Cervikalcolumnas anatomi

Holck, Per

doi:10.4045/tidsskr.09.0296

Tidsskriftet

2010

DOI: 10.4045/tidsskr.09.0296

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Cervikalcolumnas anatomi

Per Holck¹

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Cited by 7 publications

References 13 publications

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Evaluation of Cervical Vertebral Motion and Foraminal Changes During the Spurling Test Using Zero Echo Time Magnetic Resonance Imaging and Computed Tomography-Based Micromotion Analysis

Hutchins,

Lagerstrand,

Hebelka

et al. 2024

Spine

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Study Design: Clinical experimental diagnostic study. Objective: The objective of the study was to investigate cervical spine dynamics including changes of the cervical foramina in patients experiencing intermittent arm radiculopathy. Summary of Background Data: Cervical foraminal stenosis is a frequent cause of radicular arm pain. The Spurling test, while specific, lacks the precision to identify symptomatic nerve roots. The relationship between vertebral motion, foraminal changes, and radiculopathy during a Spurling test remains underexplored. Methods: Ten patients with positive Spurling tests and MRI-confirmed one or two level cervical foraminal stenosis were scanned using the Dynamic MRI Compression System (DMRICS) enabling a simulated Spurling test inside the MRI gantry of a 3T MRI scanner with a dedicated neck coil. First, a relaxed image acquisition was undertaken followed by slowly applying the Spurling test until the patient reported aggravation of radiculopathy or discomfort, where the next image series was taken. Zero Echo Time (ZTE) MRI was employed to obtain CT-like images. The images were thereafter analyzed using the Sectra® CT-based Micromotion Analysis (CTMA) software for motion analysis. Results: The C4/C5 level exhibited the most significant movements both in translation and rotation, with less movements observed in C5-6 and C6-C7 levels. No uniform pattern emerged that differentiated suspected stenotic levels from non-suspected levels. Despite relatively small vertebral movements, 9/10 of patients reported arm pain during provocation, indicating extremely narrow margins of tolerance. Conclusion: This study demonstrates the utility of ZTE MRI and CTMA in detecting subtle yet clinically relevant vertebral motions influencing the foramina in the cervical spine during the Spurling maneuver. These findings could lead to better understanding and potentially improved diagnostic strategies for cervical foraminal stenosis, although further research with a larger cohort is necessary to confirm these results.

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Evaluation of Cervical Vertebral Motion and Foraminal Changes During the Spurling Test Using Zero Echo Time Magnetic Resonance Imaging and Computed Tomography-Based Micromotion Analysis

Hutchins,

Lagerstrand,

Hebelka

et al. 2024

Spine

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Musculoskeletal pain as the effect of internal compensatory mechanisms on structural and functional changes in body build and posture in elite Polish sitting volleyball players

Zwierzchowska

Gaweł

Celebańska

et al. 2022

BMC Sports Sci Med Rehabil

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Background With the dynamic development of professional Paralympic sport, the prevalence of musculoskeletal pain and structural and/or functional disturbances in Para athletes constantly increases. The aim of the study was to evaluate the impact of internal compensatory mechanisms on selected aspects of body structure and function in elite sitting volleyball players. Methods The study included eighteen elite sitting volleyball players (male; n = 12, female; n = 6, age; 36.0 ± 6.1, body mass; 76.6 ± 16.1, body height; 179.3 ± 0.1) from the Polish national team. Retrospective and direct participatory observation methods were used in the study. NMQ-7 was used to assess the current prevalence and location of musculoskeletal pain. The evaluation of spinal curvature and pelvic inclination was performed using a non-invasive Medi Mouse method (Idiag M360) in three different trunk positions. All statistical analyses were performed using Statistica 13.3 software package. Results Lumbar hypolordosis was a predominant sagittal deviation of spinal curvature (n = 15;83%). Low back pain (LBP) and neck pain were the most frequent complaints (50%). Statistically significant differences in the values of thoracic kyphosis angle, pelvic inclination, and spine length (SL) in sagittal standing flexion and extension were found. However, there was no statistically significant difference in sagittal standing flexion for the lumbar lordosis angle with a simultaneous significant change in pelvic inclination (66.9°). Moreover, a tendency to interpenetration of relationships between variables that characterize (a) body structure and (b) function of the spine and musculoskeletal pain were observed. Shoulder pain correlated with SL (R = 0.6; p < 0.05) and body height (R = 0.5; p < 0.05). Pelvic inclination correlated with shoulder pain, LBP (R = 0.5; p < 0.05/R = 0.6; p < 0.01), and body trunk fat mass (R = − 0.6; p < 0.05). Conclusions Trunk fat mass induces internal compensatory mechanisms to maintain optimal pelvic inclination and sagittal spinal balance. Furthermore, the level of pelvic mobility may determine musculoskeletal pain in Para athletes with lower limb impairment.

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Rotation-traction manipulation induced intradiskal pressure changes in cervical spine—an in vitro study

Han,

Feng,

Wen

et al. 2024

Front. Bioeng. Biotechnol.

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Objective: Evaluate the effect of rotation-traction manipulation on intradiskal pressure in human cervical spine specimen with different force and duration parameters, and compare the intradiskal pressure changes between rotation-traction manipulation and traction.Methods: Seven human cervical spine specimens were included in this study. The intradiskal pressure was measured by miniature pressure sensor implanting in the nucleus pulposus. rotation-traction manipulation and cervical spine traction were simulated using the MTS biomechanical machine. Varied thrust forces (50N, 150N, and 250N) and durations (0.05 s, 0.1 s, and 0.15 s) were applied during rotation-traction manipulation with Intradiscal pressure recorded in the neutral position, rotation-anteflexion position, preloading, and thrusting phases. Futuremore, we documented changes in intradiscal pressure during cervical spine traction with different loading forces (50N, 150N, and 250N). And a comparative analysis was performed to discern the impact on intradiscal pressure between manipulation and traction.Results: Manipulation application induced a significant reduction in intradiscal pressure during preloading and thrusting phases for each cervical intervertebral disc (p < 0.05). When adjusting thrust parameters, a discernible decrease in intradiscal pressure was observed with increasing thrust force, and the variations between different thrust forces were statistically significant (p < 0.05). Conversely, changes in duration did not yield a significant impact on intradiscal pressure (p > 0.05). Additionally, after traction with varying loading forces (50N, 150N, 250N), a noteworthy decrease in intradiscal pressure was observed (p < 0.05). And a comparative analysis revealed that rotation-traction manipulation more markedly reduced intradiscal pressure compared to traction alone (p < 0.05).Conclusion: Both rotation-traction manipulation and cervical spine traction can reduce intradiscal pressure, exhibiting a positive correlation with force. Notably, manipulation elicits more pronounced and immediate decompression effect, contributing a potential biomechanical rationale for its therapeutic efficacy.

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Cervikalcolumnas anatomi

Cited by 7 publications

References 13 publications

Evaluation of Cervical Vertebral Motion and Foraminal Changes During the Spurling Test Using Zero Echo Time Magnetic Resonance Imaging and Computed Tomography-Based Micromotion Analysis

Evaluation of Cervical Vertebral Motion and Foraminal Changes During the Spurling Test Using Zero Echo Time Magnetic Resonance Imaging and Computed Tomography-Based Micromotion Analysis

Musculoskeletal pain as the effect of internal compensatory mechanisms on structural and functional changes in body build and posture in elite Polish sitting volleyball players

Rotation-traction manipulation induced intradiskal pressure changes in cervical spine—an in vitro study

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