title: Functional diagnostics of the cervical spine using computer tomography.
abstract: 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 degrees, and C1/C2 more than 54 degrees could indicate segmental hypermobility, a rotation at the segment C1/C2 less than 29 degrees to hypomobility. According to the postulated normal values based upon a 98% confidence level, out of 137 patients examined after cervical spine injury and with therapy-resistant 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 rotary instability should be considered as a possible therapeutic procedure after successful diagnostic stabilisation of the cervical spine by minerva cast.
authors.affiliation: Department of Neurology and Orthopedic Surgery, Wilhelm Schulthess Hospital, Zurich, Switzerland.
authors.forename: J
authors.initials: J
authors.lastname: Dvorak
authors.forename: L
authors.initials: L
authors.lastname: Penning
authors.forename: J
authors.initials: J
authors.lastname: Hayek
authors.forename: M M
authors.initials: MM
authors.lastname: Panjabi
authors.forename: D
authors.initials: D
authors.lastname: Grob
authors.forename: R
authors.initials: R
authors.lastname: Zehnder
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries* / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed