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Cervical spine degeneration specific segmental angular rotational and displacements: A quantitative study

  • Karthik Somasundaram
    Correspondence
    Corresponding author at: VA Medical Center Research – 151, 5000 W. National Avenue, Milwaukee, WI 53295, USA.
    Affiliations
    Joint Department of Biomedical Engineering, Marquette University and Medical College of Wisconsin, United States of America

    VA Medical Center Research – 151, Milwaukee, WI 53295, United States of America
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  • Joseph F. Cusick
    Affiliations
    Department of Neurosurgery, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI 53226, United States of America

    VA Medical Center Research – 151, Milwaukee, WI 53295, United States of America
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  • Narayan Yoganandan
    Affiliations
    Department of Neurosurgery, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI 53226, United States of America

    VA Medical Center Research – 151, Milwaukee, WI 53295, United States of America
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  • Frank A. Pintar
    Affiliations
    Joint Department of Biomedical Engineering, Marquette University and Medical College of Wisconsin, United States of America

    Department of Neurosurgery, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI 53226, United States of America

    VA Medical Center Research – 151, Milwaukee, WI 53295, United States of America
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      Highlights

      • The study reports the degenerated cervical spine associated kinematics.
      • Segmental angular rotation greater at the degenerated level, under extension.
      • Segmental angular rotation lowest at the adjacent level, under flexion.
      • Translation at the degenerated level is significant, noticeable in X-ray scan.

      Abstract

      Background

      The objective of the present isolated spine study was to evaluate the kinematic differences between groups of normal and degenerated cervical spine specimens. Previous studies on cervical spine degeneration support the existence of the unstable phase during the degeneration process; however, there is a lack of quantitative data available to fully characterize this early stage of degeneration.

      Method

      For this effort five degenerated and eight normal cervical spines (C2-T1) were isolated and were subject to pure bending moments of flexion, extension, axial rotation and lateral bending. The specimen quality was assessed based on the grading scale. In the present study, the degeneration was at the C5-C6 level. A four-camera motion analysis system was used to measure the overall primary and segmental motions.

      Finding

      In the extension mode, the degenerated group demonstrated a significant larger angular rotation as well as antero-posterior displacement at the degenerated level (C5-C6). In contrast, in flexion mode, the degenerated group measured a drastic decrease in angular rotation, at the adjacent level (C6-C7). In other modes of loading as well as in other segmental levels, the degenerated group had similar segmental motion as the normal group.

      Interpretation

      These preliminary results provide single level degeneration specific cervical spine kinematics. The finding demonstrates the influence of degeneration on the kinematics of the normal sub adjacent segment. The degenerated group observed larger translation displacement in the extension mode, which would potentially be a critical parameter in assisting early detection of cervical spine spondylosis with just a functional X-ray scan.

      Keywords

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