Dynamic Motion Analysis of Normal and Unstable Cervical Spines Using Cineradiography

Hino, Hiroyuki; Abumi, Kuniyoshi; Kanayama, Masahiro; Kaneda, Kiyoshi

doi:10.1097/00007632-199901150-00018

Cited by 59 publications

(28 citation statements)

References 19 publications

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“…This scenario could be the reason accounting for the small average posterior translation at C6/7 level observed in the present study. The cervical spine motion was reported to be stepwise from the upper to lower levels with motion lags from maximum extension to maximum flexion in the study of Hino et al [12]. However, the current results did not agree with this finding because the intervertebral translations took place at all cervical levels at the beginning of flexion or extension from the neutral position (Figs.…”

Section: Intervertebral Translationcontrasting

confidence: 72%

“…The intervertebral motion was usually assessed either at the end range of movement [3,7,8,28,[30][31][32] or with the fixed time frames of the spinal movements [10,12,25]. The drawbacks in previous studies were the absence of information regarding the dynamic motion sequences occurred throughout the ROM and the hardship in comparison between subjects due to the time dependent parameter.…”

Section: Intervertebral Translationmentioning

confidence: 99%

“…Abnormal intervertebral movements of spine have been reported to be associated with trauma and pathological conditions [1,4,12,25,33,38]. The evaluation of cervical intervertebral movements is essential for providing the diagnostic information in cervical related dysfunction.…”

Section: Introductionmentioning

confidence: 99%

“…A few researchers have applied the videofluoroscopy to evaluate the continuous spinal movement and the different time lags and motion sequences were detected between normal and pathological spines [12,25]. The dynamic intervertebral movements in lumbar flexion and extension were recently investigated [10,20,42], however, these studies revealed the divergent results on motion sequences in flexion and extension from upper to lower vertebrae and the variations on anatomical identification.…”

Section: Introductionmentioning

confidence: 99%

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The quantitative measurements of the intervertebral angulation and translation during cervical flexion and extension

Kuo

Lan

et al. 2007

Eur Spine J

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The insufficient exploration of intervertebral translation during flexion and extension prevents the further understanding of the cervical biomechanics and treating the cervical related dysfunction. The objective of this study was to quantitatively measure the continuous intervertebral translation of healthy cervical spine during flexion and extension by videofluoroscopic technique. A total of 1,120 image sequences were analyzed for 56 healthy adult subjects by a precise image protocol during cervical flexion and extension. Our results showed there were no statistical angular differences among five spinal levels in either flexion or extension, except for the comparison between C2/3 (13.5°) and C4/5 (22.6°) angles. During cervical flexion, the smallest anterior translations were 0.7 mm at C2/3 level, followed by 0.9 mm at C6/7, 1.0 mm at C3/4, 1.1 mm at C5/6, and the largest 1.2 mm at C4/5 levels. The significantly greater translations were measured in the posterior direction at C3/4 (1.1 mm, P = 0.037), C4/5 (1.3 mm, P = 0.039), and C5/6 (1.2 mm, P = 0.005) levels than in the anterior one. The relatively fluctuant and small average posterior translation fashion at C6/7 level (0.4 mm) possibly originated from the variations in the direction of translation during cervical extension among subjects. Normalization with respect to the widths of individual vertebrae showed the total translation percentages relative to the adjacent vertebrae were 9.5, 13.7, 16.6, 15.0, and 8.6% for C2/3 to C6/7 levels, respectively, and appeared to be within the clinical-accepted ranges of translation in cervical spine. The intervertebral translations of cervical spine during flexion and extension movements were first described in quality and quantity based on the validated radiographic protocol. This analysis of the continuous intervertebral translations may be further employed to diagnose translation abnormalities like hypomobility or hypermobility and to monitor the treatment effect on cervical spines.

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Section: Intervertebral Translationcontrasting

confidence: 72%

Section: Intervertebral Translationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The quantitative measurements of the intervertebral angulation and translation during cervical flexion and extension

Kuo

Lan

et al. 2007

Eur Spine J

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“…The video fluoroscopy is an improved technique to this relative inaccurate method. Several authors have advocated the advantages of the use of video fluoroscopy in the evaluation of intervertebral motion [3,19,27,35].…”

Section: Discussionmentioning

confidence: 99%

Assessment of adjacent-segment mobility after cervical disc replacement versus fusion: RCT with 1 year’s results

et al. 2011

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Motion Analysis of the Cervical Spine

Luers¹

2004

AMA Guides® Newsletter

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The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, defines a motion segment as “two adjacent vertebrae, the intervertebral disk, the apophyseal or facet joints, and ligamentous structures between the vertebrae.” The range of motion from segment to segment varies, and loss of motion segment integrity is defined as “an anteroposterior motion of one vertebra over another that is greater than 3.5 mm in the cervical spine, greater than 2.5 mm in the thoracic spine, and greater than 4.5 mm in the lumbar spine.” Multiple etiologies are associated with increased motion in the cervical spine; some are physiologic or compensatory and others are pathologic. The standard radiographic evaluation of instability and ligamentous injury in the cervical spine consists of lateral flexion and extension x-ray views, but no single pattern of injury is identified in whiplash injuries. Fluoroscopy or cineradiographic techniques may be more sensitive than other methods for evaluating subtle abnormal motion in the cervical spine. The increased motion thus detected then must be evaluated to determine whether it represents normal physiologic motion, normal compensatory motion, motion related to underlying degenerative disk and/or facet disease, or increased motion related to ligamentous injury. Imaging studies should be performed and interpreted as instructed in the AMA Guides.

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Dynamic Motion Analysis of Normal and Unstable Cervical Spines Using Cineradiography

Abstract: Different motion patterns were observed between normal and pathologic cervical spines. Cineradiographic motion analysis is a valuable adjunctive technique, especially in diagnosis or evaluation of conditions that cannot be identified through conventional radiographic examination.

Cited by 59 publications

References 19 publications

The quantitative measurements of the intervertebral angulation and translation during cervical flexion and extension

The quantitative measurements of the intervertebral angulation and translation during cervical flexion and extension

Assessment of adjacent-segment mobility after cervical disc replacement versus fusion: RCT with 1 year’s results

Motion Analysis of the Cervical Spine

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