Technical Brief

Ranges of Cervical Intervertebral Disc Deformation During an In Vivo Dynamic Flexion–Extension of the Neck

[+] Author and Article Information
Yan Yu

Department of Spine Surgery,
Tongji Hospital,
Tongji University School of Medicine,
Shanghai 2000065, China;
Department of Orthopedic Surgery,
Massachusetts General Hospital,
Harvard Medical School,
Boston, MA 02114

Haiqing Mao

Department of Orthopedic Surgery,
The First Affiliated Hospital of Soochow University,
Suzhou 215006, Jiangsu, China

Jing-Sheng Li

College of Health and Rehabilitation Sciences,
Sargent College,
Boston University,
Boston, MA 02215

Tsung-Yuan Tsai

School of Biomedical Engineering,
Shanghai Jiao Tong University,
Shanghai 200030, China

Liming Cheng

Department of Spine Surgery,
Tongji Hospital,
Tongji University School of Medicine,
Shanghai 200065, China

Kirkham B. Wood

Department of Orthopaedic Surgery,
Stanford University Medical Center,
Redwood City, CA 94063

Guoan Li

Department of Orthopedic Surgery,
Massachusetts General Hospital,
Harvard Medical School,
55 Fruit Street, GRJ 1215,
Boston, MA 02114
e-mail: guoanli12@gmail.com

Thomas D. Cha

Department of Orthopedic Surgery,
Massachusetts General Hospital,
Harvard Medical School,
Boston, MA 02114

1Corresponding author.

Manuscript received May 10, 2016; final manuscript received February 28, 2017; published online April 17, 2017. Assoc. Editor: Brian D. Stemper.

J Biomech Eng 139(6), 064501 (Apr 17, 2017) (7 pages) Paper No: BIO-16-1193; doi: 10.1115/1.4036311 History: Received May 10, 2016; Revised February 28, 2017

While abnormal loading is widely believed to cause cervical spine disc diseases, in vivo cervical disc deformation during dynamic neck motion has not been well delineated. This study investigated the range of cervical disc deformation during an in vivo functional flexion–extension of the neck. Ten asymptomatic human subjects were tested using a combined dual fluoroscopic imaging system (DFIS) and magnetic resonance imaging (MRI)-based three-dimensional (3D) modeling technique. Overall disc deformation was determined using the changes of the space geometry between upper and lower endplates of each intervertebral segment (C3/4, C4/5, C5/6, and C6/7). Five points (anterior, center, posterior, left, and right) of each disc were analyzed to examine the disc deformation distributions. The data indicated that between the functional maximum flexion and extension of the neck, the anterior points of the discs experienced large changes of distraction/compression deformation and shear deformation. The higher level discs experienced higher ranges of disc deformation. No significant difference was found in deformation ranges at posterior points of all the discs. The data indicated that the range of disc deformation is disc level dependent and the anterior region experienced larger changes of deformation than the center and posterior regions, except for the C6/7 disc. The data obtained from this study could serve as baseline knowledge for the understanding of the cervical spine disc biomechanics and for investigation of the biomechanical etiology of disc diseases. These data could also provide insights for development of motion preservation surgeries for cervical spine.

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Grahic Jump Location
Fig. 1

The disc coordinate system and the locations on the disc surface: A—anterior, C—center, P—posterior, L—left, and R—right points

Grahic Jump Location
Fig. 2

The virtual DIFS for reproduction of the in vivo cervical vertebrae positions

Grahic Jump Location
Fig. 3

Distraction/compression (color) and shear (arrows) deformation are normalized to disc height (expressed by percentage of the disc height) of the C3/4 disc in a typical subject at the maximum flexion and extension neck positions. In the color code, 50% indicates a distraction that is 50% of the disc height and −50% indicates a compression that is 50% of the disc height. The arrows indicate the shear deformation direction and their magnitudes are represented by the arrow length. Scale bar (=1 mm) represents a shear deformation of 40% of the disc height. (Color figure can be viewed online)

Grahic Jump Location
Fig. 4

Validation of the DFIS system in reproducing the in vivo vertebral positions. The RSA method using metal beads was used as the reference.



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