Three-dimensional transient motion characteristics of atlanto-axial joint in healthy adults under physiological load

doi:10.3969/j.issn.2095-4344.2016.17.013

Abstract

Abstract:

BACKGROUND: The cervical spine of the human body is an important structure carrying the head and connecting the spine. Its volume is small, but its flexibility was great. Activity frequency was highest. Simultaneously, cervical spine is the most complicated bony structure of geometric and kinematic characteristics of human body, bears the physiological load of the head, has functions of flexion and extension, lateral bending and rotation. Therefore, the cervical spine has become one of the most vulnerable structures with degenerative diseases of the spine. Analysis of upper cervical spine biomechanics, recognition and understanding of its normal function and mechanical mechanism will provide a theoretical basis for better treatment of upper cervical spine disorders.

OBJECTIVE: To observe the in vivo three-dimensional kinematics of the upper cervical spine in healthy human beings under physiological load with dual fluorescence X-ray imaging system and spiral CT.

METHODS: Seventeen healthy volunteers were recruited for this study. The vertebral segment motion of each subject was reconstructed with three-dimensional computed tomography and solid modeling software. In vivo cervical vertebral motion during functional postures was observed with dual fluoroscopic imaging. Coordinate systems were established at the vertebral center to obtain the intervertebral range of motion.
RESULTS AND CONCLUSION: (1) During the flexion-extension motion, significant differences in the distance in coronal axis, sagittal axis and angle of rotation were detected in C₁_-₂ and C₂_-₃segments. (2) During the left-right bending motion, the angle of rotation was obviously greater at C_1-2 segment than that at C₂_-₃segment. During the left-right twisting motion, significant differences in distance of the vertical axis and the coronal axis, lateral flexion angle and rotation angle were detectable between C₁_-₂and C₂_-₃segments. (3) These findings confirmed that dual fluorescence X-ray imaging system combined with CT scan can obtain atlanto-axial three-dimensional instantaneous motion of six-DOF data of healthy adults, and found that the main motion of the C₁_-₂ vertebrae is rotating. These data may provide us with some new information about the in vivo kinematics of the upper cervical spine and the non-fixed surgical operation.
中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Atlanto-Axial Joint, Dissection, Tissue Engineering

Wei Dong, Xia Qun, Miao Jun, Bai Jian-qiang, Liu Jia-nan, Li Hong-da. Three-dimensional transient motion characteristics of atlanto-axial joint in healthy adults under physiological load[J]. Chinese Journal of Tissue Engineering Research, 2016, 20(17): 2526-2532.

Figures/Tables 2

References

[1] Wen N, Lavaste F, Santin JJ, et al. Three-dimensional biomechanical properties of the human cervical spine in vitro. II. Analysis of instability after ligamentous injuries. Eur Spine J. 1993;2(1):12-15.

[2] Panjabi MM, Crisco JJ, Vasavada A, et al. Mechanical properties of the human cervical spine as shown by three-dimensional load-displacement curves. Spine (Phila Pa 1976). 2001;26(24):2692-2700.

[3] Dugailly PM, Sobczak S, Sholukha V, et al. In vitro 3D-kinematics of the upper cervical spine: helical axis and simulation for axial rotation and flexion extension. Surg Radiol Anat. 2010;32(2):141-151.

[4] Lee S, Harris KG, Nassif J, et al. In vivo kinematics of the cervical spine. Part I: Development of a roentgen stereophotogrammetric technique using metallic markers and assessment of its accuracy. J Spinal Disord. 1993;6(6):522-534.

[5] Dvorak J, Hayek J, Zehnder R. CT-functional diagnostics of the rotatory instability of the upper cervical spine. Part 2. An evaluation on healthy adults and patients with suspected instability. Spine (Phila Pa 1976). 1987;12(8):726-731.

[6] Kitagawa T, Fujiwara A, Kobayashi N, et al. Morphologic changes in the cervical neural foramen due to flexion and extension: in vivo imaging study. Spine (Phila Pa 1976). 2004;29(24):2821-2825.

[7] Nagamoto Y, Iwasaki M, Sugiura T, et al. In vivo 3D kinematic changes in the cervical spine after laminoplasty for cervical spondylotic myelopathy. J Neurosurg Spine. 2014;21(3):417-424.

[8] Lee JH, Kim JS, Lee JH, et al. Comparison of cervical kinematics between patients with cervical artificial disc replacement and anterior cervical discectomy and fusion for cervical disc herniation. Spine J. 2014;14(7):1199-1204.

[9] Vorro J, Bush TR, Rutledge B, et al. Kinematic measures during a clinical diagnostic technique for human neck disorder: inter- and intraexaminer comparisons. Biomed Res Int. 2013;2013:950719.

[10] Marin F, Hoang N, Aufaure P, et al. In vivo intersegmental motion of the cervical spine using an inverse kinematics procedure. Clin Biomech (Bristol, Avon). 2010;25(5):389-396.

[11] Inokuchi H, Tojima M, Mano H, et al. Neck range of motion measurements using a new three-dimensional motion analysis system: validity and repeatability. Eur Spine J. 2015;24(12):2807-2815.

