Quantifying the ranges of relative motions of the intervertebral discs and facet joints in the normal cervical spine

Wang, Haiming; Zhou, Chaochao; Yu, Yan; Tsai, Tsung-Yuan; Han, Chaofan; Li, Guoan; Cha, Thomas

doi:10.1016/j.jbiomech.2020.110023

Cited by 14 publications

(16 citation statements)

References 47 publications

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“…Previously, CT 1 , 14 , 15 , MRI 12 , and dual fluoroscopy 30 – 32 techniques have been employed to obtain in vivo cervical spine measurements. Notably, Nagamoto et al 12 used MRI to compare cervical spine kinematics during head rotation between patients with cervical spondylopathy and an asymptomatic control group.…”

Section: Discussionmentioning

confidence: 99%

“…However, MRI scans are time-intensive and MRI studies do not reflect the biomechanics of the spine under physiological loading because subjects are scanned in a supine position. Wang et al 30 investigated the ranges of motion of the three joints in the cervical spines (from C3 to C7) using biplane fluoroscopic imaging. However, due to skull occlusion, the general biplane technique has not reported the movement of the upper cervical spine.…”

Section: Discussionmentioning

confidence: 99%

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Validation and application of a novel in vivo cervical spine kinematics analysis technique

Wan

Wenjin

et al. 2021

Sci Rep

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To validate the accuracy of Cone beam computed tomography (CBCT) cervical spine modeling with three dimensional (3D)-3D registration for in vivo measurements of cervical spine kinematics. CBCT model accuracy was validated by superimposition with computed tomography (CT) models in 10 healthy young adults, and then cervical vertebrae were registered in six end positions of functional movements, versus a neutral position, in 5 healthy young adults. Registration errors and six degrees of freedom (6-DOF) kinematics were calculated and reported. Relative to CT models, mean deviations of the CBCT models were < 0.6 mm. Mean registration errors between end positions and the reference neutral position were < 0.7 mm. During flexion–extension (F–E), the translation in the three directions was small, mostly < 1 mm, with coupled LB and AR both < 1°. During lateral bending (LB), the bending was distributed roughly evenly, with coupled axial rotation (AR) opposite to the LB at C1–C2, and minimal coupled F–E. During AR, most of the rotation occurred in the C1–C2 segment (29.93 ± 7.19° in left twist and 31.38 ± 8.49° in right twist) and coupled LB was observed in the direction opposite to that of the AR. Model matching demonstrated submillimeter accuracy in cervical spine kinematics data. The presently evaluated low-radiation-dose CBCT technique can be used to measure 3D spine kinematics in vivo across functional F–E, AR, and LB positions, which has been especially challenging for the upper cervical spine.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Validation and application of a novel in vivo cervical spine kinematics analysis technique

Wan

Wenjin

et al. 2021

Sci Rep

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“…The majority of the included studies were based on CT or MRI oftentimes combined with (video)fluoroscopy 29 , 50 , 80 , 88 , 93 or biplanar radiographs. 3 , 6 , 7 , 9 , 11 , 88 Fewer studies were based solely on radiography 27 , 35 , 71 , 75 or fluoroscopy.…”

Section: Healthy Conditionsmentioning

confidence: 99%

Kinematics of the Cervical Spine Under Healthy and Degenerative Conditions: A Systematic Review

