J Spinal Disord Tech. 2013 Sep 27. [Epub ahead of print] The Compensatory Relationship of Upper and Subaxial Cervical Motion in the Presence of Cervical Spondylosis. Hayashi T, Daubs MD, Suzuki A, Scott TP, Phan K, Aghdasi B, Ruangchainikom M, Hu X, Lee C, Takahashi S, Shiba K, Wang JC. Source *Department of Orthopaedic Surgery, University of California at Los Angeles, Los Angeles, CA †Department of Orthopaedic Surgery, Japan Labour Health and Welfare Organization, Spinal Injuries Center, Fukuoka, Japan. Abstract STUDY DESIGN:: An in vivo kinematic MRI analysis of cervical spinal motion in human subjects. OBJECTIVE:: To identify associations between disc degeneration in the subaxial cervical spine and upper cervical spinal motion in patients with general age-related cervical spondylosis. SUMMARY OF BACKGROUND DATA:: The kinematic relationship between the occipital-atlantoaxial complex and subaxial cervical spine in patients with cervical spondylosis and decreased cervical motion is not well understood METHODS:: 446 symptomatic patients who had neck pain with and without neurogenic symptoms were included in this study. Kinematic magnetic resonance imaging was performed with dynamic motion of the cervical spine in upright, weight-bearing neutral, flexion and extension positions. Intervertebral disc degeneration for each segment from C2-3 to C7-T1 and sagittal angular motion between flexion and extension for each segment from Oc-C1 to C7-T1 was evaluated. Depending on the amount of sagittal subaxial angular motion, the patients were classified into 3 groups by sagittal angular motion using cut off points based on tertile (47° group: 149 cases). RESULTS:: A significant correlation was found between subaxial angular motion and intervertebral disc degeneration, indicating that the subaxial motion decreases according to the degree of disc degeneration. Mean angular motion of occipital-atlantoaxial complex, especially of Oc-C1, was significantly higher in the 47° group, whereas no significant difference was found at C1-C2. CONCLUSIONS:: Our study demonstrates that decreased subaxial cervical spinal motion is associated with intervertebral disc degeneration in a symptomatic population. This decrease in mobility at the subaxial cervical spine is compensated for by an increase in angular mobility of the upper cervical spine at the occipital-atlantoaxial complex, especially at Oc-C1.
Posted on: Tue, 01 Oct 2013 14:59:48 +0000
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