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Biomechanics of the Cervical Spine

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Handbook of Orthopaedic Trauma Implantology

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Abstract

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. Any disturbance of anatomy and mechanical properties can lead to clinical symptoms.

Due 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 upper complex is further subdivided into two motion segments (C0-1 and C1-2). The movements of individual vertebrae are coupled with the others. By summing up the contributions of each motion segment we can account for total range of motion of cervical spine.

A 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. This means that the erect position of the head is held by the muscular force from behind. 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.

Clinical cervical instability is the loss of ability to maintain normal relationship between vertebrae under physiological loads. Abnormal loads can produce varying degrees of derangement leading to pain and deformity. Neck pain is a common musculoskeletal problem experienced by many in the community. Alterations of cervical spine mechanics that compromise the stabilizing mechanisms of the cervical spine due to injury or degenerative conditions can cause pain. 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. Functional radiography is the clinical standard to detect segmental instability.

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. The primary goal of surgery is to improve neck pain, maintain stability, and preserve range of motion.

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Authors and Affiliations

  1. Jagannath Gupta Institute of Medical Sciences (JIMSH), Kolkata, West Bengal, India

    Ujjwal K. Debnath

  2. AMRI Hospital, Kolkata, West Bengal, India

    Ujjwal K. Debnath

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  1. Ujjwal K. Debnath
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Editors and Affiliations

  1. NH Narayana Superspeciality and Multispeciality Hospitals, Howrah, West Bengal, India

    Arindam Banerjee

  2. Technical University of Munich, Munich, Germany

    Peter Biberthaler

  3. Sri Lakshmi Narayana Institute of Medical Sciences, Puducherry, India

    Saseendar Shanmugasundaram

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  1. AMRI Hospital, Kolkata, India

    Chinmay Nath

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Debnath, U.K. (2023). Biomechanics of the Cervical Spine. In: Banerjee, A., Biberthaler, P., Shanmugasundaram, S. (eds) Handbook of Orthopaedic Trauma Implantology. Springer, Singapore. https://doi.org/10.1007/978-981-19-7540-0_113

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