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1
Przybyla, Andrzej Stefan. "Biomechanics of the cervical spine." Thesis, University of Bristol, 2005. http://hdl.handle.net/1983/845f95ee-39dd-4418-b6ed-200d749f87ae.
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Mameren, Hendrik van Lieshout F. van. "Motion patterns in the cervical spine." Maastricht : Maastricht : Rijksuniversiteit Limburg ; University Library, Maastricht University [Host], 1988. http://arno.unimaas.nl/show.cgi?fid=5445.
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Côrte, Ana Filipa Terleira Camacho da. "Cervical spine instability in rheumatoid arthritis." Dissertação, Faculdade de Medicina da Universidade do Porto, 2010. http://hdl.handle.net/10216/61051.
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Hueston, Susan. "Anthropometric Analysis of the Cervical Spine." Wright State University / OhioLINK, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=wright1315947078.
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Makola, Mbulelo T. "Cervical Spine Biomechanical Behavior and Injury." Wright State University / OhioLINK, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=wright1316534684.
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Côrte, Ana Filipa Terleira Camacho da. "Cervical spine instability in rheumatoid arthritis." Master's thesis, Faculdade de Medicina da Universidade do Porto, 2010. http://hdl.handle.net/10216/61051.
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MacLean, Håkan Angus. "Monitoring the Cervical Spine During Radiation Treatment." Thesis, KTH, Maskinkonstruktion (Inst.), 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-99465.
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This master thesis investigates the problem of intrafraction motion management; monitoring the movement of a tumour during radiation treatment. It evaluates the existing solutions on the market today, reviews current research on the topic, lists potential concepts and suggests a solution to the problem. The problem has been limited to monitoring of the spine and the cervical spine in particular. The proposed solution consists of a 2D ultrasound-probe, attached to the neck of the patient, that continuously monitors the position and orientation of a cervical vertebrae. To show the potential of the system a program has been developed in Matlab that post-processes ultrasound data of the cervical spine and has been shown to have submillimetre precision in detecting vertebrae movements. The solution meets all the listed requirements and offers a non-invasive, radiation-free, easy-to-use monitoring solution without any extra discomfort to the patient. The thesis is concluded by discussing potential problems and suggests what future actions are needed to develop the concept further.<br>Under strålbehandling av cancer är det vitalt att ha en korrekt uppfattning av tumörens position. Detta examensarbete undersöker problemet med tumörrelser under strålbehandling och fokuserar framförallt på övervakning av cervikalryggen. Arbetet inleds med en genomgång av befintliga övervakningslösningar och aktuell forskning i ämnet, utvärderar sedan olika övervakningskoncept och föreslår slutligen en konkret lösning på problemet. Lösningen består av en ultraljudsprob, fäst mot patientens nacke, som övervakar nackkotans position. För att demonstrera hur en lösning skulle kunna se ut har ett program skrivits i Matlab som analyserar ultraljudsdata från cervikalryggen. Programmet gör det möjligt att kontinuerligt övervaka ryggkotans position med en precision på under en millimeter. Lösningen möter alla de ställda kraven och erbjuder en ickeinvasiv, strålningsfri och lättanvänd övervakningslösning som inte innebär obehag för patienten. Arbetet avslutas med en diskussion om potentiella problem och förslag på lämpliga steg för att utveckla idén vidare.
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Cripton, Peter Alec. "Load-sharing in the human cervical spine." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape3/PQDD_0016/NQ45264.pdf.
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Sobczak, Pawel. "Computational investigation of anterior cervical spine stabilisation." Thesis, Nottingham Trent University, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.251277.
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Johnson, Jacqueline Anne. "The Canine Cervical Spine - Kinematics and Micromorphometry." The Ohio State University, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=osu1274465058.
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Yu, Yuk-ling. "The use of computerised tomography in cervical spondylotic myelopathy and radiculopathy." [Hong Kong : University of Hong Kong], 1985. http://sunzi.lib.hku.hk/hkuto/record.jsp?B12315904.
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Nuckley, David John. "Spina accresco mechanicus : on the developmental biomechanics of the spine /." Thesis, Connect to this title online; UW restricted, 2002. http://hdl.handle.net/1773/7986.
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Brolin, Karin. "Cervical Spine Injuries - Numerical Analyses and Statistical Survey." Doctoral thesis, KTH, Aeronautical Engineering, 2002. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-3418.
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<p>Injuries to the neck, or cervical region, are very importantsince there is a potential risk of damage to the spinal cord.Any neck injury can have devastating if not life threateningconsequences. High-speed transportation as well as leisure-timeadventures have increased the number of serious neck injuriesand made us increasingly aware of its consequences.Surveillance systems and epidemiological studies are importantprerequisites in defining the scope of the problem. Thedevelopment of mechanical and clinical tools is important forprimary prevention of neck injuries.</p><p>Thus, the main objectives of the present doctoral thesisare:- To illustrate the dimension of cervical injuries inSweden,- To develop a Finite Element (FE) model of the uppercervical spine, and- To study spinal stability for cervical injuries.</p><p>The incidence studies were undertaken with data from theinjury surveillance program at the Swedish National Board ofHealth and Welfare. All in-patient data from Swedish hospitals,ranging over thirteen years from 1987 to 1999, were analyzed.During this period 14,310 nonfatal and 782 fatal cervicalinjuries occurred. The lower cervical spine is the mostfrequent location for spinal trauma, although, this changeswith age so that the upper cervical spine is the most frequentlocation for the population over 65 years of age. The incidencefor cervical fractures for the Swedish population decreased forall age groups, except for those older than 65 years of age.The male population, in all age groups, has a higher incidencefor neck fractures than females. Transportation relatedcervical fractures have dropped since 1991, leaving fallaccidents as the sole largest cause of cervical trauma.</p><p>An anatomically detailed FE model of the human uppercervical spine was developed. The model was validated to ensurerealistic motions of the joints, with significant correlationfor flexion, extension, lateral bending, axial rotation, andtension. It was shown that an FE-model could simulate thecomplex anatomy and mechanism of the upper cervical spine withgood correlation to experimental data. Three studies wereconducted with the FE model. Firstly, the model of the uppercervical spine was combined with an FE model of the lowercervical spine and a head model. The complete model was used toinvestigate a new car roof structure. Secondly, the FE modelwas used for a parameter study of the ligament materialcharacteristics. The kinematics of the upper cervical spine iscontrolled by the ligamentous structures. The ligaments have tomaintain spinal stability while enabling for large rotations ofthe joints. Thirdly, the FE-model was used to study spinalinjuries and their effect on cervical spinal stability inflexion, extension, and lateral bending. To do this, the intactupper cervical spine FE model was modified to implementruptures of the various spinal ligaments. Transection of theposterior atlantooccipital membrane, the ligametum flavum andthe capsular ligament had the most impact on flexion, while theanterior longitudinal ligament and the apical ligamentinfluenced extension.</p><p>It is concluded that neck injuries in Sweden is a problemthat needs to be address with new preventive strategies. It isespecially important that results from the research on fallaccidents among the elderly are implemented in preventiveprograms. Secondly, it is concluded that an FE model of thecervical region is a powerful tool for development andevaluation of preventive systems. Such models will be importantin defining preventive strategies for the future. Lastly, it isconcluded that the FE model of the cervical spine can increasethe biomechanical understanding of the spine and contribute inanalyses of spinal stability.</p>
14
Artz, Neil. "Sensorimotor function and dysfunction in the cervical spine." Thesis, University of Bristol, 2011. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.544417.
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余毓靈 and Yuk-ling Yu. "The use of computerised tomography in cervical spondylotic myelopathy and radiculopathy." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1985. http://hub.hku.hk/bib/B31981252.
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Boak, James Christopher. "Effects of age related degeneration on cervical spine mechanics." Thesis, University of British Columbia, 2012. http://hdl.handle.net/2429/43302.
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The average age of people suffering spinal cord injuries (SCIs) is shifting toward an older population, frequently occurring in the spondylotic (degenerated) cervical spine, due to low energy impacts. Since canal stenosis (narrowing) is a common feature of a spondylotic cervical spine, flexion or extension of such a spine can compress the spinal cord. This thesis involves two studies investigating the effects of spondylosis on the kinematics of the cervical spine and on compression of the spinal cord during spine motion.
The first study developed and evaluated an image analysis technique that measures a new combination of degenerative and kinematic continuous, quantitative variables in cervical spine sagittal plane flexion-extension image pairs. This technique, evaluated using plane X-ray, effectively quantified angular range of motion, anterior-posterior (AP) translation, intervertebral disc height, pincer spinal canal diameter, and osteophyte length. The angular accuracy and linear precision were found to be ±1.3° and approximately ±0.6mm, respectively. This compared well to previous studies and is adequate for potential clinical applications.
The second study quantified the effect of increasing anterior canal stenosis on spinal cord compression during spine motion. This study used a whole porcine cadaveric cervical spine, a radio-opaque surrogate spinal cord, and an artificial osteophyte. The spine was imaged by sagittal plane X-ray during quasistatic pure moment flexion-extension bending. This study demonstrated that the cadaveric model could simulate the typical spondylotic SCI mechanisms in both flexion (bowstring stretching) and extension (pincer). Spinal cord AP diameter could be measured accurately within ±0.25mm and cord diameter differences could be measured within ±0.5mm. Cord compression due to the artificial osteophyte increased with increased canal stenosis, but never exceeded 1mm.
