Guo Runsheng, Zhou Chaochao, Wang Cong, Tsai Tsung-Yuan, Yu Yan, Wang Wei, Li Guoan, Cha Thomas
Orthopaedic Bioengineering Research Center, Newton-Wellesley Hospital, Newton, MA, USA; Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Department of Orthopaedics, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
Orthopaedic Bioengineering Research Center, Newton-Wellesley Hospital, Newton, MA, USA; Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
J Biomech. 2021 Jun 23;123:110513. doi: 10.1016/j.jbiomech.2021.110513. Epub 2021 May 11.
While previous studies have greatly improved our knowledge on the motion capability of the cervical spine, few reported on the kinematics of the entire head-neck complex (C0-T1) during dynamic activities of the head in the upright posture. This study investigated in vivo kinematics of the entire head-neck complex (C0-T1) of eight female asymptomatic subjects during dynamic left-right head axial rotation using a dual fluoroscopic imaging system and 3D-to-2D registration techniques. During one-sided head rotation (i.e., left or right head rotation), the primary rotation of the overall head-neck complex (C0-T1) reached 55.5 ± 10.8°, the upper cervical spine region (C0-2) had a primary axial rotation of 39.7 ± 9.6° (71.3 ± 8.5% of the overall C0-T1 axial rotation), and the lower cervical spine region (C2-T1) had a primary rotation of 10.0 ± 3.7° (18.6 ± 7.2% of the overall C0-T1 axial rotation). Coupled bending rotations occurred in the upper and lower cervical spine regions in similar magnitude but opposite directions (upper: contralateral bending of 18.2 ± 5.9° versus lower: ipsilateral bending of 21.4 ± 5.1°), resulting in a compensatory cervical lateral curvature that balances the head to rotate horizontally. Furthermore, upper cervical segments (C0-1 or C1-2) provided main mobility in different rotational degrees of freedom needed for head axial rotations. Additionally, we quantitatively described both coupled segmental motions (flexion-extension and lateral bending) by correlation with the overall primary axial rotation of the head-neck complex. This investigation offers comprehensive baseline data regarding primary and coupled motions of craniocervical segments during head axial rotation.
虽然先前的研究极大地增进了我们对颈椎运动能力的了解,但很少有研究报道在直立姿势下头动态活动期间整个头颈部复合体(C0-T1)的运动学情况。本研究使用双荧光透视成像系统和3D到2D配准技术,对8名无症状女性受试者在左右头部轴向动态旋转过程中整个头颈部复合体(C0-T1)的体内运动学进行了研究。在单侧头部旋转(即向左或向右头部旋转)期间,整个头颈部复合体(C0-T1)的主要旋转角度达到55.5±10.8°,上颈椎区域(C0-2)的主要轴向旋转角度为39.7±9.6°(占整个C0-T1轴向旋转的71.3±8.5%),下颈椎区域(C2-T1)的主要旋转角度为10.0±3.7°(占整个C0-T1轴向旋转的18.6±7.2%)。上颈椎和下颈椎区域发生了幅度相似但方向相反的耦合弯曲旋转(上颈椎:对侧弯曲18.2±5.9°,而下颈椎:同侧弯曲21.4±5.°),从而形成了一种补偿性颈椎侧曲,使头部能够水平旋转。此外,上颈椎节段(C0-1或C1-2)为头部轴向旋转所需的不同旋转自由度提供了主要的活动度。此外,我们通过与头颈部复合体的整体主要轴向旋转的相关性,定量描述了耦合节段运动(屈伸和侧屈)。本研究提供了关于头颈部节段在头部轴向旋转期间的主要和耦合运动的全面基线数据。