Kinematics of the Cervical Spine Under Healthy and Degenerative Conditions: A Systematic Review
- PMID: 36496482
- PMCID: PMC9794546
- DOI: 10.1007/s10439-022-03088-8
Kinematics of the Cervical Spine Under Healthy and Degenerative Conditions: A Systematic Review
Abstract
Knowledge of spinal kinematics is essential for the diagnosis and management of spinal diseases. Distinguishing between physiological and pathological motion patterns can help diagnose these diseases, plan surgical interventions and improve relevant tools and software. During the last decades, numerous studies based on diverse methodologies attempted to elucidate spinal mobility in different planes of motion. The authors aimed to summarize and compare the evidence about cervical spine kinematics under healthy and degenerative conditions. This includes an illustrated description of the spectrum of physiological cervical spine kinematics, followed by a comparable presentation of kinematics of the degenerative cervical spine. Data was obtained through a systematic MEDLINE search including studies on angular/translational segmental motion contribution, range of motion, coupling and center of rotation. As far as the degenerative conditions are concerned, kinematic data regarding disc degeneration and spondylolisthesis were available. Although the majority of the studies identified repeating motion patterns for most motion planes, discrepancies associated with limited sample sizes and different imaging techniques and/or spine configurations, were noted. Among healthy/asymptomatic individuals, flexion extension (FE) and lateral bending (LB) are mainly facilitated by the subaxial cervical spine. C4-C5 and C5-C6 were the major FE contributors in the reported studies, exceeding the motion contribution of sub-adjacent segments. Axial rotation (AR) greatly depends on C1-C2. FE range of motion (ROM) is distributed between the atlantoaxial and subaxial segments, while AR ROM stems mainly from the former and LB ROM from the latter. In coupled motion rotation is quantitatively predominant over translation. Motion migrates caudally from C1-C2 and the center of rotation (COR) translocates anteriorly and superiorly for each successive subaxial segment. In degenerative settings, concurrent or subsequent lesions render the association between diseases and mobility alterations challenging. The affected segments seem to maintain translational and angular motion in early and moderate degeneration. However, the progression of degeneration restrains mobility, which seems to be maintained or compensated by adjacent non-affected segments. While the kinematics of the healthy cervical spine have been addressed by multiple studies, the entire nosological and kinematic spectrum of cervical spine degeneration is partially addressed. Large-scale in vivo studies can complement the existing evidence, cover the gaps and pave the way to technological and clinical breakthroughs.
Keywords: Axial rotation; Center of rotation; Extension; Flexion; Lateral bending; Motion; Range of motion.
© 2022. The Author(s).
Conflict of interest statement
Prof. M. Farshad possesses stocks in two biomedical startup companies (Incremed Balgrist University, 25Segments Balgrist University), is a board member of Swiss Orthopaedics and has filled a number of patents related to spine surgery instrumentation. Details have been disclosed in a designated Conflict-of-Interest (COI) form during submission. The remaining authors declare that they have no conflict of interest.
Figures
![Figure 1](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/9794546/bin/10439_2022_3088_Fig1_HTML.gif)
![Figure 2](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/9794546/bin/10439_2022_3088_Fig2_HTML.gif)
![Figure 3](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/9794546/bin/10439_2022_3088_Fig3_HTML.gif)
![Figure 4](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/9794546/bin/10439_2022_3088_Fig4_HTML.gif)
![Figure 5](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/9794546/bin/10439_2022_3088_Fig5_HTML.gif)
![Figure 6](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/9794546/bin/10439_2022_3088_Fig6_HTML.gif)
![Figure 7](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/9794546/bin/10439_2022_3088_Fig7_HTML.gif)
![Figure 8](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/9794546/bin/10439_2022_3088_Fig8_HTML.gif)
![Figure 9](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/9794546/bin/10439_2022_3088_Fig9_HTML.gif)
![Figure 10](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/9794546/bin/10439_2022_3088_Fig10_HTML.gif)
![Figure 11](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/9794546/bin/10439_2022_3088_Fig11_HTML.gif)
![Figure 12](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/9794546/bin/10439_2022_3088_Fig12_HTML.gif)
![Figure 13](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/9794546/bin/10439_2022_3088_Fig13_HTML.gif)
![Figure 14](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/9794546/bin/10439_2022_3088_Fig14_HTML.gif)
![Figure 15](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/9794546/bin/10439_2022_3088_Fig15_HTML.gif)
![Figure 16](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/9794546/bin/10439_2022_3088_Fig16_HTML.gif)
![Figure 17](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/9794546/bin/10439_2022_3088_Fig17_HTML.gif)
Similar articles
-
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 Oct 17;47(13):3310-7. doi: 10.1016/j.jbiomech.2014.08.014. Epub 2014 Sep 2. J Biomech. 2014. PMID: 25218506
-
Influence of cervical total disc replacement on motion in the target and adjacent segments.Spine J. 2024 Jul;24(7):1313-1322. doi: 10.1016/j.spinee.2024.01.018. Epub 2024 Jan 30. Spine J. 2024. PMID: 38301903
-
Biomechanical comparison of single- and two-level cervical arthroplasty versus arthrodesis: effect on adjacent-level spinal kinematics.Spine J. 2010 Apr;10(4):341-9. doi: 10.1016/j.spinee.2010.01.006. Spine J. 2010. PMID: 20362252
-
Biomechanical analysis of screw constructs for atlantoaxial fixation in cadavers: a systematic review and meta-analysis.J Neurosurg Spine. 2015 Feb;22(2):151-61. doi: 10.3171/2014.10.SPINE13805. Epub 2014 Dec 5. J Neurosurg Spine. 2015. PMID: 25478824 Review.
-
Clinical Relevance of Cervical Kinematic Quality Parameters in Planar Movement.Orthop Surg. 2019 Apr;11(2):167-175. doi: 10.1111/os.12435. Epub 2019 Mar 18. Orthop Surg. 2019. PMID: 30884156 Free PMC article. Review.
Cited by
-
An observational study of quality of motion in the aging cervical spine: sequence of segmental contributions in dynamic fluoroscopy recordings.BMC Musculoskelet Disord. 2024 Apr 25;25(1):330. doi: 10.1186/s12891-024-07423-z. BMC Musculoskelet Disord. 2024. PMID: 38664811 Free PMC article.
-
Pericardial Adhesion and Chronic Non-Specific Neck Pain following Thoracentesis: An Osteopathic Approach.Clin Pract. 2023 Oct 25;13(6):1313-1318. doi: 10.3390/clinpract13060117. Clin Pract. 2023. PMID: 37987418 Free PMC article.
-
Cervical Foraminal Changes in Patients with Intermittent Arm Radiculopathy Studied with a New MRI-Compatible Compression Device.J Clin Med. 2023 Oct 12;12(20):6493. doi: 10.3390/jcm12206493. J Clin Med. 2023. PMID: 37892631 Free PMC article.
-
Biomechanical properties of different anterior and posterior techniques for atlantoaxial fixation: a finite element analysis.J Orthop Surg Res. 2023 Jun 26;18(1):456. doi: 10.1186/s13018-023-03905-3. J Orthop Surg Res. 2023. PMID: 37365580 Free PMC article.
References
-
- Anderst W., E. Baillargeon, W. Donaldson, J. Lee and J. Kang. Motion path of the instant center of rotation in the cervical spine during in vivo dynamic flexion-extension: implications for artificial disc design and evaluation of motion quality after arthrodesis. Spine (Phila Pa 1976) 38: E594–601, 2013. - PMC - PubMed
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Medical
Research Materials
Miscellaneous