The image analysis techniques developed in the first study and results of future studies based on these techniques may be used to improve cadaveric modelling of SCI due to low energy impacts in the presence of age-related spine degeneration. Improved understanding of injury mechanisms may aid clinical intervention to both prevent and treat SCI in the presence of age-related spine degeneration.
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Ruston, Sally A. "Movements of the cervical spine observed by diagnostic ultrasound." Thesis, University of Strathclyde, 1988. http://oleg.lib.strath.ac.uk:80/R/?func=dbin-jump-full&object_id=21326.
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An investigation was undertaken to ascertain if standard diagnostic ultrasound equipment was capable of imaging the cervical spine and observing intersegmental motion. Cervical spine anatomy was reviewed with particular attention paid to the location and structure of the ligaments, fascia and articular structures of the region. A real-time B-scanner and 5MHz probe was selected for the project. Using a model spine within a waterbath, experience in image collection and interpretation was gained. The axial and lateral resolution of the scanner was tested. The ability of the scanner to measure a known distance using its caliper function was tested against other methods of measurement. Peripheral joints were scanned with ultrasound and were X-rayed. A set distance on both of the images was measured to see if the two methods were comparable. In vivo scanning of the neck revealed two positions for the probe which were the most useful. The body type of the patient was important to the quality of the scan achieved. Muscular or necks with much adipose tissue would produce poor quality scans. It was possible to image the laminae and the vertebra in transverse section. The motion between laminae and the motion of the vertebra as seen in the transverse view was possible to observe. The quantification of motion still requires attention.
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Rodrigues, Diana Rebecca Esteves Cardoso Gavazzo. "Biomechanical analysis of surgical treatments of the cervical spine." Master's thesis, Universidade de Aveiro, 2011. http://hdl.handle.net/10773/8366.
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Mestrado em Engenharia Mecânica<br>The main objective of this thesis was to study the biomechanical implications
related to different surgical procedures for decompressing the intervertebral
discs in the cervical spine.
The different surgical techniques were evaluated so as to assess how load
transfer to the adjacent vertebrae would be affected, thereby ascertaining the
potential risks of failure of these vertebrae when compared to the vertebrae
in the native (healthy) state. For this purpose an initial analysis of the
cervical spine was performed, specifically on the C4-C6 segment, from an
anatomical, biomechanical and pathological point of view. An analysis of
surgical reconstructive processes was also carried out, with particular focus
on the two procedures known as arthrodesis and arthroplasty.
Finite element models were then developed from CT images obtained from
a healthy male patient, with the purpose of comparing the surgical cases of
arthrodesis and arthroplasty to the native case. For these tests the selected
implants were the Fidji PEEK cage (Zimmer, Inc) for the arthrodesis case
and the ProDisc-C (Synthes, Inc.) for the arthroplasty case. The different
models generated from medical CT imaging were reconstructed with the
help of 3D modelling and finite element software and submitted to loading
conditions that simulated the weight of the human head in the anatomical
(upright) position.
The results obtained for each model enabled the evaluation, and therefore
the comparison, of the alterations in load transfer from one model too another.
These alterations were determined through the measurement of the
variations in the principal strain values in the cortical bone of vertebrae C5
and C6, adjacent to the implant, and in vertebra C4, which was positioned
directly above vertebra C5. Compressive strain values were also analysed in
the trabecular bone for all three vertebrae.
The principal strain values in the anterior vertebral body of vertebrae C5 and
C6, obtained from the numerical models developed, were compared with the
respective results obtained from the experimental models subsequently used
in this study.
In addition to the numerical models developed, experimental models of the
C5-C6 segment in rigid polyurethane foam were created. The different surgical
techniques (arthroplasty and arthrodesis) were performed in-vitro. The
purpose behind the development of these models was to ascertain the extent
to which the results obtained for the numerical models could be experimentally
replicated. Alterations in load transfer in these models was registered by
means of rosette strain gauges placed in the anterior region of the vertebrae,
allowing the evaluation of the principal strain values on the model’s surface.
These experimental models were submitted to the same loading conditions
as the numerical models.
A high correlation between the principal strain values was obtained when
comparing the numerical models with the experimental models, thus revealing
the ability of the numerical models to recreate the mechanical behaviour
of the experimental models.
The comparison made between the native numerical model (in which mechanical
bone properties had not been simplified) and the model where mechanical
properties were discretized, into cortical and trabecular bone properties,
revealed differences that should not be overlooked. When comparing
implanted models with the native model an increase in principal strain values
of cortical and trabecular bone, particularly in the lateral areas of the vertebral
body were revealed, relatively to the native model. On average these
increases were lower in the cortical bone for the arthroplasty case than in
the arthrodesis case, but higher in the trabecular bone.
Thus, it is concluded that both surgical techniques contribute to the increase
of mechanical strain on the vertebrae adjacent to the implants, and thus possibly increase the risk of failure of the bone structure due to fatigue.<br>Procurou-se especificamente avaliar como cada uma das diferentes técnicas
cirúrgicas altera a transferência de carga as vértebras adjacentes, aferindo
assim potenciais riscos de falência destas quando comparadas com a situação
das vértebras no estado nativo (saudável). Para o efeito, numa primeira fase
procurou-se realizar uma naálise detalhada a coluna cervical, especificamente
ao segmento C4-C6, na sua vertente anatómica, biomecânica e patológica,
assim como dos processos cirúrgicos de reconstrução com especial enfoque
na artrodese e artroplastia cervical.
Numa fase posterior procedeu-se ao desenvolvimento de modelos numéricos
de elementos finitos a partir de imagens de TAC de um paciente saudável,
com o propósito de comparar as técnicas de artroplastia e artrodese com a
situação nativa. Para estas análises foram seleccionados os implantes Fidji
PEEK cage (Zimmer, Inc) para a técnica da artrodese, e ProDisc-C (Synthes,
Inc) para a técnica da artroplastia. Estes diferentes modelos, gerados a partir
das imagens médicas de TAC, foram reconstruídos com o auxílio de softwares
de modelação 3D e de elemento finitos, e submetidos a condiç oes de cargas
idênticas, correspondente ao peso da cabeça humana na postura anatómica.
Os resultados obtidos com estes modelos permitiram avaliar de forma comparativa
as alterações de transferência de carga através das deformações
principais no osso cortical das vértebras C5-C6 imediatamente adjacente aos
implantes, assim como na vértebra C4 do segmento anexo. Em complemento
destas deformações foram também analisadas as deformações de compressão
no osso esponjoso das mesmas vértebras.
As deformações principais no cortex anterior das vértebras C5-C6 dos modelos
experimentais desenvolvidos foram comparadas com os resultados obtidos
nos modelos numéricos correspondentes criados neste estudo.
Em complemento aos modelos numéricos anteriores, desenvolveram-se modelos
experimentais do segmento C5-C6, em espuma rígida de poliuretano,
onde as diferentes técnicas cirúrgicas (artrodese e artroplastia) foram implementadas
através de cirurgias “in-vitro”. O desenvolvimento destes modelos
pretendeu aferir até que ponto os resultados obtidos nos modelos numéicos
se reproduziam experimentalmente. As alterações de transferência de carga
nestes modelos foram realizadas com recurso a rosetas de extensómetros
colocadas na região anterior das vértebras, permitindo a avaliação das deformações
principais na sua superfície. Estes modelos foram submetidos ao
mesmo caso de carga dos modelos numéricos.
Um elevado valor de correlação entre as deformações principais foi obtido
na comparação dos modelos numéricos com os modelos experimentais, revelando
uma boa capacidade dos modelos numéricos replicarem o comportamento
mecânico dos modelos experimentais.
Os resultados obtidos na comparação do modelo numérico nativo com o
modelo em que as propriedades mecânicas foram discretizadas, em osso
cortical e esponjoso, revelaram diferenças não desprezáveis. Os resultados
obtidos entre os diferentes modelos implantados e o modelo nativo revelaram
aumentos das deformações no osso cortical e esponjoso, em particular nas
zonas laterais aos implantes, relativamente ao modelo nativo. Em média
estes aumentos foram inferiores na técnica da artroplastia relativamente a
artrodese no osso cortical e foram superiores no osso esponjoso.
Assim, conclui-se que as ambas as técnicas cirúrgicas contribuem para o
agravar da solicitação mecânica sobre as vértebras adjacentes aos implantes,
e desta forma possivelmente potenciar o risco de falência por efeito do processo
de fadiga.
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Alizadeh, Mina. "THE DEVELOPMENT OF EMG-ASSISTED CERVICAL SPINE BIOMECHANICAL MODEL." The Ohio State University, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=osu1555345628151301.
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Huber, Zach Elijah. "Creation and Validation of a Dynamic, EMG-Driven Cervical Spine Model." The Ohio State University, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=osu1365680628.
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Cross, Kasey, and Kasey Cross. "A Proposal for a Best-Practice Protocol for the Management of Patients with Suspected Cervical Spine Injury." Diss., The University of Arizona, 2017. http://hdl.handle.net/10150/626650.
