Biomechanics of spinal trauma
Youlian Hong, Roger Bartlett in Routledge Handbook of Biomechanics and Human Movement Science, 2008
Physiologic activities induce mechanical loading on the spine, resulting in internal deformations. Due to the segmented nature, the biomechanical behavior of the vertebral column is governed by the segmental response. Translations and rotations form the primary response components, and under physiologic loads, soft and hard tissues respond differently. Ligaments are tension-only elements and pre-stressed in vivo. The pre-stress induces nominal resting stiffness to the spine. In contrast, intervertebral discs provide compressive resistance, are responsible for supporting the body weight, and offer resistance in other loading modes. The cervical spine supports the weight of the head and neck, thoracic spine supports the weight of the head, neck, and thorax, and lumbar spine supports the weight of the head, neck, thorax, and abdomen. Facet joints have high compressive stiffness and very low shear stiffness. This permits opposing articular surfaces to slide, resisted primarily by joint capsule tension.
Clearance of the cervical spine in children
David E. Wesson, Bindi Naik-Mathuria in Pediatric Trauma, 2017
Most recently, the PECARN network conducted a 17-center case-control study in which pediatric blunt trauma victims sustaining cervical spine injury were compared to three separate sets of case-matched controls. Five hundred and forty cases of cervical spine injury were identified. After analysis, eight factors were identified which were associated with cervical spine injury: altered mental status, focal neurologic findings, neck pain, torticollis, substantial torso injury, conditions predisposing to cervical spine injury (e.g., various connective tissue disorders, previous cervical spine surgery, etc.), diving, and MVC. The presence of one of these eight risk factors was 98% sensitive for detection of cervical spine injury in this patient population, and in the patients with cervical spine injury who did not have any of the eight risk factors, normal neurologic outcomes were reported [15].
Surgical Emergencies
Anthony FT Brown, Michael D Cadogan in Emergency Medicine, 2020
Remember Look for the cause of any preceding fall in the elderly, such as postural hypotension, Stokes–Adams attack or other syncopal episode these require diagnosis and management in their own right, in addition to the resultant head injury.A head injury in a child may be due to non-accidental injury (see p. 319).Cervical spine injuries are associated with head injuries and appropriate examination and investigation is performed based on clinical grounds.
A multi-body model for comparative study of cervical traction simulation – development, improvement and validation
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2019
Lawrence K. F. Wong, Zhiwei Luo, Nobuyuki Kurusu, Keiji Fujino
The structure of the cervical spine model is illustrated in Figure 2. Eight rigid bodies are used to represent the head and the seven pieces of the cervical vertebrae (C1-C7). Each intervertebral joint is modelled as non-linear viscoelastic material in flexion and extension. It is built as a “free joint” element in the simulation. The “free joint” element allows stiffness and damping properties to be assigned to the joint with required number of degrees of freedom of motion. Since traction force is applied symmetrically during cervical traction, lateral shear (i.e. translation along x-axis) is not modelled in the simulation. Also, since the inclined and sitting positions do not cause axial rotation and lateral bending to the cervical spine, these two rotation directions are not modelled. In other words, only anterior/posterior shear, tension/compression and flexion/extension are modelled in the simulation. For the ligaments, a spring element at the spinous process is used to represent the combined behavior of all four posterior ligaments at each cervical level. Since we assume that the subject is in a relaxed state during cervical traction and muscle activation is minimal, thus muscle components are not included in the model. A detailed overview of the joints in the cervical spine is shown in Figure 3.
Reliability and discriminative validity of a screening tool for the assessment of neuromuscular control and movement control in patients with neck pain and healthy individuals
Published in Disability and Rehabilitation, 2022
Robby De Pauw, Eveline Van Looveren, Dorine Lenoir, Lieven Danneels, Barbara Cagnie
The procedure to assess neuromuscular control and movement pattern for the adapted CCFT consists of three subparts. During the craniocervical test protocol, the participant is positioned supine with both arms in a resting position on the abdomen and knees in flexion with both feet flat on the table. The cervical spine is positioned in a neutral position (as depicted in Figure 2(B)). Patients then are asked to perform an active craniocervical flexion movement by head-nodding. The aim of the first subpart is to reach five progressive stages (20–30 mmHg), measured by a suboccipital pressure biofeedback unit, without substitution of superficial muscles (SCM and Scaleni) or (increased) sensation of pain as described by Jull and colleagues [22]. In-between progressive phases, a rest interval of 15 s, are implemented to minimize the effect of fatigue. The second part of the tool evaluates the breathing pattern, fluency of movement and substitution of the superficial muscles during five repetitions of craniocervical flexion from 20 mmHg to a normative score of 26 mmHg [34–37]. The third and final part concerning endurance is only assessed if the first and second part is completed without any noticeable substitution. Patients were asked to maintain a gradually build craniocervical flexion at a normative score of 26 mmHg for ten seconds, aiming at a maximum of ten repetitions.
Short-term effects of spinal thrust joint manipulation on postural sway in patients with chronic mechanical neck pain: a randomized controlled trial
Published in Disability and Rehabilitation, 2022
Raúl Romero del Rey, Manuel Saavedra Hernández, Cleofás Rodríguez Blanco, Luis Palomeque del Cerro, Raquel Alarcón Rodríguez
In this respect, the cervical spine is of great importance [12]. Firstly, this is because the cervical musculature is a major source of proprioceptive information, especially the suboccipital muscles, which contain a large number of mechanoreceptors [13]. In addition, these muscles also have relationships with the central nervous system, vestibular system and visual system [10], which explains why a proprioceptive information disorder in the cervical spine may affect sensory integration [13]. On the other hand, pain may be the cause of an increase in presynaptic inhibition of muscular input and may affect the central sensory modulation of proprioceptive information that comes from neuromuscular spindles [14]. As a result, this may cause a decrease in motor control, and subsequently, a decrease in postural stability.
Related Knowledge Centers
- Cervical Rib
- Lumbar Vertebrae
- Skull
- Thoracic Vertebrae
- Vertebra
- Vertebral Vein
- Vertebral Artery
- Neck
- Inferior Cervical Ganglion
- Vertebral Foramen