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Cervical spine biomechanics

Catarina C Lins, Diego T Prado, Andrei F Joaquim
Surgical treatment is well accepted for patients with traumatic cervical facet joint dislocations (CFD), but there is uncertainty over which approach is better: anterior, posterior or combined. We performed a systematic literature review to evaluate the indications for anterior and posterior approaches in the management of CFD. Anterior approaches can restore cervical lordosis, and cause less postoperative pain and less wound problems. Posterior approaches are useful for direct reduction of locked facet joints and provide stronger fixation from a biomechanical point of view...
September 2016: Arquivos de Neuro-psiquiatria
Brian D Stemper, Brian D Corner
Synopsis Despite considerable research effort, the incidence of whiplash injury during automotive collisions has continued to rise. This is due, at least in part, to a limited recognition of biomechanical injury mechanisms and factors influencing injury risk. While automotive safety modifications reduced injury risk in some cases, impact on the overall whiplash incidence was limited. This is likely attributable to significant occupant-related differences that have a profound impact on injury risk. Many of those differences were outlined in research studies, and examples include female sex and the associated sex-based anthropometrical variation that can affect seating orientation; cervical spinal posture; and anatomical attributes, including cervical column slenderness and neck muscle morphometry...
October 2016: Journal of Orthopaedic and Sports Physical Therapy
Omar Adib, Emeline Berthier, Didier Loisel, Christophe Aubé
Injuries of the cervical spine are uncommon in children. The distribution of injuries, when they do occur, differs according to age. Young children aged less than 8 years usually have upper cervical injuries because of the anatomic and biomechanical properties of their immature spine, whereas older children, whose biomechanics more closely resemble those of adults, are prone to lower cervical injuries. In all cases, the pediatric cervical spine has distinct radiographic features, making the emergency radiological analysis of it difficult...
September 20, 2016: Skeletal Radiology
Daniel G Tobert, Valentin Antoci, Shaun P Patel, Ehsan Saadat, Christopher M Bono
Adjacent segment disease (ASD) is disappointing long-term outcome for both the patient and clinician. In contrast to adjacent segment degeneration, which is a common radiographic finding, ASD is less common. The incidence of ASD in both the cervical and lumbar spine is between 2% and 4% per year, and ASD is a significant contributor to reoperation rates after spinal arthrodesis. The etiology of ASD is multifactorial, stemming from existing spondylosis at adjacent levels, predisposed risk to degenerative changes, and altered biomechanical forces near a previous fusion site...
September 16, 2016: Clinical Spine Surgery
Sicong Ren, Duo Wai-Chi Wong, Hui Yang, Yan Zhou, Jin Lin, Ming Zhang
BACKGROUND: While appropriate pillow height is crucial to maintaining the quality of sleep and overall health, there are no universal, evidence-based guidelines for pillow design or selection. We aimed to evaluate the effect of pillow height on cranio-cervical pressure and cervical spine alignment. METHODS: Ten healthy subjects (five males) aged 26 ± 3.6 years were recruited. The average height, weight, and neck length were 167 ± 9.3 cm, 59.6 ± 11.9 kg, and 12...
2016: PeerJ
Leonard I Voronov, Krzysztof B Siemionow, Robert M Havey, Gerard Carandang, Avinash G Patwardhan
INTRODUCTION: Lateral mass screw (LMS) fixation with plates or rods is the current standard procedure for posterior cervical fusion. Recently, implants placed between the facet joints have become available as an alternative to LMS or transfacet screws for patients with cervical spondylotic radiculopathy. The purpose of this study was to evaluate the biomechanical stability of the DTRAX(®) cervical cage for single- and two-level fusion and compare this to the stability achieved with LMS fixation with rods in a two-level construct...
2016: Medical Devices: Evidence and Research
Emily J Morrison, Alan S Litsky, Matthew J Allen, Geoffrey T Fosgate, Bianca F Hettlich
OBJECTIVE: To assess technical feasibility and mechanical properties of 3 locking plate designs (Zero-P, Zero-P VA, and Uniplate 2) for use in the canine cervical spine. STUDY DESIGN: Prospective ex vivo study. ANIMALS: Cadaver cervical spines from skeletally mature large breed dogs (n = 18). METHODS: Specimens were screened using radiography and allocated into balanced groups based on bone density. Stiffness of intact C4-C5 vertebral motion units was measured in extension, flexion, and lateral bending using nondestructive 4-point bend testing...
