Anatomy and biomechanics of the craniovertebral junction. Lopez AJ, Scheer JK, Leibl KE, Smith ZA, Dlouhy BJ, Dahdaleh NS. Relevance to clinical diagnosis and treatment.

Oda T, Panjabi MM, Crisco JJIII, Oxland TR, Katz L, Nolte LP. Finite element analysis of cervical spinal instability under physiologic loading. Quantitative three dimensional anatomy of the middle and lower regions. The annual incidence and course of neck pain in the general population: a population-based cohort study. The effect of neck pain on cervical kinematics, as assessed in a virtual environment. The primary goal of surgery is to improve neck pain, maintain stability, and preserve range of motion. When symptoms of cervical radiculopathy persist or worsen despite nonsurgical treatment, surgical intervention in the form of laminoplasty or spinal fusion or arthroplasty may be recommended. Functional radiography is the clinical standard to detect segmental instability. Accurate measurement of intervertebral kinematics of the cervical spine through use of static and dynamic X-rays can support the diagnosis of widespread diseases related to neck pain. Alterations of cervical spine mechanics that compromise the stabilizing mechanisms of the cervical spine due to injury or degenerative conditions can cause pain. Neck pain is a common musculoskeletal problem experienced by many in the community. Abnormal loads can produce varying degrees of derangement leading to pain and deformity. Biomechanically normal posture is one where there is no undue stretching of ligaments, annulus, capsules, or of the soft tissues, and no undue demand on muscle activity, no undue load bearing by the disc.Ĭlinical cervical instability is the loss of ability to maintain normal relationship between vertebrae under physiological loads. This means that the erect position of the head is held by the muscular force from behind. By summing up the contributions of each motion segment we can account for total range of motion of cervical spine.Ī preload always exists on vertebra while the person sits or stands, for example, at C6 vertebra which acts as fulcrum the whole load on the top will be acting so that the center of gravity of the entire top is lined anterior to it. The movements of individual vertebrae are coupled with the others. The upper complex is further subdivided into two motion segments (C0-1 and C1-2). Any disturbance of anatomy and mechanical properties can lead to clinical symptoms.ĭue to the complexity of kinematics, generally the cervical spine is divided into upper complex as C0-1-2 (occipito-atlanto-axial joint) and lowers complex C3-7 (typical cervical vertebrae). The head neck region consists of seven cervical vertebrae, which has unique anatomy and kinematics accommodating the needs of a highly mobile unit between the head and torso while protecting the spinal cord from injury.

Unstable cervical spine flexion x ray