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Background: Research suggests that cervical spine CT examination is over used for potential injury due to blunt trauma. Education of emergency providers regarding evidence-based guidelines can help reduce the over-use of CT examination, and the development of an evidence-based protocol for the management of patients with suspected cervical spine trauma may help promote more appropriate clinical use of radiologic imaging for cervical spine clearance.
Purpose: The ultimate goal of this project is to develop a best-practice, evidence-based protocol for the management of patients with suspected cervical spine injury, in order to promote safe and efficient clinical clearance, as well as promote judicious and appropriate use of diagnostic imaging for suspected cervical spine injury.
Methods: A retrospective chart review of emergency radiographic imaging studies obtained over a three-month timeframe for suspected cervical spine injury at a 300-bed hospital in Tucson, Arizona was performed to compare ordering practices with the ACR-AC. Descriptive statistics were used for data analysis. A web-based survey was conducted of facility stakeholders including emergency physicians, nurse practitioners and physician assistants regarding their views about clinical guidelines and protocols for radiographic and clinical clearance of cervical spine injury. Descriptive statistics and thematic analysis was used for survey responses.
Results: Analysis of 263 imaging studies over a three-month timeframe demonstrated that 24.3% of cervical spine imaging studies obtained in three-month timeframe would be considered not appropriate based on the ACR-AC. The survey of emergency clinicians revealed that none of those who responded have a preference for referring to the ACR appropriateness criteria, and the majority of respondents did not support the implementation of a hospital protocol for the management of patients with suspected cervical spine trauma.
Recommendations: An institutional protocol for suspected cervical spine injury developed from the ACR-AC with incorporation of clinical clearance criteria is recommended. To promote clinician acceptance, overcome resistance to implementation, and promote individualized patient care, the protocol should also include provider education and should allow for variance based on individual patient circumstances.
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Valenson, A. J. "Dynamic Mechanical Properties of Human Cervical Spine Ligaments Following Whiplash." Yale University, 2007. http://ymtdl.med.yale.edu/theses/available/etd-06282006-145949/.
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The purpose of this study is to quantify the dynamic mechanical properties of human cervical ligaments following whiplash. Cervical ligaments function to provide spinal stability, propioception, and protection during traumatic events to the spine. The function of cervical ligaments is largely dependant on their dynamic biomechanical properties, which include force and energy resistance, elongation capability, and stiffness. Whiplash has been shown to injure human cervical spine ligaments, and ligamental injury has been shown to alter their dynamic properties, with potential clinical consequences such as joint degeneration and pain. In this study we quantified the dynamic properties of human lower cervical ligaments following whiplash and compared their properties to those of intact ligaments. Whiplash simulation was performed using biofidelic whole cervical spine with muscle force replication (WCS-MFR) models. Next, ligaments were elongated to failure at a fast elongation rate and peak force, peak elongation, peak energy, and stiffness values were calculated from non-linear force-elongation curves. Peak force was highest in the ligamentum flavum (LF) and lowest in the intraspinous and supraspinous ligaments (ISL+SSL). Elongation was smallest in middle-third disc (MTD) and greatest in ISL+SSL. Highest peak energy was found in capsular ligament (CL) and lowest in MTD. LF was the stiffest ligament and ISL+SSL least stiff. These findings were similar to those found in intact ligaments. When directly comparing ligaments following whiplash to intact ligaments in a prior study it was found that the anterior longitudinal ligament (ALL) and CL had altered dynamic properties that were statistically significant, suggesting that whiplash may alter the dynamic properties of cervical ligaments. These findings may contribute to the understanding of whiplash injuries and the development of mathematical models simulating spinal injury.
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Panzer, Matthew. "Numerical Modelling of the Human Cervical Spine in Frontal Impact." Thesis, University of Waterloo, 2006. http://hdl.handle.net/10012/2865.
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Motor vehicle accidents continue to be a leading cause of cervical spine injury despite a conscientious effort to improve occupant safety. Accurately predicting occupant head and neck response in numerical crash simulations is an essential part of the process for developing better safety solutions. <br /><br /> A biofidelic model of the human cervical spine was developed with a focus on accurate representation of the cervical spine at the local tissue level. These tissues were assembled to create a single segment model that was representative of <em>in vitro</em> spine in quasi-static loading. Finally, the single segment models were assembled to create a full cervical spine model that was simulated in dynamic loading and compared to human volunteer response. <br /><br /> Models of each segment were constructed from the basic building blocks of the cervical spine: the intervertebral disc, the vertebrae, the ligaments, and the facet joints. Each model was simulated in all modes of loading and at different levels of load. The results of the study indicate that the cervical spine segments performed very well in flexion, compression, and tension. Segment response to lateral bending and axial rotation was also good, while response in extension often proved too compliant compared to the experimental data. Furthermore, the single segment models did not fully agree with the experimental shear response, again being more compliant. <br /><br/> The full cervical spine model was assembled from the single segment models incorporating neck musculature. The model was simulated dynamically using a 15 G frontal impact test. Active muscles were used to simulate the response of the human volunteers used in the study. The response of the model was in reasonable agreement with the experimental data, and compared better than current finite element cervical spine models. Higher frequency oscillation caused most of the disagreement between the model and the experimental data, which was attributed to a lack of appropriate dynamic material properties of the soft tissues of the spine. In addition, a study into the active properties of muscle indicated that muscle response has a significant influence on the response of the head. <br /><br /> A number of recommendations were proposed that would improve the biofidelity of the model. Furthermore, it was recommended that the future goal of this model would be to implement injury-predicting capabilities through the development of advance material models.
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Keller, Michael J. "Development of a cervical spine model for rear impact conditions." Connect to resource, 2010. http://hdl.handle.net/1811/45428.
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Sim, Darryl Frederick. "Biomechanics of Dysfunction and Injury Management for the Cervical Spine." Queensland University of Technology, 2004. http://eprints.qut.edu.au/15852/.
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The research described in this thesis focuses on the biomechanics of cervical spine injury diagnosis and rehabilitation management. This research is particularly relevant to the diagnosis of minor neck injuries that typically arise from motor vehicle accidents and are classified as "whiplash injuries". The diagnosis and treatment of these chronic neck problems has been particularly difficult and frustrating and these difficulties prompted calls for the objective evaluation of the techniques and procedures used in the measurement and assessment of neck dysfunction. The biomechanical aspects of the clinical diagnosis of minor cervical spine injuries were investigated in this work by reconfiguring an existing detailed biomechanical model of the human neck to simulate injuries to particular structures, and to model abnormal muscle activation. The investigation focused on the range of motion assessment and the methods of testing and rehabilitating the function of the deep neck muscles because the model could be applied to provide further insight into these facets of neck injury diagnosis and management. The de Jager detailed head-neck model, available as a research tool from TNO (The Netherlands), was chosen for this study because it incorporated sufficient anatomical detail, but the model required adaptation because it had been developed for impact and crash test dummy simulations. This adaptation significantly broadened the model's field of application to encompass the clinical domain. The facets of the clinical diagnosis of neck dysfunction investigated in this research were range of motion and deep muscle control testing. Range of motion testing was simulated by applying a force to the head to generate the primary motions of flexion/extension, lateral flexion and axial twisting and parametric changes were made to particular structures to determine the effect on the head-neck movement. The main finding from this study of cervical range of motion testing was that while motion can be accurately measured in three dimensions, consideration of the three dimensional nature of the motion can add little to the clinical diagnosis of neck dysfunctions. Given the non-discriminatory nature of range of motion testing, the scientific collection and interpretation of the three dimensional motion patterns cannot be justified clinically. The de Jager head-neck model was then further adapted to model the cranio-cervical flexion test, which is used clinically to test the function of the deep muscle groups of the neck. This simulation provided confirmation of the efficacy of using a pressure bio-feedback unit to provide visual indication of the activation of the deep flexor muscles in the neck. However, investigation of the properties of the pressure bio-feedback unit identified significant differences in the stiffness of the bag for the different levels of inflation that must be accounted for if comparisons are to be made between subjects. Following the identification of the calibration anomalies associated with the pressure bio-feedback unit, the motion of the point of pressure of the head on the headrest and the force at this point of contact during the activation of the deep flexor muscle group were investigated as an alternative source of feedback. This output, however, was found to be subject specific, depending on the posterior shape of the skull that determined the point of contact during the head rolling action. Clinically, an important outcome of the alternative feedback assessment was that the prescribed action to target the deep flexor muscle group will feel different for each individual, ranging from a slide to a roll of the head on the headrest, and this must be accounted for when explaining the action and during rehabilitation management.
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Hulbert, Pamela Ann. "The physiological management of cervical spine pain in whiplash injury." Thesis, University of Manchester, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.488654.
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The purpose of this study was to examine the concept of the physiological management of pain following acute Grade 2 whiplash injury while facilitating recovery and maintenance of a full range of cervical spine movement. In a series of studies a statistically significant effect was demonstrated on the improved and sustained range of cervical movement p<0.0005 and on the effective control of pain p<0.0005 generated by movement to relieve post injury stiffness. In an Audit study there was a beneficial effect on the improvement in patient confidence in selfmanagement of their condition 84% following attendance at an educational neck school. The effective use of soft collars on the available range of cervical movement p<0.025 and on the balance of the body showed a statistically significant result p<O.OOl. The study results indicated that there are inbuilt systems of pain control which can be effectively used to control pain following Grade 2 whiplash injury while facilitating the recovery of full range of cervical movement. This study emphasised the importance of not allowing post injury stiffness to develop and that post injury stiffness prejudices the survival of the joint neuroreceptors. The study showed the relevance of the Quebec Task Force Guidelines in the management of whiplash injury.
