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Biomechanical Remarks

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Reconstruction of Upper Cervical Spine and Craniovertebral Junction

Abstract

Knowledge of normal biomechanics of the cervical spine is very important as it can be modified by various pathological situations. The changes that occur during injury and/or in consequence with other pathological conditions or surgical procedures can substantially influence the stability of this most important spinal joint-ligamentous complex. The motion of AO-AA joint complex is always coupled. UCS is responsible for 60% of rotation and 40% flexion and extension of the whole cervical spine. Whatever parameter measured beyond the physiological limits has to be considered as mechanical instability. Performing complex reconstruction of UCS the load distribution typical for this spine region has to be respected and the non-affected segments spared to preserve as much movement as possible.

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References

  1. Alund, M., Larsson, S.E.: Three-dimensional analysis of neck motion. A clinical method. Spine (Phila Pa 1976) 15, 87–91 (1990)

    CAS  Google Scholar 

  2. Bono, C.M., Vaccaro, A.R., Fehlings, M., et al.: Measurement techniques for upper cervical spine injuries: consensus statement of the Spine Trauma Study Group. Spine (Phila Pa 1976) 32, 593–600 (2007)

    Google Scholar 

  3. Dvorak, J., Froehlich, D., Penning, L., et al.: Functional radiographic diagnosis of the cervical spine: flexion/extension. Spine (Phila Pa 1976) 13, 748–755 (1988)

    CAS  Google Scholar 

  4. 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) 12, 726–731 (1987)

    CAS  Google Scholar 

  5. Dvorak, J., Panjabi, M.M.: Functional anatomy of the alar ligaments. Spine (Phila Pa 1976) 12, 183–189 (1987)

    CAS  Google Scholar 

  6. Dvorak, J., Panjabi, M., Gerber, M., et al.: CT-functional diagnostics of the rotatory instability of upper cervical spine. 1. An experimental study on cadavers. Spine (Phila Pa 1976) 12, 197–205 (1987)

    CAS  Google Scholar 

  7. Dvorak, J., Panjabi, M.M., Novotny, J.E., et al.: In vivo flexion/extension of the cervical spine. J Orthop Res 9, 824–834 (1991)

    Article  Google Scholar 

  8. Dvorak, J., Schneider, E., Saldinger, P., et al.: Biomechanics of the craniocervical region: the alar and transverse ligaments. J Orthop Res 6, 452–461 (1988)

    Article  CAS  PubMed  Google Scholar 

  9. Fielding, J.W., Cochran, G.B., Lawsing 3rd, J.F., et al.: Tears of the transverse ligament of the atlas. A clinical and biomechanical study. J Bone Joint Surg Am 56, 1683–1691 (1974)

    CAS  PubMed  Google Scholar 

  10. Goel, V.K., Clark, C.R., Gallaes, K., et al.: Moment-rotation relationships of the ligamentous occipito-atlanto-axial complex. J Biomech 21, 673–680 (1988)

    Article  CAS  PubMed  Google Scholar 

  11. Harris Jr., J.H., Carson, G.C., Wagner, L.K.: Radiologic diagnosis of traumatic occipitovertebral dissociation: 1. Normal occipitovertebral relationships on lateral radiographs of supine subjects. AJR Am J Roentgenol 162, 881–886 (1994)

    PubMed  Google Scholar 

  12. Harris Jr., J.H., Carson, G.C., Wagner, L.K., et al.: Radiologic diagnosis of traumatic occipitovertebral dissociation: 2. Comparison of three methods of detecting occipitovertebral relationships on lateral radiographs of supine subjects. AJR Am J Roentgenol 162, 887–892 (1994)

    PubMed  Google Scholar 

  13. Hecker, P.: Appareil ligamenteux occipito-atloidoaxoidien: étude d’anatomie comparée. Arch Anat Hist Embryol 2, 57–95 (1923)

    Google Scholar 

  14. Jeszenszky, D., Fekete, T.F., Melcher, R., et al.: C2 prosthesis: anterior upper cervical fixation device to reconstruct the second cervical vertebra. Eur Spine J 16, 1695–1700 (2007)

    Article  PubMed  Google Scholar 

  15. Lang, J.: The cranio-cervical junction – Anatomy. In: Voth, D., Glees, P. (eds.) Diseases in the cranio-cervical junction. Anatomical and pathological aspects and detailed clinical accounts, pp. 27–61. Gruyter, Berlin, New York (1987)

    Google Scholar 

  16. Lin, R.M., Tsai, K.H., Chu, L.P., et al.: Characteristics of sagittal vertebral alignment in flexion determined by dynamic radiographs of the cervical spine. Spine (Phila Pa 1976) 26, 256–261 (2001)

    CAS  Google Scholar 

  17. Monckeberg, J.E., Tome, C.V., Matias, A., et al.: CT scan study of atlantoaxial rotatory mobility in asymptomatic adult subjects: a basis for better understanding C1-C2 rotatory fixation and subluxation. Spine (Phila Pa 1976) 34, 1292–1295 (2009)

    Google Scholar 

  18. Oda, T., Panjabi, M.M., Crisco 3rd, J.J., et al.: Role of tectorial membrane in the stability of the upper cervical spine. Clin Biomech 7, 201–207 (1992)

    Article  Google Scholar 

  19. Pang, D., Nemzek, W.R., Zovickian, J.: Atlanto-occipital dislocation: part 1 – normal occipital condyle-C1 interval in 89 children. Neurosurgery 61, 514–521 (2007). discussion 521

    Article  PubMed  Google Scholar 

  20. Pang, D., Nemzek, W.R., Zovickian, J.: Atlanto-occipital dislocation – part 2: The clinical use of (occipital) condyle-C1 interval, comparison with other diagnostic methods, and the manifestation, management, and outcome of atlanto-occipital dislocation in children. Neurosurgery 61, 995–1015 (2007). discussion 1015

    Article  PubMed  Google Scholar 

  21. Panjabi, M.M., Duranceau, J., Goel, V., et al.: Cervical human vertebrae. Quantitative three-dimensional anatomy of the middle and lower regions. Spine (Phila Pa 1976) 16, 861–869 (1991)

    CAS  Google Scholar 

  22. Panjabi, M., Dvorak, J., Crisco 3rd, J.J., et al.: Effects of alar ligament transection on upper cervical spine rotation. J Orthop Res 9, 584–593 (1991)

    Article  CAS  PubMed  Google Scholar 

  23. Panjabi, M., Dvorak, J., Duranceau, J., et al.: Three-dimensional movements of the upper cervical spine. Spine (Phila Pa 1976) 13, 726–730 (1988)

    CAS  Google Scholar 

  24. Panjabi, M.M., Yue, J.J., Dvorak, J., et al.: Cervical spine kinematics and clinical instability. In: Clark, C.R., Benzel, E.C., Currier, B.L., et al. (eds.) The cervical spine, vol. 4, pp. 55–78. Lippincott, Philadelphia (2005)

    Google Scholar 

  25. Pearcy, M.J., Whittle, M.W.: Movements of the lumbar spine measured by three-dimensional X-ray analysis. J Biomed Eng 4, 107–112 (1982)

    Article  CAS  PubMed  Google Scholar 

  26. Penning, L.: Normal movements of the cervical spine. AJR Am J Roentgenol 130, 317–326 (1978)

    CAS  PubMed  Google Scholar 

  27. Penning, L., Wilmink, J.T.: Rotation of the cervical spine. A CT study in normal subjects. Spine (Phila Pa 1976) 12, 732–738 (1987)

    CAS  Google Scholar 

  28. Powers, B., Miller, M.D., Kramer, R.S., et al.: Traumatic anterior atlanto-occipital dislocation. Neurosurgery 4, 12–17 (1979)

    Article  CAS  PubMed  Google Scholar 

  29. Spence Jr., K.F., Decker, S., Sell, K.W.: Bursting atlantal fracture associated with rupture of the transverse ligament. J Bone Joint Surg Am 52, 543–549 (1970)

    PubMed  Google Scholar 

  30. Steinmetz, M.P., Mroz, T.E., Benzel, E.C.: Craniovertebral junction: biomechanical considerations. Neurosurgery 66, A7–A12 (2010)

    Article  Google Scholar 

  31. Tubbs, R.S., Kelly, D.R., Humphrey, E.R., et al.: The tectorial membrane: anatomical, biomechanical, and histological analysis. Clin Anat 20, 382–386 (2007)

    Article  PubMed  Google Scholar 

  32. Vishteh, A.G., Crawford, N.R., Melton, M.S., et al.: Stability of the craniovertebral junction after unilateral occipital condyle resection: a biomechanical study. J Neurosurg 90, 91–98 (1999)

    CAS  PubMed  Google Scholar 

  33. Werne, S.: Studies in spontaneous atlas dislocation. Acta Orthop Scand Suppl 23, 1–150 (1957)

    CAS  PubMed  Google Scholar 

  34. White, A.P.M.: Kinematics of the spine. Lippincott, Philadelphia (1990)

    Google Scholar 

  35. White, A.A., Panjabi, M.M.: Clinical biomechanics of the spine. Lippincott, Philadelphia (1990)

    Google Scholar 

  36. Wiesel, S., Kraus, D., Rothman, R.H.: Atlanto-occipital hypermobility. Orthop Clin North Am 9, 969–972 (1978)

    CAS  PubMed  Google Scholar 

  37. Wiesel, S.W., Rothman, R.H.: Occipitoatlantal hypermobility. Spine (Phila Pa 1976) 4, 187–191 (1979)

    CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Neurosurgery, Neurocenter, Regional Hospital Liberec, Husova St. 10, 46063, Liberec, Czech Republic

    P. Suchomel & P. Buchvald

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  1. P. Suchomel
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  2. P. Buchvald
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© 2011 Springer Berlin Heidelberg

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Suchomel, P., Buchvald, P. (2011). Biomechanical Remarks. In: Reconstruction of Upper Cervical Spine and Craniovertebral Junction. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-13158-5_2

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  • DOI: https://doi.org/10.1007/978-3-642-13158-5_2

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-13157-8

  • Online ISBN: 978-3-642-13158-5

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