Canal geometry changes associated with axial compressive cervical spine fracture.
METHODS
A laboratory study using isolated ligamentous human cadaveric cervical spines to investigate canal occlusion during (transient) and after (steady-state) axial compressive fracture.


OBJECTIVE
To determine whether differences exist between transient and postinjury canal occlusion under axial compressive loading, and to examine the effect of loading rate on canal occlusion.


BACKGROUND
Prior studies have shown no correlation between neurologic deficit and canal occlusion measurements made on radiographs and computed tomography scans. The authors hypothesized that postinjury radiographic assessment does not provide an appreciation for the transient occlusion that occurs during the traumatic fracture event, which may significantly affect the neurologic outcome.


METHODS
Twelve human cervical spines were instrumented with a specially designed canal occlusion transducer, which dynamically monitored canal occlusion during axial compressive impact. Six specimens were subjected to a fast-loading rate (time to peak load, approximately 20 msec), and the other six were subjected to a slow-loading rate (time to peak load, approximately 250 msec). After impact, two different postinjury canal occlusion measurements were performed.


RESULTS
Each of the six specimens subjected to the fast-loading rate incurred burst fractures, whereas the slow-loading rate produced six wedge-compression fractures. For the fast-rate group, the postinjury occlusion-measurements were significantly smaller than the transient occlusion. In contrast, transient occlusion was not found to be significantly different from postinjury occlusion in the slow-rate group. All of the comparisons between loading rate groups showed significant differences, with the fast-rate fractures producing larger amounts of canal occlusion in every category.


CONCLUSIONS
The findings indicate that even if canal occlusion could be measured immediately after axial compressive trauma, the measurement would underestimate the maximal amount of transient canal occlusion. Therefore, postinjury measurement of canal occlusion may indicate a smaller degree of neurologic deficit than what might be expected if the transient occlusion could be measured.
Carter
J W
JW
Harborview Biomechanics Laboratory, Department of Orthopedics, University of Washington, Seattle, USA. jcarter@u.washington.edu
Mirza
S K
SK
Tencer
A F
AF
Ching
R P
RP
D000368:Aged; D000369:Aged, 80 and over; D001696:Biomechanical Phenomena; D002102:Cadaver; D002574:Cervical Vertebrae / Q000293:injuries*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013115:Spinal Canal / Q000000981:diagnostic imaging / Q000503:physiopathology*; D013119:Spinal Cord Injuries / Q000209:etiology / Q000503:physiopathology; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000503:physiopathology*; D018709:Statistics, Nonparametric; D013314:Stress, Mechanical; D014057:Tomography, X-Ray Computed; D014159:Transducers