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Raynak, Geoffrey Charles. "Cervical spine injury potential resulting from sagittal plane inertial loading /." Thesis, Connect to this title online; UW restricted, 2000. http://hdl.handle.net/1773/7989.
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Buckland, Daniel Miller. "Ultrasound imaging of cervical spine motion for extreme acceleration environments." Thesis, Massachusetts Institute of Technology, 2011. http://hdl.handle.net/1721.1/68402.
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Thesis (Ph. D.)--Massachusetts Institute of Technology, Dept. of Aeronautics and Astronautics, 2011.<br>Cataloged from PDF version of thesis. Vita.<br>Includes bibliographical references (p. 52-55).<br>Neck and back pain is one of the most common musculoskeletal complaints in personnel in variable acceleration environments such as astronauts and military pilots. Ultrasound is known for dynamic imaging and diagnostic workup of the axial and appendicular skeleton, but is not currently used to image the cervical spine, the injury of which may change the biomechanics of the cervical vertebrae, which CT and MRI (the current gold standard in cervical spine imaging) are poor at capturing. To validate ultrasound as a modality for imaging dynamic motion of the cervical spine several experiments were performed in static and dynamic human and animal (ovine) models: 1. Static analysis of ex-vivo ovine cervical spines imaged by ultrasound, MRI, and CT demonstrated that the imaging modality affected the measured intervertebral disc height (p<0.01); similar evaluation was done in-vivo in Emergency Department patients who received a CT scan as part of their clinical course that showed that ultrasound could fit into existing clinical workflows. 2. Dynamic analysis of isolated ex-vivo ovine cervical spinal segments intervertebral disc displacement with a mounted ultrasound probe demonstrated a measurement uncertainty of ± 0.2 mm and no bias at low frequency sinusoidal spinal displacement. A similar evaluation in-vivo with humans with an ultrasound probe mounted on a cervical-collar found a 0.8-1.3 mm amount of cervical spine distraction from the C4-5 Functional Spinal Unit. In human cadavers subjected to passive flexion and extension of the cervical spine, ultrasound measurements of the relative flexion/extension angles between consecutive cervical vertebrae were similar to fluoroscopy. 3. Ultrasound was able to record dynamic motion of the cervical spine in-vivo in running on a treadmill, during parabolic flight, and traveling over a rough road in a military vehicle. The ultrasound methods developed and tested in this thesis could provide an inexpensive, portable and safe technique that can identify and characterize cervical spine anatomy and pathology.<br>Funding Acknowledgment: National Space Biomedical Research Institute, Army Research Office, Children's Hospital Orthopedic Surgery Foundation<br>by Daniel Miller Buckland.<br>Ph.D.
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Thompson, Crispin. "Hyperextension injury of the cervical spine with central cord syndrome." Master's thesis, University of Cape Town, 2013. http://hdl.handle.net/11427/2892.
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Jordan, Kelvin. "Statistical assessment of cervical spine and shoulder range of motion." Thesis, Keele University, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.323756.
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Measuring range of motion (for example, of the cervical spine or shoulder) is a common feature in the diagnosis and longitudinal assessment of many medical conditions. Current clinical methods, however, cannot measure combinations of movement or velocity of movement. A new threedimensional measuring system, the FASTRAK, can measure range of motion in the primary plane of movement and also in secondary planes of movement. Further, it can measure concurrent threedimensional movement of the body elsewhere; for example, of the trunk. In order for a measured change in range of motion to be confidently perceived as real change, the measuring tool has to be shown to be reliable. This study commences by performing systematic reviews assessing the evidence for the reliability of current cervical spine and shoulder range of motion measuring tools. The reliability of the FASTRAK in measuring cervical spine and shoulder range of motion is then assessed on healthy subjects with unrestricted neck and shoulder movement. The methodology and analysis provides a framework for future reliability studies of this nature. Range of motion is often limited in subjects with diagnosed ankylosing spondylitis (AS). To assess the ability of the FASTRAK to differentiate between a non-diseased population and subjects with AS, and between different severities of AS, the FASTRAK is applied to a sample of AS subjects in a longitudinal study. Pictures of movement are built up and compared, using a novel application of repeated measures multilevel modelling, for both healthy and AS subjects. The use of multilevel modelling to build these pictures of movement is evaluated. Clinical validation of the models and the usefulness and acceptability of the FASTRAK in a clinical setting is assessed through the process of semi-structured interviews with clinicians from the disciplines most likely to make range of motion measurements in clinical practice.
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Peolsson, Annelie. "Functional analysis of the cervical spine : reliability, reference data and outcome after anterior cervical decompression and fusion /." Linköping, 2002. http://www.bibl.liu.se/liupubl/disp/disp2002/med738s.pdf.
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Henriques, Thomas. "Biomechanical and Clinical Aspects on Fixation Techniques in the Cervical Spine." Doctoral thesis, Uppsala University, Department of Surgical Sciences, 2003. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-3574.
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<p>The present work is analyzing the general biomechanical aspects of fixation techniques in the upper and lower cervical spine along with clinical implications.</p><p>The in vitro biomechanical properties of five different posterior atlanto-axial fixation techniques are compared. They provided for either a one, two or three-point fixation between atlas and axes. A new device, the C1 claw was biomechanically tested, which allow for fixation without the need for a structural bone graft. The three-point reconstructions indicated superior biomechanical properties compared to all others.</p><p>The new C1 claw device was clinically evaluated in a series of 26 patients treated with a posterior C1-C2 fusion. There were no clinical or radiological failures in the series, Twenty-one patients out of twenty-three with any length of follow up either showed a solidly healed fusion or a healed fracture. </p><p>Distractive flexion (DF) injuries in the lower cervical spine treated with anterior plate alone were analyzed with respect to healing rate and complications in a consecutive series of 36 patients. Results indicated that DF injury stage 1 and 2 according to Allen and Ferguson healed without complication, whereas DF injuries stage 3 had a high frequency of failure, needing an additional posterior fixation. </p><p>The in vitro biomechanical properties of four different fixation techniques for a distractive flexion injury stage 3 were analyzed. The result indicated that anterior plate alone for fixation of a DF injury stage 3 is insufficient supporting the clinical finding in the previous study.</p><p>Adjacent level motion was analyzed following a one segment fusion in the lower cervical spine. Motion was found to increase in adjacent levels possibly contributing to accelerated degeneration.</p>
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Lison, Almkvist Viktor. "FE-Analysis of Stabilization of Cervical Spine Fracture in Ankylosing Spondylitis." Thesis, KTH, Hållfasthetslära (Inst.), 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-175357.
