The Effects of Disc Degeneration and Muscle Dysfunction on Cervical Spine Stability from a Biomechanical Study

Chen, Cheng; Pj, Chen; Yw, Kuo; Wang, Jaw‐Lin

doi:10.1243/09544119jeim805

Cited by 14 publications

(13 citation statements)

References 47 publications

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“…Using a porcine model of spine disc degeneration in vitro, Cheng et al21 investigated the relationship between cervical muscle recruitment and cervical spine stability in animals with both intact and degenerative cervical spines to test the hypothesis that muscle that is dysfunctional from fatty change is not as efficient in stabilizing the spine. They found that spinal stability was more affected by muscle dysfunction than by disc degeneration.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Relationship between Paraspinal Muscle Fatty Degeneration and Cervical Spine Motion Using Kinetic Magnetic Resonance Imaging

Inoue

Montgomery

Aghdasi

et al. 2012

Global Spine Journal

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The alignment and mobility of the cervical spine is influenced by factors related to the vertebral bodies, intervertebral discs, ligaments, facet joints, and muscles. Few reports have described the role played by the paraspinal muscles in cervical spine mobility. In this study, we investigate the relationship between fatty degeneration of the paraspinal muscles and cervical motion as assessed with kinetic magnetic resonance imaging (kMRI). One hundred eighty-eight symptomatic patients underwent cervical kMRI in neutral, flexion, and extension positions. We quantified cervical paraspinal muscle fatty infiltration and measured angular variation and translational motion at each cervical level, and the global Cobb angle. Cervical paraspinal muscle fatty degeneration demonstrated a pattern in which C3 and C7 had significantly more fatty infiltration than C4, C5, and C6. Additionally, when the normal group was compared with the fatty degeneration group with respect to angular variation, translational motion, and Cobb angle, no significant differences were found except in angular variation at the C3–C4 level. In conclusion, we found a significantly larger quantity of fatty degeneration in the paraspinal muscles at C3 and C7 than the middle cervical levels. Also, we demonstrate that fatty degeneration does not significantly affect cervical lordotic alignment or mobility characteristics.

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Section: Discussionmentioning

confidence: 99%

Analysis of Relationship between Paraspinal Muscle Fatty Degeneration and Cervical Spine Motion Using Kinetic Magnetic Resonance Imaging

Inoue

Montgomery

Aghdasi

et al. 2012

Global Spine Journal

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“…When some segments are fused, adjacent unfused segments need to increase mobility to compensate for the reduced range of motion, which may heighten the intradiscal pressure in adjacent discs and lead to development of ASD 39,40 . Since biomechanical research has shown that the application of electrical stimulation to cervical muscles can reduce the neutral zone and range of motion in the sagittal plane of healthy and degenerative porcine cervical spines, 41 proper muscle function are crucial for the stability and mobility of the cervical spine (especially after ACDF). This may explain the close association between preoperative morphometry of deep neck extensors (but not other imaging phenotypes) and ASD development.…”

Section: Discussionmentioning

confidence: 99%

Preoperative paraspinal neck muscle characteristics predict early onset adjacent segment degeneration in anterior cervical fusion patients: A machine‐learning modeling analysis

Wong

Harada

Lee

et al. 2020

Journal Orthopaedic Research

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Early onset adjacent segment degeneration (ASD) can be found within six months after anterior cervical discectomy and fusion (ACDF). Deficits in deep paraspinal neck muscles may be related to early onset ASD. This study aimed to determine whether the morphometry of preoperative deep neck muscles (multifidus and semispinalis cervicis) predicted early onset ASD in patients with ACDF. Thirty‐two cases of early onset ASD after a two‐level ACDF and 30 matched non‐ASD cases were identified from a large‐scale cohort. The preoperative total cross‐sectional area (CSA) of bilateral deep neck muscles and the lean muscle CSAs from C3 to C7 levels were measured manually on T2‐weighted magnetic resonance imaging. Paraspinal muscle CSA asymmetry at each level was calculated. A support vector machine (SVM) algorithm was used to identify demographic, radiographic, and/or muscle parameters that predicted proximal/distal ASD development. No significant between‐group differences in demographic or preoperative radiographic data were noted (mean age: 52.4 ± 10.9 years). ACDFs comprised C3 to C5 (n = 9), C4 to C6 (n = 20), and C5 to C7 (n = 32) cases. Eighteen, eight, and six patients had proximal, distal, or both ASD, respectively. The SVM model achieved high accuracy (96.7%) and an area under the curve (AUC = 0.97) for predicting early onset ASD. Asymmetry of fat at C5 (coefficient: 0.06), and standardized measures of C7 lean (coefficient: 0.05) and total CSA measures (coefficient: 0.05) were the strongest predictors of early onset ASD. This is the first study to show that preoperative deep neck muscle CSA, composition, and asymmetry at C5 to C7 independently predicted postoperative early onset ASD in patients with ACDF. Paraspinal muscle assessments are recommended to identify high‐risk patients for personalized intervention.

