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Tidsskrift For Den Norske Laegeforening... Jan 2010Knowledge of biomechanics and the cervical spine's anatomy has become more topical as the incidence of whiplash neck disorders has increased. Unfortunately, injuries... (Review)
Review
BACKGROUND
Knowledge of biomechanics and the cervical spine's anatomy has become more topical as the incidence of whiplash neck disorders has increased. Unfortunately, injuries after traffic accidents are often brought to court, where the medical expert's knowledge is of utmost importance to ensure a correct medical evaluation.
MATERIAL AND METHODS
The article is based on information identified through non-systematic searches of PubMed and on the author's experience as a professor of anatomy.
RESULTS
The cervical spine is particularly vulnerable to forces perpendicular to the length axis. Stability depends largely on the soft tissue. Injuries of soft tissue (especially in ligaments and intervertebral discs) may lead to instability and periosteal reaction with subsequent new formation of bone.
INTERPRETATION
The cervical spine is a relatively weak and vulnerable part of the body. One should consider locally restricted new formations of tissue with corresponding height reduction of the intervertebral disc as a sign of genuine injury.
Topics: Adult; Animals; Biological Evolution; Biomechanical Phenomena; Cervical Vertebrae; Child; Humans; Intervertebral Disc; Ligaments; Odontoid Process; Spinal Injuries
PubMed: 20094120
DOI: 10.4045/tidsskr.09.0296 -
The Angle Orthodontist Mar 2018The cervical vertebral maturation (CVM) method is used to determine the craniofacial skeletal maturational stage of an individual at a specific time point during the...
The cervical vertebral maturation (CVM) method is used to determine the craniofacial skeletal maturational stage of an individual at a specific time point during the growth process. This diagnostic approach uses data derived from the second (C2), third (C3), and fourth (C4) cervical vertebrae, as visualized in a two-dimensional lateral cephalogram. Six maturational stages of those three cervical vertebrae can be determined, based on the morphology of their bodies. The first step is to evaluate the inferior border of these vertebral bodies, determining whether they are flat or concave (ie, presence of a visible notch). The second step in the analysis is to evaluate the shape of C3 and C4. These vertebral bodies change in shape in a typical sequence, progressing from trapezoidal to rectangular horizontal, to square, and to rectangular vertical. Typically, cervical stages (CSs) 1 and CS 2 are considered prepubertal, CS 3 and CS 4 circumpubertal, and CS 5 and CS 6 postpubertal. Criticism has been rendered as to the reproducibility of the CVM method. Diminished reliability may be observed at least in part due to the lack of a definitive description of the staging procedure in the literature. Based on the now nearly 20 years of experience in staging cervical vertebrae, this article was prepared as a "user's guide" that describes the CVM stages in detail in attempt to help the reader use this approach in everyday clinical practice.
Topics: Age Determination by Skeleton; Cervical Vertebrae; Female; Humans; Male; Radiography
PubMed: 29337631
DOI: 10.2319/111517-787.1 -
The Angle Orthodontist Aug 2002The present study aimed to provide a version of the Cervical Vertebral Maturation (CVM) method for the detection of the peak in mandibular growth based on the analysis...
The present study aimed to provide a version of the Cervical Vertebral Maturation (CVM) method for the detection of the peak in mandibular growth based on the analysis of the second through fourth cervical vertebrae in a single cephalogram. The morphology of the bodies of the second (odontoid process, C2), third (C3), and fourth (C4) cervical vertebrae were analyzed in six consecutive cephalometric observations (T1 through T6) of 30 orthodontically untreated subjects. Observations for each subject consisted of two consecutive cephalograms comprising the interval of maximum mandibular growth (as assessed by means of the maximum increment in total mandibular length, Co-Gn), together with two earlier consecutive cephalograms and two later consecutive cephalograms. The analysis consisted of both visual and cephalometric appraisals of morphological characteristics of the three cervical vertebrae. The construction of the new version of the CVM method was based on the results of both ANOVA for repeated measures with post-hoc Scheffé's test (P < .05) and discriminant analysis. The new CVM method presents with five maturational stages (Cervical Vertebral Maturation Stage [CVMS] I through CVMS V, instead of Cvs 1 through Cvs 6 in the former CVM method). The peak in mandibular growth occurs between CVMS II and CVMS III, and it has not been reached without the attainment of both CVMS I and CVMS II. CVMS V is recorded at least two years after the peak. The advantages of the new version of the CVM method are that mandibular skeletal maturity can be appraised on a single cephalogram and through the analysis of only the second, third, and fourth cervical vertebrae, which usually are visible even when a protective radiation collar is worn.