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Ankylosing Spondylitis (AS), or Bechterew’s disease, is an inflammatory rheumaticdisease that through the formation of additional bone tissue in the spine eventuallyleads to the complete fusion of the vertebrae, in effect turning the spine into one longbone. Due to the reduced flexibility of the spine with the long lever arms, spinalfractures in AS-patients are relatively common even after minor trauma. The aim of this thesis was to use an existing finite element model of a healthy spineand adapt it to the conditions of AS, thus gaining some insight into the effects ofsurgical stabilization of cervical fractures, using posterior screws and rods. Althoughthis type of surgery is often performed, it has not been previously investigated in abiomechanical model. This thesis should be considered as a starting point for how afinite element model of the spine could be used to investigate the effect of spinalimplants in the case of a fracture in the ankylosed spine. An existing FE-model was modified to some of the conditions of AS: The vertebraewere fused by adding ossifications at the intervertebral discs (with the Head-C1 andC1-C2 joints left mobile). A fracture was simulated at the C6C7 disc level. Fourdifferent implant configurations were tested: Short instrumentation C6C7, mediuminstrumentation C5toT1, long instrumentation C3toT3, and a long instrumentationC3C6C7T3 with skipped intermediate levels. Three loads (1.5g, 3.0g, 4.5g) wereapplied according to a specific load curve. Kinematic data such as the gap distance inthe fracture site were obtained. Furthermore the stresses in the ossified parts of thediscs were evaluated. It was shown that the chosen methods of adapting the model to the AS conditions, andmodeling the fracture and implant, changed the kinematics so that less movementoccurred between the vertebra, which is typical for AS. Measured as fracture gap, alltested implant configurations were equally good at stabilizing the fracture, althoughthey all allowed more movement than the non-fractured AS-model did. All implantconfigurations were also able to stabilize the fracture in terms of the horizontal translation in the fracture. The disc ossifications were somewhat shielded from stress for those ossifications that were within the range of the implant. This was so for all implant configurations. No increased stress was observed in the ossifications immediately outside the range for the implants, relative the non-fractured AS-model. For the C6C7 and C5toT1 implant configurations as well as the non-fractured ASmodel,the stresses were highest at the T1T2 level. Stresses in the ossifications in the thoracic spine were generally low, apart from the T1T2 level. The results show that the chosen AS-adaptations and the modeled implant seem reasonable for testing some of the considerations of cervical fractures in the ankylosed spine as well as for some implant configurations. The results also make it possible to speculate about the optimal type of implant. The effects of screw placement and anchoring, osteoporosis, muscle activation and possible spinal deformity on the implant stability were not investigated, and should be a matter for further studies.<br>Ankyloserande Spondylit (AS), eller Bechterew’s sjukdom, är en inflammatorisk, reumatisk sjukdom som innebär att ny benvävnad formas i ryggraden. Detta leder till att kotorna slutligen smälter samma. I praktiken leder detta till att ryggraden fogas samman till ett enda långt ben. Vid en reducerad flexibilitet med långa hävstänger är frakturer i kotpelaren relativt vanliga för patienter med AS även vid mindre trauma. Syftet med denna uppsats var att använda en existerande FE-modell av en frisk rygg och nacke, och anpassa den till det tillstånd som är typiskt för AS. Vidare var syftet att erhålla insikt om hur kirurgisk stabilisering med skruvar och stänger av en fraktur i nacken beter sig. Trots att denna typ av operation utförs förhållandevis ofta, så har detta inte tidigare undersökts i någon biomekanisk modell. Denna uppsats kan ses som en utgångspunkt för hur en FE-modell av ryggraden kan användas för att undersöka effekten av stabiliserande implantat av en fraktur vid AS. En existerande FE-modell modifierades för att överensstämma med några av de villkor som gäller vid AS: Kotorna fogades samman via förbeningar i diskarna. (Huvud-C1 och C1-C2-lederna lämnades rörliga). En fraktur simulerades i C6C7- nivån. Fyra olika konfigurationer av implantat provades: Kort implantat C6C7, mellanlångt implantat: C5tillT1, långt implantat C3tillT3 och ett långt implantat C3C6C7T3 där mellanliggande kotor hoppades över. Tre lastfall (1.5g, 3.0g, 4.5g) applicerades enligt en specifik lastkurva. Kinematisk data såsom “fracture gap distance” i frakturen registrerades. Vidare registrerades också spänningarna i de förbenade delarna av diskarna. Det var möjligt att, genom att anpassa modellen till AS och modellera fraktur och implantat, påverka nackens kinematik så att mindre rörelse skedde mellan kotorna, vilket är typiskt för AS. Med utgångspunkt i mätningarna av “fracture gap distance”, var det möjligt för alla konfigurationer av implantat att stabilisera frakturen, även om implantaten tillät mer rörelse än AS-modellen som saknade fraktur. Detta gällde även för horisontell translation i frakturen. Vad gällde spänningarna i förbeningarna så avlastades dessa för de förbeningar som var belägna inom implantatets räckvidd. Detta gällde för alla implantatkonfigurationer. Inga spänningskoncentrationer observerades i förbeningarna precis utanför implantatens räckvidd i förhållande till AS-modellen utan fraktur. Vad gällde C6C7 och C5toT1 implantaten, liksom ASmodellen utan fraktur, så registrerades de högsta spänningarna i T1T2-nivån. Spänningarna i förbeningarna i bröstryggen var generellt låga, bortsett från T1T2- nivån. Resultaten visade att de valda anpassningarna till AS och sättet att modellera implantaten verkade vettiga för att undersöka några av de överväganden som uppstår vid nackfrakturer i en ankyloserad kotpelare, samt ett par implantatvarianter. Resultaten möjliggör även spekulationer kring vilken typ av implantat som är optimal. Huruvida implantatstabiliteten påverkades av placeringen av skruvar, infästningen i benvävnaden, osteoporos, muskelaktivering och möjlig missbildning av ryggen undersöktes inte. Detta kan undersökas i framtida studier.
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Aurand, Alexander M. "Dynamic Moments on the Cervical Spine Imposed by Head-Mounted Equipment." The Ohio State University, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=osu1430747355.
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Le, Peter Phuong. "A Method to Describe Coactivation for the Lumbar and Cervical Spine." The Ohio State University, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=osu1479207898554988.
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Saari, Amy. "Spinal cord deformation during axial impact injury of the cervical spine." Thesis, University of British Columbia, 2006. http://hdl.handle.net/2429/32337.
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Head-first impact can occur during home and occupational falls, automotive rollovers,
various sports, and other activities. These incidents often result in both spinal column and
spinal cord trauma. To better understand the resulting bony and neurological injuries, and
to develop devices to prevent them, several investigators have studied the response of the
cervical spinal column under axial impact. In general these studies have not related the
spinal column injuries sustained to the accompanying spinal cord injury. As such, the
relationship between these two aspects of trauma is not well understood. Furthermore,
most of the models used to study dynamic axial impact do not account for musculature
present in vivo which may influence the response of the model to the impact.
The objectives of this work were to develop an appropriate cervical spine model that
incorporates the effect of musculature so as to assess its effect on the kinematic response
of the cervical spine to the impact, and to quantify spinal cord deformation during injury
sustained during dynamic head to ground impact. Insight into the relationship between
spinal column and spinal cord injuries could improve animal models used to study spinal
cord injury at a cellular level by providing data on depth and area of compression and
velocity of compression. Previously there has been little data on these parameters which
are needed to recreate clinically relevant injuries in these animal models.
The impact model developed for this work was a cadaveric human cervical spine model
that used a follower preload to simulate vertebral loading due to musculature. A novel
method of visualizing the deformation of the spinal cord paired high speed
cineradiography with a radiodense biofidelic surrogate spinal cord placed within the
cadaveric human cervical spine. This system provided a continuous sagittal profile of the
spinal cord deformation resulting from the impact induced injuries.
The influence of the simulated musculature was assessed via the response of the spine to
impact. During impact none of the specimens were observed to respond with a snapthrough
and/or complex buckling response as has been previously reported in axial
impact studies. The corresponding spinal cord deformations were used to correlate injury
mode to severity of cord damage. The degree and velocity of the compression of the
spinal cord were used to determine the expected neurological injury from in vivo animal
tests assessing these in terms of probability of recovery. Thus the relationship between
bony injury and neurological injury could be made in an in vitro model.<br>Applied Science, Faculty of<br>Mechanical Engineering, Department of<br>Graduate
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Cruz, Halisson Yoshinari 1984. "Avaliação do SLICS no tratamento das lesões da coluna cervical subaxial = Evaluation of the SLICS use in the treatment of subaxial cervical spine." [s.n.], 2015. http://repositorio.unicamp.br/jspui/handle/REPOSIP/312695.
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Orientadores: Helder Tedeschi, Andrei Fernandes Joaquim<br>Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas<br>Made available in DSpace on 2018-08-27T03:41:44Z (GMT). No. of bitstreams: 1
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Previous issue date: 2015<br>Resumo: Introdução: O SLICS (Subaxial Cervical Spine Injury Classification System) foi proposto para auxílio na tomada de decisão do traumatismo da coluna cervical sub-axial, contudo poucos trabalhos avaliaram sua segurança e eficácia. Método: comparar coorte histórica de pacientes tratados com base na preferência do cirurgião com pacientes tratados baseando-se no escore obtido com a aplicação do sistema. Foram incluidos pacientes com lesão traumática aguda de C3-7 com exames radiológicos e dados clínicos completos. O status neurológico foi avaliado através do ASIA Impairment Scale (AIS). Resultados: entre 2009-10, 12 pacientes foram incluídos (seguimento médio de 24,5 meses). Na admissão hospitalar 5 pacientes (41,6%) apresentavam AIS E, 1 (8,3%) AIS D, 1 (8,3%) AIS C, 1 (8,3%) AIS B e 4 (33.3%) AIS A. Dois de sete pacientes com déficit incompleto melhoraram durante o seguimento clínico. O SLICS escore variou de 2 a 9 pontos (média de 5.5 e mediana de 5.75), onde dois pacientes tinham escore menor do que 4. Entre 2011-13, 28 pacientes foram incluídos (média de 6,1 meses), com média de idade de 41,5 anos. Na admissão hospitalar 12 pacientes (42,9%) apresentavam AIS E, 4 (14,3%) AIS D, 5 (17,9%) AIS C, 2 (7,15%) AIS B e 5 (17,9%) AIS A. Seis pacientes entre os 11 com déficit incompleto apresentaram melhora. O escore de SLICS variou de 4 a 9 pontos, com média e mediana de 6. Conclusões: observamos que após a aplicação do sistema, houve uma diminuição de indicação cirúrgica nos pacientes com lesões mais estáveis ou menos graves, sem que se detectasse piora neurológica em ambos os grupos. Isso sugere que o SLICS pode ser útil para auxiliar a diferenciação das lesões mais instáveis que acometem a coluna cervical sub-axial que requeiram tratamento cirúrgico<br>Abstract: Introduction: The SLICS (Subaxial Cervical Spine Injury Classification System) was proposed to help in the decision-making process of surgical treatment of sub-axial cervical spine trauma, eventhough the literature assessing its safety and efficacy is scarce. Methods: we compared a cohort series of patients treated based on surgeon¿s preference with patients treated based on the SLICS. We have only included patients with acute spinal trauma from C3-7 that had complete clinical and radiological data. Results: between 2009-10, 12 patients were included (mean 24.5 months of follow-up). The preoperative AIS was: 5 patients (41.6%) were AIS E, 1 (8.3%) AIS D, 1 (8.3%) AIS C, 1 (8.3%) AIS B and 4 (33.3%) AIS A. Two out of seven patients had neurological improvement during follow-up. The SLICS score ranged from 2 to 9 points (mean of 5.5 and median of 5.75 points) with two patients with less than 4 points. From 2011-13, 28 patients were included with a SLICS (mean of 6.1 months of follow-up). The preoperative AIS was: 12 patients (42.9%) with AIS E, 4 (14.3%) AIS D, 5 (17.9%) AIS C, 2 (7.15%) AIS B and 5 (17.9%) AIS A. Six patients out of 11 had some neurological improvement. The SLICS score ranged from 4 to 9 points (mean and median of 6). There was no neurological deterioration in any group. Conclusions: after using the SLICS there was a decrease in the number of patients with less severe injuries that were treated surgically, with no reflection on neurological outcome. This suggests that the SLICS can be helpful in differentiating mild from severe injuries, potentially improving the results of treatment<br>Mestrado<br>Neurologia<br>Mestre em Ciências Médicas
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Nascimento, Anderson Luis do. "Estudo morfométrico do pedículo cervical." Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/17/17142/tde-07062017-134424/.
