Summary
35 healthy adults and 137 patients after cervical spine injury were examined by functional CT. The range of axial rotation at the level occiput/atlas, atlas/axis and the segment below were measured in all subjects. A rotation occiput/atlas of more than 7°, and C1/C2 more than 54° could indicate segmental hypermobility, a rotation at the segment C1/C2 less than 29° to hypomobility. According to the postulated normal values based upon a 98% confidence level, out of 137 patinets examined after cervical spine injury and with therapyresistant neck pain, 45 showed signs of segmental hypermobility of the upper cervical spine, 17 showed hyper- or hypomobility at different levels, 10 patients presented segmental hypomobility at C1/C2 level alone. In all patients, according to the clinical assessment, functional pathology was suspected in the upper cervical spine. Surgical correction of rotatory instability should be considered as a possible therapeutic procedure after successful diagnostic stabilisation of the cervical spine by minerva cast.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
De Jong PTVM, Vianney JMB, Cochen B, Jongkees LBW (1977) Ataxia and nystagmus induced by injection of local anaesthetics in the neck. Ann Neurol 1:240
Dvorak J, Dvorak V (1987) Manuelle Medizin: Diagnostik. 3. Aufl. Thieme, Stuttgart
Dvorak J, Panjabi MM (1987) Functional anatomy of the alar ligaments. Spine 12:183–189
Dvorak J, Panjabi MM, Hayek J (1987) Diagnostik der Hyper- und Hypomobilität der oberen Halswirbelsäule mittels funktioneller Computertomographie. Orthopäde 16:13–19
Dvorak J, Panjabi MM, Gerber M, Wichman W (1987) CT-functional diagnostics of the rotatory instability of the upper cervical spine. Spine 12:197–205
Dvorak J, Schneider E, Saldinger PF, Rahn B (1988) Biomechanics of the cranio-cervical region: the alar and transverse ligaments. J Orthop Res (in press)
Dvorak J, Hayek J, Zehnder R (1988) CT-functional diagnostics of the rotatory instability of upper cervical spine. Part II: an evaluation on healthy adults with suspected instability. Spine (in press)
Dvorak J, Aebi M, Baumgartner H Panjabi MM (1988) Functional CT Scans for diagnostics of atlanto-axial rotatory fixation. Neuroorthopedics 1988 (in press)
Fielding JW, Cochron GVB, Lansing JF, Hohl M (1974) Tears of the transverse ligament of the atlas. J Bone Joint Surg [Am] 56:8–12
Fielding JW, Hawkins RJ (1977) Atlanto-axial rotatory fixation. J Bone Joint Surg [Am] 59:37–44
Fredrikson JM, Schwarz D, Kornhuber HH (1965) Convergence and interaction of vestibular and deep somatic afferents upon neurons in the vestibular nuclei of the cat. Acta Oto-Laryngol [Stockh] 61:168–188
Grob D, Magerl F (1987) Operative Stabilisierung bei Frakturen C1 und C2. Orthopäde 16:46–55
Ommaya AK (1985) The head: Kinematics and brain injury mechanisms. In: Aldman B, Chapon A (eds) The biomechanics of impact trauma. Elsevier, New York, pp 117–138
Penning L, Wilmink JT (1987) Rotation of the cervical spine. A CT-study in normals. Spine (in press)
Reich Ch, Dvorak J (1986) The functional evaluation of craniocervical ligaments in sidebending using x-rays. Manual Medicine 2:108–113
White AA, Panjabi MM (1978) Clinical biomechanics of the spine. Lippincott, Philadelphia
Wyke BD (1979) Neurology of the cervical spinal joints. Physiotherapy 65:72
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Dvorak, J., Penning, L., Hayek, J. et al. Functional diagnostics of the cervical spine using computer tomography. Neuroradiology 30, 132–137 (1988). https://doi.org/10.1007/BF00395614
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF00395614