Experimental production of forward dislocation in the human cervical spine

Bauze, R. J.; Ardran, G. M.

doi:10.1302/0301-620x.60b2.659473

Cited by 109 publications

(38 citation statements)

References 6 publications

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“…There exist few biomechanical studies of BFD with which our results may be compared, with most being limited by unrealistic quasi-static loading or manual ligament transection [3,4,24]. These previous models have been used to determine ligament injuries, investigate loading directions responsible for BFD, and to study vertebral artery occlusion [26] and stabilization techniques [9,16,27].…”

Section: Discussionmentioning

confidence: 99%

“…Beatson [4] created dislocations using whole cervical spine specimens, and reported ruptures of the interspinous, capsular, and posterior longitudinal ligaments and annular fibers, though neither the high speed loading nor motion patterns were reported. Bauze and Ardran [3] applied flexion and compression loading to whole cervical spine specimens that were immobilized inferior to C5/6 to cause BFD at this spinal level. Interspinous, capsular, and anterior longitudinal ligament injuries were observed.…”

Section: Introductionmentioning

confidence: 99%

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Cervical facet joint kinematics during bilateral facet dislocation

et al. 2007

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Previous biomechanical models of cervical bilateral facet dislocation (BFD) are limited to quasi-static loading or manual ligament transection. The goal of the present study was to determine the facet joint kinematics during high-speed BFD. Dislocation was simulated using ten cervical functional spinal units with muscle force replication by frontal impact of the lower vertebra, tilted posteriorly by 42.5°. Average peak rotations and anterior sliding (displacement of upper articulating facet surface along the lower), separation and compression (displacement of upper facet away from and towards the lower), and lateral shear were determined at the anterior and posterior edges of the right and left facets and statistically compared (P < 0.05). First, peak facet separation occurred, and was significantly greater at the left posterior facet edge, as compared to the anterior edges. Next, peak flexion rotation and anterior facet sliding occurred, followed by peak facet compression. The highest average facet translation peaks were 22.0 mm for anterior sliding, 7.9 mm for separation, 9.9 mm for compression and 3.6 mm for lateral shear. The highest average rotation of 63°occurred in flexion, significantly greater than all other directions. These events occurred, on average, within 0.29 s following impact. During BFD, the main sagittal motions included facet separation, flexion rotation, anterior sliding, followed by compression, however, non-sagittal motions also existed. These motions indicated that unilateral dislocation may precede bilateral dislocation.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cervical facet joint kinematics during bilateral facet dislocation

et al. 2007

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“…Bilateral facet dislocation was most common at the C6-7 level and unilateral facet dislocation at the C5-6 level in their series. Axial rotation exists in unilateral facet dislocation [1]. Maiman et al [9] described 28 patients with bilateral facet dislocation.…”

Section: Discussionmentioning

confidence: 99%

“…The most common levels were C5-6 and C6-7, having ten each (total 71.4%). Bilateral facet dislocation is associated with significant soft tissue injury, including rupture of the posterior ligamentous complex, facet joint capsules, annulus fibrosus, and usually the anterior and posterior longitudinal ligaments [1,2,4,16] with both facets remaining intact but dislocated. The inferior facet of the upper vertebra slides over the tip of the superior facet of the lower vertebra.…”

Section: Discussionmentioning

confidence: 99%

Morphometric analyses of the cervical superior facets and implications for facet dislocation