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A inserção do parafuso pedicular cervical é um procedimento cirúrgico tecnicamente desafiador. Assim, o amplo conhecimento da morfologia das vértebras cervicais, particularmente do pedículo, é essencial para minimizar o risco de ferimentos graves a estruturas neurovasculares. O objetivo deste estudo foi conduzir uma avaliação detalhada de exames de tomografia computadorizada (TC) na população brasileira do ponto de entrada, trajetória, e dimensões dos pedículos da coluna cervical. Duzentos pacientes consecutivos foram retrospectivamente avaliados utilizando a TC da coluna cervical, com a reconstrução da imagem de cada vértebra no plano axial com 2 mm, e no plano sagital com 3 mm. Os parâmetros no plano axial incluíram a espessura pedicular (EP), o comprimento pedicular axial (CPA), o ângulo pedicular transverso (APT) e a distância do ponto de entrada ao ângulo entre a lâmina e o processo espinhoso (DPE). As medidas no plano sagital envolveram a altura pedicular (AP) e o ângulo pedicular sagital (APS). A EP e AP média são menores nos pacientes do sexo feminino do que nos pacientes do sexo masculino em todas as vertebras cervicais, porém não houve diferença significativa do APT entre os sexos. O APS variou de 15,2° a 23,7°. Os valores médios do CPA e DPE apresentaram uma tendência a diminuir de proximal para distal na coluna cervical. A EP encontrada foi menor que 4 mm em 7,5% dos pacientes do sexo masculino (C3) e em 25% dos pacientes do sexo feminino (C3), e menores que 4,5 mm em 20% dos pacientes do sexo masculino (C3) e em 66% dos pacientes do sexo feminino (C3). A confiabilidade intra e interobservador foram muito boas para a medida tomográfica da EP, e boa para a AP. Para o CPA, a confiabilidade intraobservador foi boa, porém a confiabilidade interobservador variou de moderada a boa. Considerando o APT e APS, a confiabilidade intraobservador foi boa, mas a confiabilidade interobservador moderada para o APT e fraca para o APS. As medidas do DPE evidenciaram fraca confiabilidade intraobservador e fraca ou moderada confiabilidade interobservador. Nossos resultados apresentaram tendência similar aos de estudos prévios, no entanto a frequência de pacientes com a EP < 4,5 mm em nossa população é maior, sugerindo um risco aumentado durante a tentativa de realizar a técnica transpedicular<br>Pedicular screw insertion is a technically challenged surgical procedure. Thus, extensive knowledge of the morphology of the cervical vertebra, primarily the pedicle, is crucial to reduce severe damage to neurovascular structures. The goal of this study was to conduct a detailed computed tomography (CT) assessment in the Brazilian population of the screw starting point, trajectory, and dimensions of pedicle in the cervical spine. Two hundred consecutive patients were retrospectively evaluated using cervical spine CT, with imaging reconstruction of each cervical vertebra in the axial plane with 2mm, and in sagittal reconstructions with 3mm. Parameters in axial plane included the pedicle width (PW), pedicle axis length (PAL), pedicle transverse angle (PTA), and the distance from the entry point to the point between the lamina and spinous process (DEP). Measurements in the sagittal plane involved the pedicle height (PH) and the pedicle sagittal angle (PSA). The mean PW and PH were smaller in females than in males in all cervical vertebrae, but there were no significant differences of PTA among genders. PSA ranged from 15.2° to 23.7°. Mean values of PAL and DEP had a tendency to decrease from the proximal to distal cervical vertebrae. PW was <4 mm in 7.5% of men (C3) and 25% of women (C3), and <4.5 mm in 20% (C3 male) and 66% (C3 female). The intra- and inter-observer reliability were very good for the tomographic measurement of PW, and good for PH. For PAL, the intraobserver reliability was good, but the interobserver reliability varied from moderate to good. Considering PTA and PSA, the intraobserver reliability was good, but the interobserver reliability moderate for PTA and poor or fair for PSA. DEP measurements showed poor intraobserver reliability, and poor or moderate interobserver reliability. Our results presented similar trend of previous studies, but the frequency of patients with PW <4.5 mm in our population is higher, suggesting an increased risk during the attempting of transpedicular screw technique
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Sakai, Denis Seguchi 1980. "Influência do nível de lesão torácico no alinhamento cervical no plano sagital = The influence of the thoracic level of spinal cord injured subjects in the sagittal alignment of the cervical spine." [s.n.], 2013. http://repositorio.unicamp.br/jspui/handle/REPOSIP/313746.
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Orientador: Alberto Cliquet Junior<br>Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas<br>Made available in DSpace on 2018-08-23T16:33:33Z (GMT). No. of bitstreams: 1
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Previous issue date: 2013<br>Resumo: Introdução: O trauma raquimedular apresenta maior incidência em indivíduos do sexo masculino entre 15 e 40 anos de idade. A denervação da musculatura segmentar da coluna vertebral abaixo do nível da lesão medular altera a postura do tronco no plano sagital destes indivíduos. Adaptações posturais ocorrem na coluna cervical e podem predispor à degeneração precoce do disco intervertebral e/ou das articulações facetárias, resultando na formação de osteófitos nos corpos vertebrais, diminuição do calibre dos forâmens intervertebrais e do canal vertebral. O envelhecimento da coluna cervical (espondilose cervical) é um processo lento. Sua sintomatologia é imprevisível e ocorre após a 5a década de vida na população geral, podendo decorrer de compressões radiculares ou medulares. As compressões radiculares apresentam-se clinicamente como dores irradiadas nos membros superiores, diminuição da força muscular (paresia) e alterações da sensibilidade (parestesia). Já as compressões medulares (ou mielopatia cervical) levam à incoordenação dos movimentos finos nas mãos, alterações de marcha (claudicação), do equilíbrio e disfunções no controle esfincteriano vesical e anal. Os paraplégicos preservam as funções nos membros superiores e dependem exclusivamente destes para a realização das atividades diárias. As alterações mecânicas no plano sagital na coluna cervical de indivíduos paraplégicos poderiam, deste modo, desencadear precocemente o processo de envelhecimento da coluna cervical levando a sintomas compressivos radiculares e/ou medulares cervicais com uma importante perda de função para estes indivíduos. Objetivo: O objetivo primário deste estudo foi correlacionar o alinhamento da coluna cervical no plano sagital de indivíduos paraplégicos com o nível de lesão neurológica torácica. O objetivo secundário foi caracterizar e comparar as alterações degenerativas radiográficas em diferentes níveis de lesão medular torácica. viii Metodologia: Foi realizada a análise radiográfica da coluna cervical de 12 indivíduos paraplégicos torácicos (9 do sexo masculino e 3 do sexo feminino) com lesão medular há mais de 1 ano (média de 9,1 anos, de 4 a 15 anos). Os indivíduos foram divididos em 2 grupos: 6 apresentavam lesão medular abaixo de T9 e outros 6, acima ou em T8, de acordo com a classificação da American Spinal Injury Association (ASIA). A lordose global, mensurada de C2 a C7 e a lordose local, mensurada para cada nível cervical foram comparadas. Sinais radiográficos de degeneração cervical (diminuição da altura do disco intervertebral, formação de osteófitos e esclerose dos platôs vertebrais) também foram analisados utilizando o método de Gore et al., e os resultados foram comparados entre os grupos. Resultados: O grupo com lesão medular em T8 ou acima apresentou maiores medidas de lordose global (55o ± 5,7o vs 26,2o ± 3,8o, p<0,0001), especialmente nos segmentos C5-C6 (10,7o ± 5,9o vs 1o ± 3,1o, p=0,02) e C6-C7 (18o ± 3,5o vs 4,5o ± 3,6o, p<0,0001). Não foram encontradas diferenças quanto às alterações degenerativas radiográficas entre os grupos em C4-C5 (p=0,16), C5-C6 (p=0,06) e C6-C7 (p=0,31). Conclusão: Este estudo preliminar indica que o nível de lesão medular influencia o alinhamento cervical no plano sagital aumentando a lordose especialmente nos segmentos mais distais e nos indivíduos com lesão medular em T8 ou acima<br>Abstract: Introduction: Spinal cord injury occurs more frequently in males between 15 and 40 years old. The loss of innervation in the segmental musculature of the spine below the level of spinal cord injury modifies the posture of the trunk in these subjects. Consequently, adaptative postural changes occur in the cervical spine predisposing to early degeneration of the intervertebral disc and/or facet joints, osteophyte formation and narrowing of the spinal canal and foramina. The degeneration of the cervical spine, known as cervical spondylosis, is a slow process and its symptoms usually occur after the 5th decade of life, and may result in radicular and/or cord compressions. Radicular compressions may present as radiating pain to the upper extremities, diminished strength and abnormal sensation. Spinal cord compressions, on the other hand, may present as a loss of fine movements in the hands, abnormal gait, impaired balance and dysfunctions in the vesical and anal sphincters. Paraplegics depend on the upper extremities for everyday activities and the development of radicular and/or spinal cord compressive symptoms in these subjects can be devastating. Mechanical changes in the sagittal plane of the cervical spine of paraplegics might result in early degeneration of this segment and an increasing disability for everyday activities over