were less reported due to technical difficulties in accurate imaging of these two segments. In this study, we investigated the intervertebral ROMs of the entire cervical spine (C0-T1) during in vivo functional neck motions of asymptomatic human subjects, including maximal flexion-extension, left-right lateral bending, and left-right axial torsion, using previously validated dual fluoroscopic imaging and model registration techniques. During all neck motions, C0-1, similar to C7-T1, was substantially less mobile than other segments and always contributed less than 10% of the cervical rotations. During the axial rotation of the neck, C1-2 contributed 73.2 +/- 17.3% of the cervical rotation, but each of other segments contributed less than 10% of the cervical rotation. During both lateral bending and axial torsion neck motions, regardless of primary or coupled motions, the axial torsion ROM of C1-2 was significantly greater than its lateral bending ROM (p < 0.001), whereas the opposite differences were consistently observed at subaxial segments. This study reveals that there are distinct motion patterns at upper and lower cervical segments during in vivo neck motions. The reported data could be useful for the development of new diagnosis methods of cervical pathologies and new surgical techniques that aim to restore normal cervical segmental motion. (C) 2019 Elsevier Ltd. All rights reserved.