et al. 2022

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Knowledge of spinal kinematics is essential for the diagnosis and management of spinal diseases. Distinguishing between physiological and pathological motion patterns can help diagnose these diseases, plan surgical interventions and improve relevant tools and software. During the last decades, numerous studies based on diverse methodologies attempted to elucidate spinal mobility in different planes of motion. The authors aimed to summarize and compare the evidence about cervical spine kinematics under healthy and degenerative conditions. This includes an illustrated description of the spectrum of physiological cervical spine kinematics, followed by a comparable presentation of kinematics of the degenerative cervical spine. Data was obtained through a systematic MEDLINE search including studies on angular/translational segmental motion contribution, range of motion, coupling and center of rotation. As far as the degenerative conditions are concerned, kinematic data regarding disc degeneration and spondylolisthesis were available. Although the majority of the studies identified repeating motion patterns for most motion planes, discrepancies associated with limited sample sizes and different imaging techniques and/or spine configurations, were noted. Among healthy/asymptomatic individuals, flexion extension (FE) and lateral bending (LB) are mainly facilitated by the subaxial cervical spine. C4–C5 and C5–C6 were the major FE contributors in the reported studies, exceeding the motion contribution of sub-adjacent segments. Axial rotation (AR) greatly depends on C1–C2. FE range of motion (ROM) is distributed between the atlantoaxial and subaxial segments, while AR ROM stems mainly from the former and LB ROM from the latter. In coupled motion rotation is quantitatively predominant over translation. Motion migrates caudally from C1–C2 and the center of rotation (COR) translocates anteriorly and superiorly for each successive subaxial segment. In degenerative settings, concurrent or subsequent lesions render the association between diseases and mobility alterations challenging. The affected segments seem to maintain translational and angular motion in early and moderate degeneration. However, the progression of degeneration restrains mobility, which seems to be maintained or compensated by adjacent non-affected segments. While the kinematics of the healthy cervical spine have been addressed by multiple studies, the entire nosological and kinematic spectrum of cervical spine degeneration is partially addressed. Large—scale in vivo studies can complement the existing evidence, cover the gaps and pave the way to technological and clinical breakthroughs.

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“…Recent studies have demonstrated that the motion tracking technique based on dual fluoroscopic imaging is a reliable method for determining intervertebral motion and adjacent segment kinematics in various functional spine motions ( Wawrose et al, 2020 ; Zhou et al, 2020 ). Therefore, in this study, we used a DFIS combined with a validated 3D-to-2D registration technique ( Wang et al, 2020 ; Zhou et al, 2021 ) to quantify in vivo intervertebral and upper-lower lumbar segment kinematics in asymptomatic subjects during forward–backward bending.…”

Section: Introductionmentioning

confidence: 99%

Lumbar segment-dependent soft tissue artifacts of skin markers during in vivo weight-bearing forward–Backward bending

Ling

et al. 2022

Front. Bioeng. Biotechnol.

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Traditional optical motion capture (OMC) with retroreflective markers is commonly used to measure joint kinematics but was also reported with unavoidable soft tissue artifacts (STAs) when quantifying the motion of the spine. Additionally, the patterns of the STA on the lumbar spine remain unclear. This study aimed to 1) quantify the in vivo STAs of the human lower back in three-dimensional directions during weight-bearing forward–backward bending and 2) determine the effects of the STAs on the calculated flexion angles between the upper and lower lumbar spines and adjacent vertebrae by comparing the skin marker (SM)- and virtual bone marker (VM)-based measurements. Six healthy volunteers were imaged using a biplanar radiographic system, and thirteen skin markers were mounted on every volunteer’s lower back while performing weight-bearing forward–backward bending. The STAs in the anterior/posterior (AP), medial/lateral (ML), and proximal/distal (PD) directions were investigated. The flexion angles between the upper and lower lumbar segments and adjacent intervertebral segments (L2–L5) throughout the cycle were calculated. For all the participants, STAs continuously increased in the AP direction and exhibited a reciprocal trend in the PD direction. During flexion, the STA at the lower lumbar region (L4–L5: 13.5 ± 6.5 mm) was significantly higher than that at the upper lumbar (L1–L3: 4.0 ± 1.5 mm) in the PD direction (p < 0.01). During extension, the lower lumbar (L4–L5: 2.7 ± 0.7 mm) exhibited significantly less STAs than that exhibited by the upper lumbar region (L1–L3: 6.1 ± 3.3 mm) (p < 0.05). The STA at the spinous process was significantly lower than that on both sides in the AP direction (p < 0.05). The present results on STAs, based on dual fluoroscopic measurements in healthy adult subjects, presented an anatomical direction, marker location, and anatomic segment dependency, which might help describe and quantify STAs for the lumbar spine kinematics and thus help develop location- and direction-specific weighting factors for use in global optimization algorithms aimed at minimizing the effects of STAs on the calculation of lumbar joint kinematics in the future.

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Quantifying the ranges of relative motions of the intervertebral discs and facet joints in the normal cervical spine

Cited by 14 publications

References 47 publications

Validation and application of a novel in vivo cervical spine kinematics analysis technique

Validation and application of a novel in vivo cervical spine kinematics analysis technique

Kinematics of the Cervical Spine Under Healthy and Degenerative Conditions: A Systematic Review

Lumbar segment-dependent soft tissue artifacts of skin markers during in vivo weight-bearing forward–Backward bending

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