Anatomical Gender Differences in Cervical Vertebrae of Size-Matched Volunteers

Stemper, Brian D.; Yoganandan, Narayan; Pintar, Frank A.; Maiman, Dennis J.; Meyer, Mark; DeRosia, John; Shender, Barry S.; Paskoff, Glenn

doi:10.1097/brs.0b013e318160462a

Cited by 83 publications

(49 citation statements)

References 31 publications

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“…Dimensional measurements match with literature. 16 Histological examination showed cervical spinal segment's intervertebral disc with a gray, inhomogeneous structure with unclear distinction between the nucleus and annulus. These were classified to have grade III degeneration.…”

Section: Resultsmentioning

confidence: 99%

Role of posterior elements in the disc bulging of a degenerated cervical spine

et al. 2015

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BackgroundMany studies have been developed to characterize the mechanical behavior of the intervertebral disc specifically for the lumbar spine and there have been limited studies done on the cervical spine with the goal to evaluate the strength of the cervical spine under compression without any information on the bulging of the intervertebral discs. The goal of the current study is to examine the deformation response of the cervical intervertebral disc classified with grade III or greater degeneration and analyze the relationship between axial deformation and anterior and posterior bulge under compression up to 550 N.

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Section: Resultsmentioning

confidence: 99%

Role of posterior elements in the disc bulging of a degenerated cervical spine

et al. 2015

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“…This may contribute to decreased stability of the cervical column and an increased risk of injury in females. Republished with permission from Stemper et al 94 Copyright ©2008 Wolters Kluwer Health, Inc. to a variability in outcomes sufficient to partially explain the analytical finding that underlying mechanical factors, such as collision severity, have no predictive value for patient outcomes across a large sample of patients, 111 while experimental vical spine, increasing soft tissue strains in structures associated with whiplash injury. 6,21,65,91 As shown here, morphological differences among occupants can have a significant effect on cervical spine biomechanics and may contribute Likewise, Curry and colleagues 17 identified onset of end-plate failures with segmental prealignment and cortical fracture with lordotic curvature during axial loading.…”

Section: Cervical Spinal Posturementioning

confidence: 99%

mentioning

confidence: 99%

Whiplash-Associated Disorders: Occupant Kinematics and Neck Morphology

Stemper¹,

Corner²

2016

J Orthop Sports Phys Ther

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FIGURE 1.Initial phases of head-neck response to automotive rear impacts. The rear impact initiates with the occupant in a neutral upright position. As the thorax is accelerated anteriorly, the head remains stationary during the retraction phase, producing an S-shaped cervical spine curvature. Eventually, loads from the thorax are transferred up the cervical spine and the head-neck complex transitions into extension, with the cervical spine in an overall C-shaped extension curvature. The head eventually rebounds forward (not shown), and the cervical spine then transitions into flexion. Used with permission from Stemper et al. 93 Copyright ©2011 Wiley-Liss, Inc. foam/springs and rearward deflection, which absorb energy and decrease impact severity for the occupant. The magnitude of seatback deformation and deflection is dependent on the occupant's torso mass and center of gravity. Greater mass and higher center of gravity contribute to greater deflection and decreased overall impact severity. Average female body mass is 20% lighter and torso height is 8% shorter. 30,31 Therefore, the ability to deflect the seatback is decreased in females, who would experience more severe loading on the head-neck complex during a given rear impact.This section highlighted the role of body size on cervical spine injury risk during automotive rear impacts, advancing the theory that size-based mismatches between the vehicle seat and occupant anthropometrics contribute to greater injury risk for smaller occupants. This concept would hold true for either males or females, but may help explain the preponderance of whiplash injuries in females due to their generally smaller body size. Shorter sitting height can result in head interaction with the bottom of the head restraint, which increases injury risk. However, taller occupants with incorrectly adjusted head restraints also experience increased injury risk due to the head rotating over the head restraint and increasing extension moments on the cervical spine. Decreased body mass and shorter center-of-torso mass in smaller occupants also contribute to decreased dynamic energy absorption of the seatback. While these differences illustrate mechanisms of increased injury risk for smaller occupants, other morphological differences may also contribute. Differences in Head and Neck MorphologyGiven that a majority of injuries resulting from automotive rear impacts affect the cervical spine, 9 differences in headneck morphology can influence injury risk. Once again, sex-based differences will be used to demonstrate this concept. Neck slenderness, a mechanical term body sizes farther from those standards may not be protected as well.Research studies report that head-tohead restraint backset is lower in females than in males due to rearward incline of automotive seats and decreased sitting height for average females compared to males.12 Sitting height for average females is approximately 6 cm shorter than that for average males. 30,31 This means that the posterior aspect of the head for the comp...

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“…Chatzigianni and Halazonetis, 6 using lateral cephalograms, reported that gender dimorphism was found for both cervical vertebral size and shape. Hellsing 22 and Stemper et al 23 also found gender differences in vertebral size. However, we found no gender differences in CS.…”

Section: Discussionmentioning

confidence: 99%

“…This might produce differences compared with previous studies. 6,[22][23][24] Through GPA and PCA, we found meaningful PCs (Table 1); the first three PCs in the vertebral foramen for ACV1 and two PCs in the vertebral body for the ACV3 and ACV4. Figure 3 shows the mean shape.…”

Section: Discussionmentioning

confidence: 99%

The skeletal maturation status estimated by statistical shape analysis: axial images of Japanese cervical vertebra

Yi²,

Choi³

et al. 2015

Dentomaxillofacial Radiology

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Objectives: To evaluate axial cervical vertebral (ACV) shape quantitatively and to build a prediction model for skeletal maturation level using statistical shape analysis for Japanese individuals. Methods: The sample included 24 female and 19 male patients with hand-wrist radiographs and CBCT images. Through generalized Procrustes analysis and principal components (PCs) analysis, the meaningful PCs were extracted from each ACV shape and analysed for the estimation regression model. Results: Each ACV shape had meaningful PCs, except for the second axial cervical vertebra. Based on these models, the smallest prediction intervals (PIs) were from the combination of the shape space PCs, age and gender. Overall, the PIs of the male group were smaller than those of the female group. There was no significant correlation between centroid size as a size factor and skeletal maturation level. Conclusions: Our findings suggest that the ACV maturation method, which was applied by statistical shape analysis, could confirm information about skeletal maturation in Japanese individuals as an available quantifier of skeletal maturation and could be as useful a quantitative method as the skeletal maturation index.

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Anatomical Gender Differences in Cervical Vertebrae of Size-Matched Volunteers

Abstract: Present results of decreased linear and areal cervical dimensions leading to decreased column stability may partially explain increased traumatic injury rates in women.

Cited by 83 publications

References 31 publications

Role of posterior elements in the disc bulging of a degenerated cervical spine

Role of posterior elements in the disc bulging of a degenerated cervical spine

Whiplash-Associated Disorders: Occupant Kinematics and Neck Morphology

The skeletal maturation status estimated by statistical shape analysis: axial images of Japanese cervical vertebra

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