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Dynamic motion analysis of normal and unstable cervical spines using cineradiography. An in vivo study.
Spine 1999 January 16
STUDY DESIGN: Cervical motion patterns were analyzed in a normal population and in patients with cervical instability by using cineradiography.
OBJECTIVES: To determine normal and pathologic motion patterns in the cervical spine through an in vivo continuous motion analysis.
SUMMARY OF BACKGROUND DATA: Cineradiographic techniques have been used in a limited number of studies to quantify spinal motion. There is a paucity of information regarding dynamic motion patterns in normal and pathologic cervical spines.
METHODS: Ten healthy subjects and 12 patients with unstable cervical spines (C1-C2 subluxation caused by rheumatoid arthritis, n = 10; instability below C2, n = 2) were studied. Cervical motion during flexion from the maximum extension position was recorded using cineradiography. Cervical segmental motions (C1-C2 to C5-C6) were continuously measured through quantifying cineradiographic images projected on a digitizer.
RESULTS: Normal cervical spines showed a well-regulated stepwise motion pattern that initiated at C1-C2 and transmitted to the lower segments with time lags. Pathologic spines showed a different order of onset of segmental motion. In patients with rheumatoid arthritis who had atlantoaxial subluxation, C1-C2 motion initiated significantly earlier than C2-C3 motion. In patients with segmental instability below C2, motion in the unstable segments preceded that in the upper intact segments.
CONCLUSIONS: Different motion patterns were observed between normal and pathologic cervical spines. Cineradiographic motion analysis is a valuable adjunctive technique, especially in diagnosis or evaluation of conditions that cannot be identified through conventional radiographic examination.
OBJECTIVES: To determine normal and pathologic motion patterns in the cervical spine through an in vivo continuous motion analysis.
SUMMARY OF BACKGROUND DATA: Cineradiographic techniques have been used in a limited number of studies to quantify spinal motion. There is a paucity of information regarding dynamic motion patterns in normal and pathologic cervical spines.
METHODS: Ten healthy subjects and 12 patients with unstable cervical spines (C1-C2 subluxation caused by rheumatoid arthritis, n = 10; instability below C2, n = 2) were studied. Cervical motion during flexion from the maximum extension position was recorded using cineradiography. Cervical segmental motions (C1-C2 to C5-C6) were continuously measured through quantifying cineradiographic images projected on a digitizer.
RESULTS: Normal cervical spines showed a well-regulated stepwise motion pattern that initiated at C1-C2 and transmitted to the lower segments with time lags. Pathologic spines showed a different order of onset of segmental motion. In patients with rheumatoid arthritis who had atlantoaxial subluxation, C1-C2 motion initiated significantly earlier than C2-C3 motion. In patients with segmental instability below C2, motion in the unstable segments preceded that in the upper intact segments.
CONCLUSIONS: Different motion patterns were observed between normal and pathologic cervical spines. Cineradiographic motion analysis is a valuable adjunctive technique, especially in diagnosis or evaluation of conditions that cannot be identified through conventional radiographic examination.
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