In vivo three-dimensional kinematics of the cervical spine during maximal axial rotation
In vivo three-dimensional kinematics of the cervical spine during maximal axial rotation
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DOI：
10.1016/j.math.2012.12.002
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发表时间：
2013-08-01
期刊：
影响因子：
--
通讯作者：
Klein, Paul
中科院分区：
文献类型：
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作者：
Salem, Walid;Lenders, Cyrille;Klein, Paul
颈椎表现出相当大的活动性，尤其是轴向旋转。轴向旋转对解剖结构施加压力，如椎动脉，这在临床检查中通常被评估。关于颈椎的体内三维节段运动学的文献相当稀少。本研究旨在研究最大被动头部旋转时颈椎的三维运动学，特别强调耦合运动。20名健康志愿者参加了这项研究。在中性和最大轴向旋转位置进行低剂量CT扫描。每个分离的椎体在这两个位置进行半自动分割。采用有限螺旋轴法描述离散位置间的三维运动。C0和C1之间轴向旋转的平均（+/- SD）最大幅度为2.5 +/- 1.0度，同时向另一侧侧屈（5.0 +/- 3.0度）和伸展（12.0 +/- 4.5度）。在C1-C2水平，平均轴向旋转为37.5 +/- 6.0度，伴侧屈曲（2.5 +/- 6.0度）和伸展（4.0 +/- 6.0度）。对于较低水平，发现C4-C5水平的轴向旋转最大（5.5 +/- 1.0度），同时向同侧侧屈曲（-4.0 +/- 2.5度）。C2-C3、C3-C4和C4-C5节段发生伸展，而C5-C6和C6-C7节段发生屈曲。偶联侧屈发生在相对侧的上颈椎和同一侧的下颈椎。(C) 2013 Elsevier Ltd.版权所有。
The cervical spine exhibits considerable mobility, especially in axial rotation. Axial rotation exerts stress on anatomical structures, such as the vertebral artery which is commonly assessed during clinical examination. The literature is rather sparse concerning the in vivo three-dimensional segmental kinematics of the cervical spine. This study aimed at investigating the three-dimensional kinematics of the cervical spine during maximal passive head rotation with special emphasis on coupled motion. Twenty healthy volunteers participated in this study. Low-dose CT scans were conducted in neutral and in maximum axial rotation positions. Each separated vertebra was segmented semi automatically in these two positions. The finite helical-axis method was used to describe 3D motion between discrete positions. The mean (+/- SD) maximum magnitude of axial rotation between C0 and C1 was 2.5 +/- 1.0 degrees coupled with lateral flexion to the opposite side (5.0 +/- 3.0 degrees) and extension (12.0 +/- 4.5 degrees). At the C1-C2 level, the mean axial rotation was 37.5 +/- 6.0 degrees associated with lateral flexion to the opposite side (2.5 +/- 6.0 degrees) and extension (4.0 +/- 6.0 degrees). For the lower levels, axial rotation was found to be maximal at C4-C5 level (5.5 +/- 1.0 degrees) coupled with lateral flexion to the same side (-4.0 +/- 2.5 degrees). Extension was associated at levels C2-C3, C3-C4 and C4-C5, whereas flexion occurred between C5-C6 and C6-C7. Coupled lateral flexion occurred to the opposite side at the upper cervical spine and to the same side at the lower cervical spine. (C) 2013 Elsevier Ltd. All rights reserved.