October 2016: Veterinary Surgery: VS
Paul C Ivancic
Synopsis Head and spinal injuries commonly occur during motor vehicle crashes (MVCs). The goal of this clinical commentary is to discuss real-life versus simulated MVCs and to present clinical, biomechanical, and epidemiological evidence of MVC-related injury mechanisms. It will also address how this knowledge may guide and inform the design of injury mitigation devices and assist in clinical decision making. Evidence indicates that there exists no universal injury tolerance applicable to the entire population of the occupants of MVCs...
October 2016: Journal of Orthopaedic and Sports Physical Therapy
Leonard I Voronov, Krzysztof B Siemionow, Robert M Havey, Gerard Carandang, Frank M Phillips, Avinash G Patwardhan
INTRODUCTION: Supplemental posterior instrumentation has been widely used to enhance stability and improve fusion rates in higher risk patients undergoing anterior cervical discectomy and fusion (ACDF). These typically involve posterior lateral mass or pedicle screw fixation with significant inherent risks and morbidities. More recently, cervical cages placed bilaterally between the facet joints (posterior cervical cages) have been used as a less disruptive alternative for posterior fixation...
2016: Medical Devices: Evidence and Research
Zhong Wang, Hui Zhao, Ji-Ming Liu, Li-Wen Tan, Peng Liu, Jian-Hua Zhao
The uncovertebral joint (UJ) is an important load-bearing structure in the subaxial cervical spine (SCS) and the medial wall of the intervertebral foramen (IVF). To investigate the UJ׳s role in load distribution and transmission under physiological loading, we developed and validated a detailed finite element model (C2-T1). Based on the initial model, two additional models were modified to simulate surgical resection and degeneration of UJs, to evaluate their influence on SCS kinematics and load distribution...
September 6, 2016: Journal of Biomechanics
Alexandra Vorik, Fabian Unteregger, Salome Zwicky, Julia Schiwowa, Silke Potthast, Claudio Storck
OBJECTIVES/HYPOTHESIS: Biplanar imaging technique is not sufficient for an exact visualization and evaluation of the laryngeal biomechanics during speaking or singing. The aim of this pilot study was to test a 3D-visualization software MIMICS (Materialize Interactive Medical Image Control System, Materialize, Leuven, Belgium) for visualizing laryngeal cartilages and resonance space of living humans during singing based on high-resolution computed tomography (HRCT) and analyzing the biomechanics thereof...
July 11, 2016: Journal of Voice: Official Journal of the Voice Foundation
Zhenhua Liao, Weiqiang Liu
This article reviews the progress of biomechanical studies on anterior cervical fusion and non-fusion surgery in recent years. The similarities and differences between animal and human cervical spines as well as the major three biomechanical test methods are introduced. Major progresses of biomechanical evaluation in anterior cervical fusion and non-fusion devices, hybrid surgery, coupled motion and biomechanical parameters, such as the instant center of rotation, are classified and summarized. Future development of loading method, multilevel hybrid surgery and coupling character are also discussed...
February 2016: Sheng Wu Yi Xue Gong Cheng Xue za Zhi, Journal of Biomedical Engineering, Shengwu Yixue Gongchengxue Zazhi
Wei Ji, Jie Tong, Zhiping Huang, Minghui Zheng, Xiuhua Wu, Jianting Chen, Qingan Zhu
BACKGROUND: Ventral defect caused by resection of the lesions involving the upper cervical spine was commonly reconstructed with a fabricated mesh cage. Recently, a clival screw and plate fitted to the osseous anatomy of the craniovertebral junction was developed for this pathological state. OBJECTIVE: To evaluate the stability a clivus plate system fixation (CPSF) for the craniovertebral junction and compared with a conventional fashioned mesh cage fixation (FMCF)...
June 30, 2016: World Neurosurgery
Wei Tian, Kai Yan, Xiao Han, Jie Yu, Peihao Jin, Xiaoguang Han
STUDY DESIGN: Prospective non-randomized comparative study. OBJECTIVE: To compare the long-term clinical and radiographic results of cervical artificial disc replacement (CADR) and anterior cervical discectomy and fusion (ACDF), and to provide our evidence whether CADR could reduce adjacent segment degeneration (ASD). SUMMARY OF BACKGROUND DATA: CADR is widely used in spine surgery today. In spite of the short-term results of it having been ascertained, the long-term results are still under observation...