Topics: Adolescent; Age Determination by Skeleton; Analysis of Variance; Axis, Cervical Vertebra; Cephalometry; Cervical Vertebrae; Chi-Square Distribution; Child; Discriminant Analysis; Female; Follow-Up Studies; Humans; Longitudinal Studies; Male; Mandible; Multivariate Analysis; Odontoid Process; Statistics as Topic
PubMed: 12169031
DOI: 10.1043/0003-3219(2002)072<0316:AIVOTC>2.0.CO;2 -
Orthopaedics & Traumatology, Surgery &... Feb 2023Malformations of the cervical spine are a challenge in pediatric orthopedic surgery since the treatment options are limited. These congenital anomalies are often... (Review)
Review
Malformations of the cervical spine are a challenge in pediatric orthopedic surgery since the treatment options are limited. These congenital anomalies are often syndrome-related and have multiple repercussions on the function and statics of the cervical spine in all three planes. They are related to developmental abnormalities during the somite segmentation that occurs during the third week of embryonic development. Successful somitogenesis requires proper functioning of a clock regulated by complex signaling pathways that guide the steps needed to form the future spine. There is no specific classification for vertebral malformations at the cervical level. To characterize the progressive nature of a malformation, one must use general classifications. In the specific case of Klippel-Feil syndrome, these malformations can affect several vertebral levels in a continuous or discontinuous manner, but also the vertebral body and vertebral arch in a variable way. Thus, establishing a reliable prognosis in the coronal and sagittal planes is a complex undertaking. While technical mastery of certain osteotomy procedures has led to advances in the surgical treatment of rigid deformities of the cervical spine, the indications are still very rare. Nevertheless, the procedure has become safer and more accurate because of technical aids such as surgical navigation, robotics and 3D printed models or patient-specific guides. Occipitocervical transitional anomalies have embryological specificities that can explain the bony malformations seen at this level. However, most are rare, and the main concern is identifying any instability that justifies surgical stabilization. The presence of a cervical spine anomaly should trigger the search for occipitocervical instability and vice-versa.
Topics: Child; Humans; Klippel-Feil Syndrome; Cervical Vertebrae; Spinal Diseases
PubMed: 36302448
DOI: 10.1016/j.otsr.2022.103459 -
Neurology India 2022
Topics: Cervical Vertebrae; Humans; Neck; Spinal Diseases
PubMed: 36076699
DOI: 10.4103/0028-3886.355111 -
Acta Odontologica Latinoamericana : AOL Dec 2018In maxillary orthopedics and related areas, it is essential to determine patient growth peak in order to provide timely diagnosis and treatments. This requires the use...
In maxillary orthopedics and related areas, it is essential to determine patient growth peak in order to provide timely diagnosis and treatments. This requires the use of biological indicators that enable children and adolescents to be assigned to maturation stages. The aim of this study was to determine the correlation between cervical vertebrae maturation stages and chronological age in children and adolescents. In this study were evaluated 93 lateral cranium radiographs of 6- to 17-year-old patients who visited the Postgraduate Maxillary Orthopedics Clinic at the School of Dentistry at Universidad del Zulia. Two examiners made independent assessments of cervical vertebrae maturation stage using the method described by Baccetti et al. For each stage, descriptive statistics for chronological age were evaluated, classified according to sex. In addition, parametric and non-parametric tests were performed in which p <0.05 was considered significant. Mean age of the children and adolescents studied was 9.6 years, with standard deviation 2.5 years. The correlation coefficient (r= 0.771) certified a high positive correlation between bone maturation and chronological age. This correlation coefficient was highly positive for girls (r=0.858) and moderately positive for boys (r=0.688). The model obtained explains 59.4 % of the variation between bone maturation and chronological age, evidencing an average age increase of three years when maturation stage increases by approximately 1 year. The results suggest that although the degree of covariance between chronological age and maturation stages was highly positive in this study, chronological age does not allow bone maturation to be determined precisely, since it may be influenced by genetic and/or environmental factors.
