The shift of segmental contribution ratio in patients with herniated disc during cervical lateral bending

Abstract

BackgroundAbnormal intervertebral movements of spine have been reported to be associated with trauma and pathological conditions. The importance of objective spinal motion imaging assessment in the frontal plane was frequently underestimated. The clinical evaluation of the segmental motion contribution could be useful for detecting the motion pattern of individual vertebrae. Therefore the purpose of this study was to investigate the shift of segmental contribution ratio in patients with herniated disc during cervical lateral bending to provide additional insights to cervical biomechanics.MethodsA total of 92 subjects (46 healthy adult subjects and 46 disc-herniated patients) were enrolled in this case–control study. The motion images during cervical lateral bending movements were digitized using a precise image protocol to analyze the intervertebral motion and contribution.ResultsOur results showed that the intervertebral angulation during cervical lateral bending for the C2/3 to C6/7 segments were 7.66°±2.37°, 8.37°±2.11°, 8.91°±3.22°, 7.19°±2.29°, 6.31°±2.11°, respectively for the healthy subjects. For the patients with herniated disc, the intervertebral angulation for the C2/3 to C6/7 segments were 6.87°±1.67°, 7.83°±1.79°, 7.73°±2.71°, 5.13°±2.05°, 4.80°±1.93°, respectively. There were significant angulation and translational differences between healthy subjects and the patients with herniated disc in the C5/6 and C6/7 segments (P=0.001-0.029). The segmental contributions of the individual vertebral segments were further analyzed. There was a significant increase in segmental contribution ratio of C3/4 (P=0.048), while a significant decrease in contribution ratio of C5/6 (P=0.037) was observed in the patients with herniated disc. Our results indicated that the segmental contribution shifted toward the middle cervical spine in the patients with herniated disc.ConclusionsThe segmental contributions of cervical spine during lateral bending movement were first described based on the validated radiographic protocol. The detection of the shift of segmental contribution ratio could be helpful for the diagnosis the motion abnormality resulted from the disc or, facet pathologies, and arthritic changes of cervical spine.

Myofascial Treatment for Microcirculation in Patients with Postural Neck and Shoulder Pain

“…The MATLAB computer programs were written to construct the midplanes of the vertebrae defined as a line running through the midpoints between the anterior and posterior two corners, and the bisectrix between the two midplanes were derived [ 31 ]. The perpendiculars were constructed from the anterior–inferior corners of the cranial vertebra and anterior–superior corner of caudal vertebra onto the bisectrix.…”

“…To compensate for variations in stature and radiographic magnification, the mean depth of the caudally adjacent vertebra was used to normalize the measurements of intervertebral alignment relationships. The MATLAB computer programs were written to construct the midplanes of the vertebrae defined as a line running through the midpoints between the anterior and posterior two corners, and the bisectrix between the two midplanes were derived [31]. The perpendiculars were constructed from the anterior-inferior corners of the cranial vertebra and anterior-superior corner of caudal vertebra onto the bisectrix.…”

Prediction of in vivo lower cervical spinal loading using musculoskeletal multi-body dynamics model during the head flexion/extension, lateral bending and axial rotation

“…In addition, some studies suggested that movement abnormalities induced by cervical spine disease, disk fusion or arthroplasty may be the result of the alteration of SCHMs, while constant SCHMs cannot describe these special circumstance. 42,43 As a consequence, dynamic SCHMs could better reflect inherent natural biomechanics at each disk level. However, the out-of-plane CM is mainly due to the oblique orientated facet joints.…”

Origin of neck pain and direction of movement influence dynamic cervical joint motion and pressure pain sensitivity

“…Therefore, neck pain is often described by subjective signs and symptoms. However, objective measures of neck pain has been used in previous studies such as reduced range of motion, decreased cervical muscle strength, lower movement velocity, increased neck reposition error, altered cervical joint motion and altered pressure pain sensitivity (Bahat et al, 2010;Dvir and Prushansky, 2008;Johnston et al, 2008;Lan et al, 2014;Madrid et al, 2016;Sjolander et al, 2008;Tsang et al, 2013).…”

“…Individual cervical joint motion has been reported to be more important compared with total range of motion (ROM) in diagnosis and decision of surgery and postoperative assessments (Branney and Breen, 2014;Lan et al, 2014;Schwab et al, 2006). Anatomy dictates a difference in deep and superficial cervical muscles ability to influence single joint motion, as only the deep muscles such as the multifidus can directly control the motion of a single joint .…”