June 28, 2016: Clinical Spine Surgery
Cheng-Cheng Yu, Ding-Jun Hao, Da-Geng Huang, Li-Xiong Qian, Hang Feng, Hou-Kun Li, Song-Chuan Zhao
STUDY DESIGN: Biomechanical analysis of a novel prosthesis based on the physiological curvature of endplate was performed. OBJECTIVE: To compare the biomechanical differences between a novel prosthesis based on the physiological curvature of the endplate and the Prestige LP prosthesis after cervical disc replacement (CDR). SUMMARY OF BACKGROUND DATA: Artificial disc prostheses have been widely used to preserve the physiological function of treated and adjacent motion segments in CDR, while most of those present a flat surface instead of an arcuate surface which approximately similar to anatomic structures in vivo...
2016: PloS One
Cheng-Cheng Yu, Peng Liu, Da-Geng Huang, Yong-Hong Jiang, Hang Feng, Ding-Jun Hao
STUDY DESIGN: The study aimed to build a new cervical artificial disc C3-C7 segment prosthesis, and perform a biomechanical comparison between the new prosthesis and the Prestige LP prosthesis using a three-dimensional non-linear finite element (FE) model. PURPOSE: The study compared the biomechanical differences between the new cervical artificial disc prosthesis based on the physiological curvature of the end plate and the Prestige LP prosthesis after artificial disc replacement...
June 23, 2016: Spine Journal: Official Journal of the North American Spine Society
Jae Yoon Chung, Jong-Beom Park, Hyoung-Yeon Seo, Sung Kyu Kim
Anterior cervical fusion has become a standard of care for numerous pathologic conditions of the cervical spine. However, subsequent development of clinically significant disc disease at levels adjacent to fused discs is a serious long-term complication of this procedure. As more patients live longer after surgery, it is foreseeable that adjacent segment pathology (ASP) will develop in increasing numbers of patients. Also, ASP has been studied more intensively with the recent popularity of motion preservation technologies like total disc arthroplasty...
June 2016: Asian Spine Journal
Jennica J Tucker, James M Cirone, Tyler R Morris, Courtney A Nuss, Julianne Huegel, Erik I Waldorff, Nianli Zhang, James T Ryaby, Louis J Soslowsky
Rotator cuff tears are common musculoskeletal injuries often requiring surgical intervention with high failure rates. Currently, pulsed electromagnetic fields (PEMFs) are used for treatment of long-bone fracture and lumbar and cervical spine fusion surgery. Clinical studies examining the effects of PEMF on soft tissue healing show promising results. Therefore, we investigated the role of PEMF on rotator cuff healing using a rat rotator cuff repair model. We hypothesized that PEMF exposure following rotator cuff repair would improve tendon mechanical properties, tissue morphology, and alter in vivo joint function...
June 10, 2016: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Félix P Kuhn, Antoine Feydy, Nathalie Launay, Marie-Martine Lefevre-Colau, Serge Poiraudeau, Sébastien Laporte, Marc A Maier, Pavel Lindberg
INTRODUCTION: The study aims to assess the influence of neck extension on water diffusivity within the cervical spinal cord. METHODS: IRB approved the study in 22 healthy volunteers. All subjects underwent anatomical MR and diffusion tensor imaging (DTI) at 1.5 T. The cervical cord was imaged in neutral (standard) position and extension. Segmental vertebral rotations were analyzed on sagittal T2-weighted images using the SpineView® software. Spinal cord diffusivity was measured in cross-sectional regions of interests at multiple levels (C1-C5)...
September 2016: Neuroradiology
Batbayar Khuyagbaatar, Kyungsoo Kim, Won Man Park, Yoon Hyuk Kim
Clinically, spinal cord injuries (SCIs) are radiographically evaluated and diagnosed from plain radiographs, computed tomography (CT), and magnetic resonance imaging. However, it is difficult to conclude that radiographic evaluation of SCI can directly explain the fundamental mechanism of spinal cord damage. The von-Mises stress and maximum principal strain are directly associated with neurological damage in the spinal cord from a biomechanical viewpoint. In this study, the von-Mises stress and maximum principal strain in the spinal cord as well as the cord cross-sectional area (CSA) were analyzed under various magnitudes for contusion, dislocation, and distraction SCI mechanisms, using a finite-element (FE) model of the cervical spine with spinal cord including white matter, gray matter, dura mater with nerve roots, and cerebrospinal fluid (CSF)...
August 1, 2016: Journal of Biomechanical Engineering
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