Topics: Adolescent; Age Determination by Skeleton; Bone Development; Cervical Vertebrae; Child; Humans; Linear Models; Radiography; Reference Values; Sex Factors
PubMed: 30829366
DOI: No ID Found -
Veterinary Medicine and Science Jul 2022Elephants are currently the largest mammals on earth. A comprehensive examination of the anatomy of this animal to diagnose various disorders is required. In addition,...
BACKGROUND
Elephants are currently the largest mammals on earth. A comprehensive examination of the anatomy of this animal to diagnose various disorders is required. In addition, due to the heavy head of these animals, adaptations have been made in the anatomical structure of the neck that is worth studying.
OBJECTIVE
This study aimed to investigate a standard morphologic and morphometric description of the elephant cervical spine. Another aim of this study was to compare the changes in the cervical skeleton of elephants with horses and cattle.
METHODS
For this study, the cervical vertebrae of the Asian elephant, cattle and horse were examined. CT Images were obtained using Somatom Spirit II CT Machine. Statistical analysis was done by SPSS 24 software.
RESULTS
Two dorsal tubercles and a groove between them were observed on the dorsal arch of the atlas vertebra of the Asian elephant. In elephant samples, the variation of vertebral body height, spinous process height, transverse process width, vertebral body length and vertebral foramen volume indices were statistically significant. The volume of the vertebral foramen in the elephant decreases in the second vertebra compared to the first vertebra, decreases in the third vertebra, decreases in the fourth, increases in the fifth, decreases in the sixth and increases in the seventh.
CONCLUSIONS
In this study, the structure of the cervical vertebrae of the Asian elephant was examined, and certain features were observed. One of the main features was the reduction of the length of the vertebrae, which leads to the decrease of the ratio of neck length to the size of the body. This condition can be due to the high weight of the head in the elephant. To maintain this weight, it is necessary to reduce the length of the neck and confer less mobility.
Topics: Animals; Cervical Vertebrae; Elephants; Tomography, X-Ray Computed
PubMed: 35636427
DOI: 10.1002/vms3.837 -
Medicine May 2020Intramedullary cervical spinal cord teratomas (ICTs) are extremely rare, and diagnosis and treatment are challenging. We conducted a systematic review of the literature...
BACKGROUND
Intramedullary cervical spinal cord teratomas (ICTs) are extremely rare, and diagnosis and treatment are challenging. We conducted a systematic review of the literature on the diagnosis and treatment of ICT.
METHOD
The presentation, imaging manifestations, diagnosis, management, surgery findings, prognosis and histology were reviewed following Preferred Reporting Items for Systematic Reviews and Meta Analyses guidelines. English-language studies and case reports published from inception to 2018 were retrieved. Data on presentation, imaging characteristics, diagnosis, management, surgery findings, outcomes, and histopathology were extracted.
RESULTS
Ten articles involving 10 patients were selected. The lesions were located in the upper cervical vertebrae in 4 cases, whereas in the lower cervical vertebrae in the remaining 6 cases. In 5 cases, the lesions were located on the dorsal side of the spinal cord, and in the center of the spinal cord in the remaining 5 cases. Quadriparesis (60%), paraplegia (30%), monoplegia (10%), and neck pain (50%) were the main presentations. The lesion appeared as a intramedullary heterogeneous signal during an MRI scan, and the lesion signal would be partially enhanced after the contrast medium was applied. All patients underwent surgical intervention through a posterior approach. Neurological function improved postoperatively in all patients. Two patients with pathology confirmed to be immature teratomas experienced recurrence.
