Effects of occipital-atlas stabilization on the upper cervical spine rotation combinations: an in vitro study

• Published in: Scientific reports 2023-03, Vol.13 (1), p.3578-3578, Article 3578
• Main Authors: Hidalgo-García, César, Lorente, Ana I., López-de-Celis, Carlos, Lucha-López, María Orosia, Rodríguez-Sanz, Jacobo, Maza-Frechín, Mario, Tricás-Moreno, José Miguel, Krauss, John, Pérez-Bellmunt, Albert
• Format: Article
• Language: English
• Subjects: 692/698; 692/700; Ascomycota; Bone Screws; Cervical Vertebrae; Cryopreservation; Humanities and Social Sciences; multidisciplinary; Range of motion; Research Design; Science; Science (multidisciplinary); Spine; Spine (cervical)
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-023-30512-3

The purpose of this study is to compare axial rotation range of motion for the upper cervical spine during three movements: axial rotation, rotation + flexion + ipsilateral lateral bending and rotation + extension + contralateral lateral bending before and after occiput-atlas (C0–C1) stabilization. Ten cryopreserved C0–C2 specimens (mean age 74 years, range 63–85 years) were manually mobilized in 1. axial rotation, 2. rotation + flexion + ipsilateral lateral bending and 3. rotation + extension + contralateral lateral bending without and with a screw stabilization of C0–C1. Upper cervical range of motion and the force used to generate the motion were measured using an optical motion system and a load cell respectively. The range of motion (ROM) without C0–C1 stabilization was 9.8° ± 3.9° in right rotation + flexion + ipsilateral lateral bending and 15.5° ± 5.9° in left rotation + flexion + ipsilateral lateral bending. With stabilization, the ROM was 6.7° ± 4.3° and 13.6° ± 5.3°, respectively. The ROM without C0–C1 stabilization was 35.1° ± 6.0° in right rotation + extension + contralateral lateral bending and 29.0° ± 6.5° in left rotation + extension + contralateral lateral bending. With stabilization, the ROM was 25.7° ± 6.4° ( p  = 0.007) and 25.3° ± 7.1°, respectively. Neither rotation + flexion + ipsilateral lateral bending (left or right) or left rotation + extension + contralateral lateral bending reached statistical significance. 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° ( p  = 0.005) and 23.7° ± 8.5° ( p  = 0.013) respectively. The stabilization of C0–C1 reduced the upper cervical axial rotation in right rotation + extension + contralateral lateral bending and right and left axial rotations; however, this reduction was not present in left rotation + extension + contralateral lateral bending or both combinations of rotation + flexion + ipsilateral lateral bending.