time. Objective: The primary endpoint of this study was to analyse the differences in the cervical spine alignment in paraplegics according to their level of spinal cord injury. The secondary endpoint was to compare degenerative findings on conventional radiographs between two different groups of paraplegics. Participants/methods: Twelve paraplegics (9 males and 3 females) sustaining more than 1 year of injury (average 9,1, from 4 to 15 years) had their sagittal cervical spine x-rays analyzed. They were divided into 2 groups: 6 patients had injuries below T9 and another 6, at or above T8, according to the American Spinal Injury Association (ASIA) classification. The global lordosis, x measured from C2 to C7, and the local lordosis, measured for each level were compared between the groups. Radiographic cervical degeneration (loss of disc height, osteophytes formation and end-plate sclerosis) was also quantified using a previous method described by Gore et al. and compared between the groups. Results: Results indicate that paraplegics sustaining higher spinal cord injuries (at or above T8) have an increased global lordosis (55o ± 5,7o vs 26,2o ± 3,8o, p<0,0001) specially in the lower segments - C5-C6 (10,7o ± 5,9o vs 1o ± 3,1o, p=0,02) and C6-C7 (18o ± 3,5o vs 4,5o ± 3,6o, p<0,0001). No differences were found comparing the radiographic scores for cervical degeneration between the groups at C4-C5 (p=0,16), C5-C6 (p=0,06) and C6-C7 (p=0,31). Conclusion: This preliminary study indicates that the level of spinal cord injury influences the cervical sagittal alignment with an increase in lordosis specially in the lower segments and in subjects with spinal cord injury at or above T8<br>Mestrado<br>Fisiopatologia Cirúrgica<br>Mestre em Ciências
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Beard, Josh R. Petschauer Meredith A. "Cervical spine motion in ice hockey players during a log roll technique." Chapel Hill, N.C. : University of North Carolina at Chapel Hill, 2007. http://dc.lib.unc.edu/u?/etd,1039.
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Thesis (M.A.)--University of North Carolina at Chapel Hill, 2007.<br>Title from electronic title page (viewed Mar. 27, 2008). "... in partial fulfillment of the requirements for the degree of Master of Arts in the Department of Exercise and Sport Science Athletic Training." Discipline: Exercise and Sports Science; Department/School: Exercise and Sport Science.
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Jansen, Neville. "Development of a low imaging signature cervical spine disc arthroplasty / Neville Jansen." Thesis, North-West University, 2010. http://hdl.handle.net/10394/4843.
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Spinal disc replacements have the fundamental goal of pain relief while prolonging lifespan of
adjacent intervertebral discs. This study focuses on reducing magnetic resonance (MR) artefacts,
thereby improving the post–operative imaging qualities of the Kineflex cervical disc arthroplasty.
Magnetic resonance imaging (MRI) is used to evaluate the success of the resulting design, as it
provides the greatest distinction between various cellular types, and is the technique of choice for
spinal diagnosis.
Initial research includes a survey of the most recent findings regarding cervical kinematics, the
pathology of degenerative disc disease, treatments of cervical myelopathy and radiculopathy, and the
complications associated with total disc replacement. The influence of modern imaging techniques
and the properties of common biomaterials are investigated to obtain the basis for development
Reducing the occurrence of MR artefacts is achieved through material selection and design
adaptation. Various biomaterials used in spinal applications are evaluated for their clinical
performance. Smaller artifacts are achieved by replacement of cobalt–chromium–molybdenum
(CCM) of the original device, with a combination of polyether–ether–ketone (PEEK) and titanium
due to a lower magnetic susceptibility
Testing of the device is performed in two phases: verification and validation. The prototype device is
successfully verified by means of MR, computed tomography (CT) and fluoroscopy imaging of a
human cadaver spine with the device in the C5–6 position. Successful verification of the prototype
warranted further development. After reviewing manufacturing techniques, validation is achieved on
a production–ready device to characterise the MR signature of the end product.
Artefact area is reduced from 1842mm² to 242mm², allowing for visibility of both spinal nerve roots
and adjacent intervertebral discs. The spinal canal remains affected by encroachment of artefacts by
2–3mm, but the improvement in imaging signature over the existing CCM device is significant. The
resulting Kineflex product is expected to find considerable application in industry.<br>Thesis (M.Ing. (Mechanical Engineering))--North-West University, Potchefstroom Campus, 2011.
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Golinski, Waldemar Z. "Three-dimensional dynamic modelling of the human cervical spine in whiplash situations." Thesis, Nottingham Trent University, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.324592.
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Cheever, Kelly. "EFFECT OF EXPOSURE TO CONTACT SPORT PARTICIPATION ON CERVICAL SPINE SENSORIMOTOR FUNCTION." Diss., Temple University Libraries, 2018. http://cdm16002.contentdm.oclc.org/cdm/ref/collection/p245801coll10/id/518275.
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Kinesiology<br>Ph.D.<br>Head and neck injuries are common in contact sports. Proper function of the cervical spine sensorimotor system is important in limiting these injuries. Repetitive stress incurred during contact sport participation may negatively affect this system and increase injury risk. Currently, there is a paucity of research examining contact sport exposure and cervical spine sensorimotor function. The purpose of this study was to examine the effect of contact sport participation on cervical sensorimotor function. The independent variables were group (rugby, non-contact), sex (male, female), and time (pre-season, post-season). The primary dependent variable was neck position sense error as measured by total neck reposition (TNRE) error and maximum neck reposition error (MaxNRE). Secondary dependent variables included neck disability index, signs and symptom (S/S) number, symptom severity, concussion history, cervical range of motion, and isometric neck strength. This prospective observational study included forty-nine participants (15 male rugby, 11 female rugby, 11 non-contact male control, 12 non-contact female control) from Temple University campus recreation club sport teams. Athletes participated in two testing sessions, one prior to the season (i.e., pre-season) and one following the season. Data were analyzed using descriptive and inferential statistics. Independent-sample t-tests with Bonferroni corrections were used to assess statistically significant differences in dependent variables at pre-season between groups (Aim 1) and sex (Aim 2). Independent-samples t-tests with Bonferroni correction were also used to explore statistically significant differences in dependent variables change scores from pre-season to post-season between groups (Aim 1). Pearson correlations (r > .60) were used to assess potential covariates but none were identified. Pearson correlations were also used to evaluate the relationship between pre-season maximum and total neck reposition sense error and the following dependent variables: years of contact sport participation, concussion S/S number and severity score, global cervical range of motion and global cervical isometric strength (Aim 3). For Aim 1, between group differences were identified for global cervical isometric strength, t (1, 45) = 2.98, p = .005, and total joint reposition error t (1, 45) = 2.78, p = .008, only. There were no significant change score differences between groups across time. For Aim 2, sex differences were identified in years of contact sport exposure (p = .004), height (p < .001) and global isometric strength (p <.001), only. For Aim 3, preseason concussion S/S number and severity scores were significantly correlated (p < .05) with total joint reposition error (r = .352) and maximum joint reposition error (r = .476). The present study findings indicate a difference in cervical spine sensorimotor function between collegiate club rugby athletes and controls. Specifically, rugby athletes exhibited significantly greater neck reposition sense error than controls. Additionally, concussion S/S scores were related to reposition sense error. Differences in position sense error were not identified between males and females, however females did exhibit less neck strength mirroring previous reports. These findings suggest that exposure to contact sport-related impacts may lead to changes in cervical spine sensorimotor function. These changes are important as they could represent an increased risk of injury and can be modified proactively. A comprehensive cervical spine pre-season examination including concussion S/S and position sense assessments could identify individuals needing preventative intervention. Future research should explore the risk associated with these proprioceptive deficits and the benefits of proactive therapeutic intervention designed to mitigate sensorimotor deficits in contact sport athletes.<br>Temple University--Theses
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Redmond, Colin. "Red flag screening for serious pathology presenting in cervical spine musculoskeletal disorders." Thesis, Queen Margaret University, 2013. https://eresearch.qmu.ac.uk/handle/20.500.12289/7721.
