Cervical flexion and extension includes anti-directional cervical joint motion in healthy adults

Publication date: Available online 20 July 2017
Source:The Spine Journal
Author(s): Xu Wang, René Lindstroem, Maciej Plocharski, Lasse Riis Østergaaard, Thomas Graven-Nielsen
Background contextAnti-directional cervical joint motion has previously been demonstrated. However, quantitative studies of anti-directional and pro-directional cervical flexion and extension motions have not been published.PurposeQuantitative assessment of directional and anti-directional cervical joint motion in healthy subjects.Study designObservational study.Patients sampleEighteen healthy subjects.Outcome measuresAnti-directional and pro-directional cervical flexion and extension motion from each cervical joint in degrees.MethodsFluoroscopy videos of cervical flexion and extension motions (from neutral to end-range) were acquired from 18 healthy subjects. The videos were divided into 10% epochs of C0/C7 range of motion (ROM). The pro-directional and anti-directional motions in each 10% epoch were extracted, and the ratios of anti-directional motions with respect to the pro-directional motions (0% = no anti-directional movement) were calculated for joints and 10% epochs. This study was funded by University $ 2,000.ResultsThe flexion and extension ROM for C0/C7 were 51.9±9.3° and 57.2±12.2°. The anti-directional motions of flexion and extension ROM constituted 42.8±9.7% and 41.2±8.2% of the respective pro-directional movements. For flexion, the first three joints (C0/C1, C1/C2, C2/C3) demonstrated larger ratios compared to the last three joints (C4/C5, C5/C6, C6/C7) (P<0.03). For extension, C1/C2 and C2/C3 ratios were larger compared to C0/C1, C4/C5, and C5/C6 (P<0.03). Comparisons between flexion and extension motions showed larger C0/C1 ratio but smaller C5/C6 and C6/C7 ratios in extension (P<0.05).ConclusionsThis is the first report of quantified anti-directional cervical flexion and extension motion. The anti-directional motion is approximately 40% of the pro-directional motion. The results document that large proportions of anti-directional cervical flexion and extension motions were normal.



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