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“…Cervical muscular function is of great significance to the cervical stability, alignment, head posture, and motion ( Cheng et al, 2011 ; Thakar et al, 2014 ; Ding et al, 2020 ). Cervical muscular dysfunction can contribute to a series of disorders and neuromuscular diseases, such as neck pain (NP) ( Cheng et al, 2011 ), cervical dystonia, and cervical bending and rotation deformities ( Hussein et al, 2017 ), as well as abnormal postures, such as wryneck posture. Rehabilitation and non-invasive treatments are always needed for treating the cervical disorders related to muscular dysfunction.…”

Section: Introductionmentioning

confidence: 99%

“…Although previous studies have proved the HR phenomenon and estimated the efficacy on several kinds of muscular diseases, the muscular electrophysiology mechanism of HR is still unclear. The superficial and deep cervical rotators synergistically contribute to the posture control and rotation movement ( Panjabi et al, 1998 ; Cheng et al, 2011 ; Agyei et al, 2019 ). This study aims to identify the impacts of HR on myoelectrical activity of cervical rotators and neuromuscular function, as well as the affecting factors.…”

Section: Introductionmentioning

confidence: 99%

Effects of hanger reflex on the cervical muscular activation and function: A surface electromyography assessment

Wang

Liu

2022

Front. Physiol.

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Introduction: Cervical muscular dysfunction is closely associated with disorders and neuromuscular diseases of the cervical spine, and the hanger reflex (HR) has the potential to become a rehabilitation method. The muscular electrophysiology mechanism of HR is unclear. This study aims to identify the impacts of HR on cervical rotators’ myoelectrical activity and function.Methods: We designed a self-control clinical trial, and asymptomatic volunteers were continuously included from 1 September 2021 to 30 April 2022 in our department. Rotation tasks were performed on both sides under each of the situations: no HR, unilateral HR, and bilateral HR. Surface electromyography (SEMG) was used to detect the myoelectrical activity of agonistic splenius capitis (SPL), upper trapezius (UTr), and sternocleidomastoid (SCM). The co-contraction ratio (CCR) during rotation tasks was calculated. Correlation analyses and multiple linear regression were performed.Results: Finally, 90 subjects were enrolled (power >90%). The adjusted EMG value (aEMG) of SPL UTr, SCM, and rotating CCR under the unilateral HR and bilateral HR were higher than no HR; the aEMG of SPL and rotating CCR under the bilateral HR were higher than the unilateral HR. Multiple linear regression showed that HR pattern and age were the independent affecting factors for the aEMG of SPL (p < 0.001, p < 0.001), UTr (p < 0.001, p < 0.001), and SCM (p < 0.001, p < 0.001); BMI was an independent affecting factor for the aEMG of SPL (p < 0.001) and SCM (p < 0.001); HR pattern was the only affecting factor for CCR (p < 0.001).Conclusion: HR can increase the cervical rotators’ myoelectrical activities and rotating CCR, and the effects of bilateral HR are greater than unilateral HR, suggesting that bilateral HR has a greater clinical potential to become a rehabilitation method for treating cervical neuromuscular disorders.

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The Effects of Disc Degeneration and Muscle Dysfunction on Cervical Spine Stability from a Biomechanical Study

Cited by 14 publications

References 47 publications

Analysis of Relationship between Paraspinal Muscle Fatty Degeneration and Cervical Spine Motion Using Kinetic Magnetic Resonance Imaging

Analysis of Relationship between Paraspinal Muscle Fatty Degeneration and Cervical Spine Motion Using Kinetic Magnetic Resonance Imaging

Preoperative paraspinal neck muscle characteristics predict early onset adjacent segment degeneration in anterior cervical fusion patients: A machine‐learning modeling analysis

Effects of hanger reflex on the cervical muscular activation and function: A surface electromyography assessment

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