Quantifying the Effects of Age, Gender, Degeneration, and Adjacent Level Degeneration on Cervical Spine Range of Motion Using Multivariate Analyses

Simpson, Andrew K.; Biswas, Dhrubes; Emerson, John W.; Lawrence, Brandon D.; Grauer, Jonathan N.

doi:10.1097/brs.0b013e31816044e8

Cited by 86 publications

(65 citation statements)

References 14 publications

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“…Active range of motion (ROM) of cervical spine has been studied in healthy subjects by numerous investigators [1,2]. Increasing age results in 30-40% decrease in cervical range of motion in all three cardinal planes, while gender and BMI do not have a substantial influence on cervical range of motion [1][2][3][4][5].…”

Section: Introductionmentioning

confidence: 99%

The effect of multilevel anterior cervical fusion on neck motion

Wang

Yuan

et al. 2012

Eur Spine J

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Background Anterior cervical decompression and fusion (ACDF) procedures are successful in treating multilevel cervical radiculopathy and cervical myelopathy. It was reported that this procedure would result in a loss of cervical range of motion. However, few studies have focused on the exact impact of multilevel (more than 3 levels) ACDF on cervical range of motion. Methods 29 patients underwent a 3-level or 4-level ACDF. In all the patients, preoperative active cervical ROM measurement was performed, and postoperative measurement was performed at 1-year follow-up by a CROM device. The pre-and postoperative data were compared to each other using paired t tests (a = 0.05).Results The patients had significantly less ROM after the surgery in all planes of motion. Major reduction was observed in flexion (39.5%), left and right lateral flexion (25.7 and 25.9%), with relatively minor impact on extension (18.3%), left and right rotation (14.0 and 14.4%) observed. In the three cardinal planes, major reduction was observed in the sagittal plane (28.2%) and coronal plane (25.8%), while minor impact observed in the horizontal plane (14.1%). Conclusions The patients of cervical spondylotic myelopathy had an obvious reduction in active cervical ROM following multilevel ACDF. However, patients might not experience great difficulties in performing daily activities with regard to the loss of neck motion after fusion.

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Section: Introductionmentioning

confidence: 99%

The effect of multilevel anterior cervical fusion on neck motion

Wang

Yuan

et al. 2012

Eur Spine J

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“…Studies in patients with neck pain [22] without radiological evidence of spine degeneration clearly demonstrate a progressive reduction in segmental ROM with age, amounting to approximately 5°for every 10 years of aging. On the other hand, patients with preexisting degenerative spines tend to lose cervical motion more rapidly with aging.…”

Section: Discussionmentioning

confidence: 96%

Reduction in range of cervical motion on serial long-term follow-up in patients undergoing oblique corpectomy for cervical spondylotic myelopathy

et al. 2013

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Purpose To determine whether motion preservation following oblique cervical corpectomy (OCC) for cervical spondylotic myelopathy (CSM) persists with serial followup. Methods We included 28 patients with preoperative and at least two serial follow-up neutral and dynamic cervical spine radiographs who underwent OCC for CSM. Patients with an ossified posterior longitudinal ligament (OPLL) were excluded. Changes in sagittal curvature, segmental and whole spine range of motion (ROM) were measured. Nathan's system graded anterior osteophyte formation. Neurological function was measured by Nurick's grade and modified Japanese Orthopedic Association (JOA) scores. ResultsThe majority (23 patients) had a single or 2-level corpectomy. The average duration of follow-up was 45 months. The Nurick's grade and the JOA scores showed statistically significant improvements after surgery (p \ 0.001). 17 % of patients with preoperative lordotic spines had a loss of lordosis at last follow-up, but with no clinical worsening. 77 % of the whole spine ROM and 62 % of segmental ROM was preserved at last follow-up. The whole spine and segmental ROM decreased by 11.2°a nd 10.9°, respectively (p B 0.001). Patients with a greater range of segmental movement preoperatively had a statistically greater range of movement at follow-up. The analysis of serial radiographs indicated that the range of movement of the whole spine and the range of movement at the segmental spine levels significantly reduced during the follow-up period. Nathan's grade showed increase in osteophytosis in more than two-thirds of the patients (p B 0.01). The whole spine range of movement at followup significantly correlated with Nathan's grade. Conclusions Although the OCC preserves segmental and whole spine ROM, serial measurements show a progressive decrease in ROM albeit without clinical worsening. The reduction in this ROM is probably related to degenerative ossification of spinal ligaments.

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“…1). Compared with the average segmental range of motion of 79to 149in a healthy study population, 31) the cervical spine of our 21-year-old patient displayed severe instability, which may be associated with the higher rate of degeneration. She also had a habit of cracking her neck, so we hypothesized that the neck cracking may be associated with the cervical disc degeneration.…”

Section: H Ikeda Et Almentioning

confidence: 99%

“…5,7,23) Aging is associated with decreases in cervical range of motion of approximately 59per decade. 8,31) Cervical disc degenerative change with aging is also associated with the reduced cervical range of motion. Cervical disc degeneration, caused by the loss of both proteoglycan and water in the disc, generally consists of the following 3 clinical stages: dysfunction, unstable phase, and stabilization with progression of the degenerative changes.…”

Section: H Ikeda Et Almentioning

confidence: 99%

Nontraumatic Cervical Disc Herniation in a 21-Year-Old Patient With No Other Underlying Disease

Ikeda

Hanakita

Takahashi

et al. 2012

Neurol. Med. Chir.(Tokyo)

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A 21-year-old woman presented with cervical myelopathy due to nontraumatic cervical disc herniation associated with cervical canal stenosis. The patient underwent removal of the herniated disc and anterior fusion with an autogenous iliac crest bone graft. After surgery, the patient showed satisfactory improvement. Cases of cervical disc herniation in our center and reported cases without cervical trauma in either young adults or in childhood were reviewed retrospectively. We discuss the pathogenesis of cervical disc herniation in our young patient in the context of these other cases. Cervical disc herniation rarely occurs before the age of 30 years. A history of cervical trauma and preexisting fusion of the cervical spine are risk factors for cervical disc herniation. The present case is the youngest known of nontraumatic disc herniation without other underlying disease. Hypermobility due to neck cracking and a relatively narrow spinal canal might have been important in causing cervical myelopathy by disc herniation.

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Quantifying the Effects of Age, Gender, Degeneration, and Adjacent Level Degeneration on Cervical Spine Range of Motion Using Multivariate Analyses

Cited by 86 publications

References 14 publications

The effect of multilevel anterior cervical fusion on neck motion

The effect of multilevel anterior cervical fusion on neck motion

Reduction in range of cervical motion on serial long-term follow-up in patients undergoing oblique corpectomy for cervical spondylotic myelopathy

Nontraumatic Cervical Disc Herniation in a 21-Year-Old Patient With No Other Underlying Disease

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