[12] Anderst WJ, Donaldson WF 3rd, Lee JY, et al. Continuous cervical spine kinematics during in vivo dynamic flexion-extension. Spine J. 2014;14(7):1221-1227.

[13] 夏群,Shaobai Wang,Guoan Li.腰椎椎体间旋转中心的在体研究[J].中华骨科杂志,2010,30(4):325-329.

[14] Wang S, Passias P, Li G, et al. Measurement of vertebral kinematics using noninvasive image matching method-validation and application. Spine (Phila Pa 1976). 2008;33(11):E355-361.

[15] 宁尚龙,夏群,苗军,等.腰椎间盘突出症椎体间在体运动的观察[J].中华骨科杂志,2012,32(5):393-397.

[16] Lin CC, Lu TW, Wang TM, et al. In vivo three-dimensional intervertebral kinematics of the subaxial cervical spine during seated axial rotation and lateral bending via a fluoroscopy-to-CT registration approach. J Biomech. 2014;47(13):3310-3317.

[17] 白剑强,夏群,闫广辉,等.腰椎椎弓根在体相对运动轨迹的研究[J].中华骨科杂志,2011,31(5):424-430.

[18] 白剑强,夏群,苗军,等.双X线透视成像系统进行颈椎在体运动研究方法学的探索[J].医用生物力学,2012,27(2): 166-170,206.

[19] Ishii T, Mukai Y, Hosono N, et al. Kinematics of the upper cervical spine in rotation: in vivo three-dimensional analysis. Spine (Phila Pa 1976). 2004;29(7):E139-144.

[20] Ishii T, Mukai Y, Hosono N, et al. Kinematics of the cervical spine in lateral bending: in vivo three-dimensional analysis. Spine (Phila Pa 1976). 2006;31(2):155-160.

[21] Nagamoto Y, Ishii T, Sakaura H, et al. In vivo three-dimensional kinematics of the cervical spine during head rotation in patients with cervical spondylosis. Spine (Phila Pa 1976). 2011;36(10): 778-783.

[22] Takasaki H, Hall T, Oshiro S, et al. Normal kinematics of the upper cervical spine during the Flexion-Rotation Test - In vivo measurements using magnetic resonance imaging. Man Ther. 2011;16(2):167-171.

[23] Salem W, Lenders C, Mathieu J, et al. In vivo three-dimensional kinematics of the cervical spine during maximal axial rotation. Man Ther. 2013;18(4): 339-444.

[24] Zhao X, Wu ZX, Han BJ, et al. Three-dimensional analysis of cervical spine segmental motion in rotation. Arch Med Sci. 2013;9(3):515-520.

[25] Li G, DeFrate LE, Park SE, et al. In vivo articular cartilage contact kinematics of the knee: an investigation using dual-orthogonal fluoroscopy and magnetic resonance image-based computer models. Am J Sports Med. 2005;33(1):102-107.

[26] Wang S, Xia Q, Passias P, et al. Measurement of geometric deformation of lumbar intervertebral discs under in-vivo weightbearing condition. J Biomech. 2009;42(6):705-711.

[27] Li G, Wang S, Passias P, et al. Segmental in vivo vertebral motion during functional human lumbar spine activities. Eur Spine J. 2009;18(7):1013-1021.

[28] Wang S, Park WM, Kim YH, et al. In vivo loads in the lumbar L3-4 disc during a weight lifting extension. Clin Biomech (Bristol, Avon). 2014;29(2):155-160.

[29] Miao J, Wang S, Wan Z, et al. Motion characteristics of the vertebral segments with lumbar degenerative spondylolisthesis in elderly patients. Eur Spine J. 2013; 22(2):425-431.

[30] 胥鸿达,苗军,夏群.生理载荷下腰椎退变滑脱椎管容积的体内三维试验[J].中国组织工程研究,2014,18(53):8634-8640.

[31] Wang S, Park WM, Gadikota HR, et al. A combined numerical and experimental technique for estimation of the forces and moments in the lumbar intervertebral disc. Comput Methods Biomech Biomed Engin. 2013; 16(12):1278-1286.

[32] Shin JH, Wang S, Yao Q, et al. Investigation of coupled bending of the lumbar spine during dynamic axial rotation of the body. Eur Spine J. 2013;22(12): 2671-2677.

[33] Yao Q, Wang S, Shin JH, et al. Lumbar facet joint motion in patients with degenerative spondylolisthesis. J Spinal Disord Tech. 2013;26(1):E19-27.

[34] Li W, Wang S, Xia Q, et al. Lumbar facet joint motion in patients with degenerative disc disease at affected and adjacent levels: an in vivo biomechanical study. Spine (Phila Pa 1976). 2011;36(10):E629-637.

[35] Xia Q, Wang S, Kozanek M, et al. In-vivo motion characteristics of lumbar vertebrae in sagittal and transverse planes. J Biomech. 2010;43(10):1905-1909.

[36] Xia Q, Wang S, Passias PG, et al. In vivo range of motion of the lumbar spinous processes. Eur Spine J. 2009;18(9):1355-1362.

[37] Anderst WJ, Donaldson WF 3rd, Lee JY, et al. Three-dimensional intervertebral kinematics in the healthy young adult cervical spine during dynamic functional loading. J Biomech. 2015;48(7):1286-1293.