Ebraheim

Patil

Liu

et al. 2006

International Orthopaedics (SICO

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The articular facets of the cervical spine have been well addressed; however, little information is available on the relationship of the superior facets of the cervical spine to traumatic dislocation in the literature. Morphometric analyses of the superior facets of 30 dried cervical spines from C3 to C7 were performed to determine any morphological differences. The angle of the superior facet with respect to the transverse plane was also measured on computed tomography (CT) scans of 30 patients having neck injury without fracture/dislocation. The vertical and surface lengths of the superior facet were significantly lower (P<0.01) at C6-C7 levels than at C3-5 levels. The anteroposterior diameter of the superior facet was smaller (P<0.05) at C6 and C7 levels compared to C3-5 levels. Although the superior facet joint surface is in a more coronal orientation in lower cervical vertebrae, the inclination of the superior facet is more horizontal relative to the transverse plane when measured in vivo. A combination of lower height, smaller anteroposterior diameter of the superior facet, and a more horizontally oriented superior facet at C6 and C7 levels in vivo may explain the predilection of translation relative to one another in the lower cervical spine. Résumé Les facettes articulaires de la colonne cervicale sont bien analysées cependant une meilleure connaissance des relations de l'articulaire supérieure lors des traumatismes avec luxations de la colonne dans la littérature est possible. L'analyse morphométrique de l'articulaire supér-ieure a été analysée sur 30 colonnes cervicales de cadavres, de C3 à C7, de façon à analyser les différences morphologiques. L'angle supérieur de l'articulaire a été mesuré sur le scanner de 30 patients ayant présenté un traumatisme cervical sans fracture, ni luxation. Les dimensions verticales et les surfaces de l'articulaire supérieure sont, significativement, moins importantes au niveau C6 et C7 qu'au niveau C3 à C5 (p<0.01). Le diamètre antéropostér-ieur de l'articulaire supérieure est également plus petit au niveau de C6 C7 qu'au niveau de C3 C5 (p<0.05). De la même façon, l'articulaire supérieure est dans un plan plus frontal dans la partie basse de la colonne. L'inclinaison de cette articulaire est, de même, plus horizontale par rapport au plan transversal, mesure in vivo. La combinaison de tous ces facteurs : dimensions moins importantes, petits diamètres, antéropostérieur et facettes supérieures de l'articulaire plus horizontale en C6 C7, expliquent la fréquence des translations relatives possibles des vertèbres dans la partie basse de la colonne et donc la fragilité de cette zone.

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“…The importance of players being of equal standard in the front row of the scrum, particularly at schoolboy level, has been appreciated. 9 The detection by means of a MRI of narrowing of the cervical vertebral canal and the detection of undue mobility of vertebrae has shown latterly the import ance of minor degrees of injury to the discs. 10 Now a rugby player who has sustained an injury to his skull resulting in a painful neck without neurological in volvement can have a scan performed and it has been frequently shown that there is damage to the disc which puts the player at risk if he carries on playing rugby.…”

Section: Summary Of the Researchmentioning

confidence: 99%

The prevention of spinal injuries in rugby football

Silver

Stewart²

1994

Spinal Cord

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The incidence of injuries to the spinal cord sustained at rugby in South Africa, New Zealand and Australia is reviewed. Ninety-seven injuries seen at Stoke Mandeville Hospital at the National Spinal Injuries Centre (NSIC) between 1956 and 1993 are analysed in detail. There were 93 accidents at rugby union, two at American football and two at rugby league. The injuries were of the cervical spine apart from four hysterics and one thoracic injury. The thoracic injury occurred after the game when the player fell downstairs. The injuries were analysed according to the mechanism of injury, the neurological condition, the causation, the standard of the player and the position in the field. The injuries caused were the result of force being applied to the skull which was transmitted to the cervical spine resulting in injury to the cervical cord. As a result of this research, representations were made to the appropriate authorities and changes in the laws were made. As a result of these law changes there has been a dramatic reduction in the overall number of injuries and the elimination of the injury from the loose scrum. This paper discusses the historical sequence of how these preventative measures came about to reduce the incidence of injuries and the legal implications whereby the authors took part in two law suits. The legal consequences are analysed in detail.

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Experimental production of forward dislocation in the human cervical spine

Cited by 109 publications

References 6 publications

Cervical facet joint kinematics during bilateral facet dislocation

Cervical facet joint kinematics during bilateral facet dislocation

Morphometric analyses of the cervical superior facets and implications for facet dislocation

The prevention of spinal injuries in rugby football

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