CONCLUSION
ICTs are extremely rare entities that are mainly located in the center or dorsal part of the spinal cord which mainly manifest as quadriplegia and neck pain. MRI is a useful modality that provides diagnostic clues. Surgery from a posterior approach is the primary treatment, and the effect of adjuvant therapy remains uncertain. The prognosis is mainly related to the pathological nature of the tumor and not the method of resection.
Topics: Cervical Vertebrae; Humans; Spinal Cord Neoplasms; Teratoma
PubMed: 32358400
DOI: 10.1097/MD.0000000000020107 -
Orthopaedic Surgery Apr 2019Comprehending cervical spinal motion underlies the understanding of the mechanisms of cervical disorders. We aimed to better define the clinical relevance of cervical... (Review)
Review
Comprehending cervical spinal motion underlies the understanding of the mechanisms of cervical disorders. We aimed to better define the clinical relevance of cervical spine kinematics, focusing on quality parameters describing cervical spine planar motion. The most common study focuses were kinematic quality parameters after cervical arthroplasty and in normal subjects, patients with cervical degeneration, and patients with cervical deformities. Kinematic quality parameters are important for cervical degeneration prevention, being detected sooner than differences on imaging examinations and being significantly related to the degree of cervical degeneration. Kinematic quality parameters are effective for evaluating the changes of cervical motion pattern after cervical fusion and non-fusion, assessing operative and adjacent segments in the early stages, and predicting adjacent segment degeneration. However, owing to current research limitations, and controversy about the changes of kinematic quality parameters after different surgical procedures, current assessments are limited to cervical spine flexion and extension. Different osteotomy methods of cervical deformity have different effects on cervical motion patterns and quality parameters. Choosing the most effective surgical method remains a challenge and kinematic quality parameters in cervical deformity are important future research topics. This review highlights the instantaneous center of rotation, the center of rotation, and the instantaneous axis of rotation as being important kinematic quality parameters of cervical spinal motion. These can be used to detect abnormal cervical mobility, to diagnose cervical degeneration, to design disc protheses, and to evaluate surgical effects earlier than other methods. Owing to limitations of research methods there is variation in the way parameters are defined by various researchers. No uniform standard exists for defining degenerative motion quality parameters in normal asymptomatic, degenerative, and postoperative patients. Therefore, further study is required. New study techniques and defining kinematic quality parameters in normal subjects will clarify the definitions of these parameters, enhancing their future clinical usefulness.
Topics: Biomechanical Phenomena; Cervical Vertebrae; Humans; Movement; Spinal Diseases
PubMed: 30884156
DOI: 10.1111/os.12435 -
The Journal of International Medical... Aug 2016To analyze the incidence and age and gender profiles of hyperplasia in individual cervical vertebrae.
OBJECTIVE
To analyze the incidence and age and gender profiles of hyperplasia in individual cervical vertebrae.
METHODS
In this retrospective study, computed tomography three-dimensional reconstruction images of cervical vertebrae from patients with neck discomfort were analyzed for the presence of hyperplasia and compared with age and gender data.
RESULTS
Scans from a total of 580 patients (352 males, 228 females) were analyzed. The highest incidence of hyperplasia was seen in C2 (25%), followed by C1 (23%), C6 (16%), C5 (15%), C7 (9%), C4 (8%) and C3 (4%). Patients with C2 hyperplasia were the youngest and those with C1 hyperplasia were the second youngest, while patients with C7 hyperplasia were the oldest. Of those with C2, C1 and C7 hyperplasia, males were significantly younger than females, whereas of those with C3, C4, C5 and C6 hyperplasia, females were significantly younger than males.
CONCLUSIONS
Hyperplasia of the cervical spine shows different age and gender profiles among the seven vertebrae. These findings may be helpful for the early recognition of cervical hyperplasia and highlight the importance of protecting the atlanto-axial joint in daily life.
Topics: Adolescent; Adult; Aged; Cervical Vertebrae; Female; Humans; Hyperplasia; Incidence; Male; Middle Aged; Sex Characteristics; Tomography, X-Ray Computed; Young Adult
PubMed: 27235407
DOI: 10.1177/0300060516645038