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Personalised gravitational loading of the cervical spine from biplanar X-rays for asymptomatic and clinical subjects in neutral standing position

  • Christophe Muth-seng
    Correspondence
    Corresponding author at: Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers, 151 Boulevard de l'Hôpital, 75013 Paris, France.
    Affiliations
    Arts et Métiers Institute of Technology, Université Sorbonne Paris Nord, IBHGC - Institut de Biomécanique Humaine Georges Charpak, HESAM Université, F-75013, Paris, France
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  • Maxime Huneidi
    Affiliations
    Service de chirurgie orthopédique et traumatologique, Groupe Hospitalier Pellegrin, CHU de Bordeaux, Bordeaux 33076, France
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  • Cécile Heidsieck
    Affiliations
    Arts et Métiers Institute of Technology, Université Sorbonne Paris Nord, IBHGC - Institut de Biomécanique Humaine Georges Charpak, HESAM Université, F-75013, Paris, France
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  • Sébastien Laporte
    Affiliations
    Arts et Métiers Institute of Technology, Université Sorbonne Paris Nord, IBHGC - Institut de Biomécanique Humaine Georges Charpak, HESAM Université, F-75013, Paris, France
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  • Jean-Yves Le Coz
    Affiliations
    Arts et Métiers Institute of Technology, Université Sorbonne Paris Nord, IBHGC - Institut de Biomécanique Humaine Georges Charpak, HESAM Université, F-75013, Paris, France
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  • Olivier Gille
    Affiliations
    Service de chirurgie orthopédique et traumatologique, Groupe Hospitalier Pellegrin, CHU de Bordeaux, Bordeaux 33076, France
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  • Wafa Skalli
    Affiliations
    Arts et Métiers Institute of Technology, Université Sorbonne Paris Nord, IBHGC - Institut de Biomécanique Humaine Georges Charpak, HESAM Université, F-75013, Paris, France
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      Highlights

      • Method to obtain gravitational cervical spine loading from biplanar X-rays.
      • Significant differences in loading with age and cervical surgery.
      • Differences related to postural changes.
      • Should facilitate muscle force quantification for patient evaluation.

      Abstract

      Background

      As a leading cause of disability with a high societal and economic cost, it is crucial to better understand risk factors of neck pain and surgical complications. Getting subject-specific external loading is essential for quantifying muscle forces and joint loads but it requires exertion trials and load cells which are uncommon in clinical settings.

      Methods

      This paper presents a method to compute the gravitational loading at four levels of the cervical spine (C3C4, C4C5, C5C6, C6C7) in neutral standing position from biplanar radiographs exclusively. The resulting load was decomposed in local disc frames and its components were used to compare different populations: 118 asymptomatic subjects and 46 patients before and after surgery (anterior cervical discectomy and fusion or total disc replacement). Comparisons were performed at C6C7 and the upper level adjacent to surgery.

      Findings

      Significant changes in gravitational loading were observed with age in healthy subjects as well as in patients after surgery and have been associated with changes in posture.

      Interpretation

      This approach quantifies the influence of postural changes on gravitational loading on the cervical spine. It represents a simple way to obtain necessary input for muscle force quantification models in clinical routine and to use them for patient evaluation. The study of the subsequent subject-specific spinal loading could help further the understanding of cervical spine biomechanics, degeneration mechanisms and complications following surgery.

      Keywords

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