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Aim To develop a list of red flag clinical indicators for possible serious pathology masquerading as, or presenting alongside, neck related musculoskeletal disorders in the adult population. Background Musculoskeletal physiotherapists provide assessment and treatment for pain and functional impairments relating to musculoskeletal disorders, such as back and neck pain. In order to apply safe and effective treatment to these conditions it is vitally important that any underlying serious complaints have been excluded. Clinical indicators known as ‘red flags’ have been developed for diagnostic triage in back pain to help identify serious underlying conditions, such as cancer and infection. Red flags for serious pathology in neck pain or neck related pathology has not received the same level of attention as red flags in back pain. A literature review identified inconsistent evidence for clinical tests and clinical indicators for serious pathology in neck related musculoskeletal disorders. This presents a serious clinical challenge for musculoskeletal physiotherapists. Method A mixed method study design was developed involving: a) Qualitative descriptive method through Physiotherapy focus group; and, b) Three round Delphi survey method involving consultant neurologists and consultant neurosurgeons. The Delphi method involves combined qualitative and quantitative data phases. Thematic content analysis was used to analyse the qualitative data. A combined descriptive and inferential (non-parametric) statistical analysis was used to analyse the quantitative data. Kendall’s W (Kendall’s coefficient of concordance) was used to evaluate the level of consensus across all participants for the quantitative phase of the Delphi method. Findings A list of neck related red flag clinical indicators within five specific categories were developed: 1. progressive pain; 2. cancer, infection, trauma; 3. neurological deficit (spinal cord compromise); 4. headache (associated with neck pain/stiffness); 5. brainstem, cervical arterial and cranial nerve dysfunctions. An increase in Kendall’s W was demonstrated between Rounds 2 and 3 in four out of five categories, indicating an increase in consensus levels between participants. This process highlights the complexity of interpreting clinical features within musculoskeletal presentations.
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Thiel, Haymo Wilhelm. "Chiropractic manipulation of the cervical spine : a prospective study of treatment outcomes." Thesis, University of Portsmouth, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.438816.
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Estes, Bradley T. "A biomechanical analysis of the plates and screws implanted in posterior cervical spine plating via the lateral mass." Thesis, Georgia Institute of Technology, 1993. http://hdl.handle.net/1853/19481.
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Heitplatz, Frank. "Transient numerical investigation into whiplash injury and the effects on the cervical spine." Thesis, Nottingham Trent University, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.285729.
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DeVries, Nicole Ann. "The biomechanics of the sheep cervical spine: an experimental and finite element analysis." Diss., University of Iowa, 2011. https://ir.uiowa.edu/etd/1215.
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Animal models are essential for making the transition from scientific concepts to clinical application. Such models have proven valuable for spinal research. The cervical spine of sheep is often used because there is similar geometry between sheep and human. Although anatomical similarities are important, biomechanical correspondence is imperative to understand the effects of disorders, surgical techniques, and implant designs. Therefore, the purpose of this study was to conduct a comprehensive study of the sheep cervical spine biomechanics, including experimental and finite element analysis. To determine the flexibility of the multilevel spine, ten adult Suffolk sheep C2-C7 spines were tested, undergoing flexion-extension, lateral bending, and axial rotation. In addition to intact multilevel testing, the roles of the stabilizing structures were studied by sequentially destabilizing function spinal units. The sheep spine is highly flexible, especially in lateral bending (±65˚); motion increases with caudal progression. The sheep spine also has a large neutral zone accounting for 50-75% of the total motion. The facets and capsular ligaments play a key role in stabilization, providing the most stability at the C2-C3 level. In addition to flexibility testing, the sheep spinal ligaments underwent tensile testing until failure to determine the material properties. The ligamentum flavum has the largest failure stress and the capsular ligaments have the largest mean failure force. The longitudinal ligaments have the largest failure strain and the lowest failure force. Overall, the C2-C3 ligaments had the highest failure forces as compared to the ligament type at different levels. This corresponds to the stability the ligaments have at the C2-C3 level during flexibility testing. Moreover, a finite element model of the C2-C7 sheep cervical spine was developed and validated to provide additional insight in the sheep biomechanics. The model compared favorably with experimental testing for all loading cases except extension. In general, the model matched the experimental results within one standard deviation for the multilevel motion as well as the motion at each level. Since the sheep is highly flexible and there is a large neutral zone it was difficult to capture the nonlinearity in all loading directions. The model was used to study the effects of fusion at the C3-C4 level. As expected the motion at the fusion was less than one degree, with the non-fused levels accommodating the loss in motion. The motion increased 15-27%, with the largest increase at C6-C7. To obtain the same rotation as the intact model (±2.5 Nm), larger moments were required, increasing to over 5 Nm for flexion and lateral bending and over 3 Nm for extension and axial rotation.
The study provides insight into the sheep cervical spine biomechanics. Researchers and scientists should consider the high flexibility and large neutral zone when designing a study that is to correlate to human spines. The model provides additional details such as stresses in the bone and intervertebral disc that can help researchers determine the effects of different surgical techniques and implant designs. Overall, this study provides valuable biomechanical data that can aid designing preclinical animal studies of the sheep.
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Araujo, Luciane Farias de. "Aplicabilidade de analise corporal e de rocabado na avaliação postural de individuos com e sem disfunção temporomandibular." [s.n.], 2005. http://repositorio.unicamp.br/jspui/handle/REPOSIP/289008.
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Orientador: Francisco Haiter Neto<br>Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba<br>Made available in DSpace on 2018-08-04T03:59:30Z (GMT). No. of bitstreams: 1
Araujo_LucianeFariasde_D.pdf: 1820402 bytes, checksum: 03ccca96db91bba812e586ce3a350bc6 (MD5)
Previous issue date: 2005<br>Resumo: No presente trabalho propõe-se avaliar a existência de evidências clínicas e/ou radiográficas que identifiquem indivíduos com disfunção temporomandibular e da região cervical, bem como avaliar a eficácia da análise corporal computadorizada e da análise cefalométrica de Rocabado no diagnóstico destes pacientes. Para isso, foram avaliadas radiografias cefalométricas de perfil e fotografias de corpo inteiro de 100 pacientes, sendo 50 destes com sinais e sintomas de disfunção temporomandibular e 50 indivíduos assintomáticos, constituindo o grupo controle. A amostra foi selecionada a partir de ficha clínica de documentações ortodônticas em arquivo de uma clínica odontológica da cidade de Recife ¿ PE. Foi realizada
avaliação fisioterapêutica das radiografias e fotografias, para fins de diagnóstico. Análise corporal e de Rocabado foram executadas para averiguação de sua aplicabilidade na detecção de desarmonias posturais da cabeça e dos segmentos corporais. As avaliações fisioterapêuticas diagnosticaram alterações posturais em ambos os grupos, sugerindo não existir associação entre elas e as disfunções temporomandibulares (p>0,05). Valores de Kappa indicaram que, na análise de Rocabado, o índice de curvatura da coluna cervical e o ângulo crânio-cervical apresentaram diagnósticos significantemente equivocados, o mesmo acontecendo com a predição da curva da coluna cervical pela análise fotográfica, não devendo,
portanto, ser aplicados como instrumentos de diagnóstico. As análises corporais frontal, de perfil e de costas mostraram-se confiáveis quanto aos seus resultados, podendo ser utilizada como forma de avaliação de alterações posturais<br>Abstract: The aim of this paper was to evaluate the existence of clinical and/or radiographic evidences that identify patients with temporomandibular dysfunction and cervical region, as well as evaluating the effectiveness of the computerized corporal analysis and the cephalometric analysis of Rocabado in the diagnosis of these patients. In order to this, lateral cephalometric radiography and photographs of the entire body of 100 patients, being 50 of these with signals and symptoms of temporomandibular dysfunction and 50 asymptomatic individuals, constituting the control group. The sample was selected from the clinical information of orthodontic documentations in a file of a Dental clinic of the city of Recife - PE. It was carried
through physiotherapeutic analysis of the x-rays and photographs for diagnosis ends. Corporal analysis and of Rocabado were executed for scertainment of its applicability in the detention of postural disharmony of the head and the corporal segments. The physiotherapeutics evaluations diagnosed postural alterations in both groups, suggesting not to exist association between them and the temporomandibular dysfunction (p>0,05). Values of Kappa indicated the same that, in the analysis of Rocabado, bending of the skull-cervical angle and the index column cervical were ignificantly presented making a diagnostic mistake, happening with the prediction of the curve of the cervical column for the photographic analysis, not having, therefore, to be applied as diagnosis instruments. The frontal corporal analyses of the profile and coasts revealed trustworthy how much to its results, being able to be used as form of evaluation the postural alterations<br>Doutorado<br>Radiologia Odontologica<br>Doutor em Radiologia Odontológica
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Das, Mohammed. "Image analysis techniques for vertebra anomaly detection in X-ray images." Diss., Rolla, Mo. : University of Missouri--Rolla i.e. [Missouri University of Science and Technology], 2008. http://scholarsmine.mst.edu/thesis/MohammedDas_Thesis_09007dcc804c3cf6.pdf.
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Thesis (M.S.)--Missouri University of Science and Technology, 2008.<br>Degree granted by Missouri University of Science and Technology, formerly known as University of Missouri--Rolla. Vita. The entire thesis text is included in file. Title from title screen of thesis/dissertation PDF file (viewed March 24, 2008) Includes bibliographical references (p. 87-88).