Ligament deformation patterns of the craniocervical junction during head axial rotation tracked by biplane fluoroscopes.
Ligament deformation patterns of the craniocervical junction during head axial rotation tracked by biplane fluoroscopes.
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DOI：
10.1016/j.clinbiomech.2021.105442
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发表时间：
2021-08
期刊：
影响因子：
--
通讯作者：
Cha T
中科院分区：
文献类型：
--
作者：
Zhou C;Guo R;Wang C;Tsai TY;Yu Y;Wang W;Li G;Cha T
通常，颅脑损伤和不稳定的治疗决定是基于影像学检查结果，但在体内韧带运动学知之甚少。本研究旨在确定颅颈交界处初级韧带的体内变形模式（即，C 0 -2），包括十字韧带、前韧带和副韧带。八个无症状的女性受试者的头骨和颈椎动态成像使用双平面透视成像系统，当他们进行左，右头部轴向旋转。使用三维到二维配准技术，在体内的位置和方向的颈椎节段被确定。实施优化算法以确定韧带缠绕路径，并且由此产生的韧带变形由伸长百分比表示。使用配对t检验，韧带变形在端部范围的位置进行了比较，在中立的位置。在左右旋转头部时，节段运动无显著差异（p > 0.05）。一般来说，十字韧带的每个组件都会发生轻微变形。对于髂韧带，同侧韧带从−0.7 ± 13.8%延长至16.6 ± 15.7%（p < 0.001*）。对于副韧带，对侧韧带从−2.9 ± 7.5%延长至10.1 ± 6.2%（p < 0.001*）。本研究揭示了在动态轴向头部旋转过程中，颅颈交界韧带有不同的变形模式。这些韧带变形数据可以增强我们对颅颈交界韧带协同作用的认识，并指导颅颈不稳定的治疗。
Frequently, treatment decisions for craniocervical injuries and instability are based on imaging findings, but in vivo ligament kinematics were poorly understood. This study was to determine in vivo deformation patterns of primary ligaments in the craniocervical junction (i.e., C0-2), including the cruciform ligament, alar ligaments, and accessory ligaments, during dynamic head axial rotation. The skulls and cervical spines of eight asymptomatic female subjects were dynamically imaged using a biplane fluoroscopic imaging system, when they performed left and right head axial rotations. Using a 3D-to-2D registration technique, the in vivo positions and orientations of cervical segments were determined. An optimization algorithm was implemented to determine ligament wrapping paths, and the resulting ligament deformations were represented by percent elongations. Using paired t-tests, ligament deformations in the end-range position were compared to those in the neutral position. No significant differences were observed in segmental motions during left and right head rotations (p > 0.05). In general, slight deformations occurred in each component of the cruciform ligament. For the alar ligaments, the ipsilateral ligament was lengthened from −0.7 ± 13.8% to 16.6 ± 15.7% (p < 0.001*). For the accessory ligaments, the contralateral ligament was lengthened from −2.9 ± 7.5% to 10.1 ± 6.2% (p < 0.001*). This study reveals that there are distinct deformation patterns in craniocervical junction ligaments during dynamic axial head rotation. These ligament deformation data can enhance our understanding of the synergic function of craniocervical junction ligaments, and guide the treatment of craniocervical instability.
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