寰枢椎稳定性对颈椎上段运动学的影响:一项体外研究。

Effects of occipital-atlas stabilization in the upper cervical spine kinematics: an in vitro study.

机构信息

Unidad de Investigación en Fisioterapia, Facultad de Ciencias de la Salud de la Universidad de Zaragoza, c/ Domingo Miral s/n, 50009, Zaragoza, Spain.

Impact Laboratory, Aragon Institute of Engineering Research, Universidad de Zaragoza, Alcañiz, Spain.

出版信息

Sci Rep. 2021 May 25;11(1):10853. doi: 10.1038/s41598-021-90052-6.

Abstract

This study compares upper cervical spine range of motion (ROM) in the three cardinal planes before and after occiput-atlas (C0-C1) stabilization. After the dissection of the superficial structures to the alar ligament and the fixation of C2, ten cryopreserved upper cervical columns were manually mobilized in the three cardinal planes of movement without and with a screw stabilization of C0-C1. Upper cervical ROM and mobilization force were measured using the Vicon motion capture system and a load cell respectively. The ROM without C0-C1 stabilization was 19.8° ± 5.2° in flexion and 14.3° ± 7.7° in extension. With stabilization, the ROM was 11.5° ± 4.3° and 6.6° ± 3.5°, respectively. The ROM without C0-C1 stabilization was 4.7° ± 2.3° in right lateral flexion and 5.6° ± 3.2° in left lateral flexion. With stabilization, the ROM was 2.3° ± 1.4° and 2.3° ± 1.2°, respectively. The ROM without C0-C1 stabilization was 33.9° ± 6.7° in right rotation and 28.0° ± 6.9° in left rotation. With stabilization, the ROM was 28.5° ± 7.0° and 23.7° ± 8.5° respectively. Stabilization of C0-C1 reduced the upper cervical ROM by 46.9% in the sagittal plane, 55.3% in the frontal plane, and 15.6% in the transverse plane. Also, the resistance to movement during upper cervical mobilization increased following C0-C1 stabilization.

摘要

本研究比较了寰枕(C0-C1)稳定前后三个基本平面的上颈椎活动范围(ROM)。在解剖翼状韧带的浅层结构并固定 C2 后,10 个冷冻保存的上颈椎柱在三个基本运动平面上进行手动活动,不固定和固定 C0-C1 螺钉。使用 Vicon 运动捕捉系统和负载细胞分别测量上颈椎 ROM 和活动力。在没有 C0-C1 稳定的情况下,ROM 在屈曲时为 19.8°±5.2°,伸展时为 14.3°±7.7°。稳定后,ROM 分别为 11.5°±4.3°和 6.6°±3.5°。在没有 C0-C1 稳定的情况下,右侧侧屈时的 ROM 为 4.7°±2.3°,左侧侧屈时的 ROM 为 5.6°±3.2°。稳定后,ROM 分别为 2.3°±1.4°和 2.3°±1.2°。在没有 C0-C1 稳定的情况下,右侧旋转时的 ROM 为 33.9°±6.7°,左侧旋转时的 ROM 为 28.0°±6.9°。稳定后,ROM 分别为 28.5°±7.0°和 23.7°±8.5°。C0-C1 的稳定使矢状面的上颈椎 ROM 减少了 46.9%,额状面减少了 55.3%,横切面减少了 15.6%。此外,C0-C1 稳定后,上颈椎活动的阻力增加。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ea7e/8149863/ac75a6e6005f/41598_2021_90052_Fig1_HTML.jpg

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