Kinematic analysis of the relationship between the grade of disc degeneration and motion unit of the cervical spine.
METHODS
Kinetic MRIs of cervical spines were obtained and analyzed according to the amount of motion and the degenerative grade of the intervertebral disc.


OBJECTIVE
To define the relationship between the grade of disc degeneration and the motion unit of the cervical spine and elucidate changes in the role of each cervical spine unit during flexion-extension motion caused by degeneration.


BACKGROUND
Degenerative changes in the cervical disc occur with age. The correlation between the degree of cervical disc degeneration and extent of cervical spine mobility has not yet been determined. The effect of degeneration on the overall motion of the functional spinal unit also remains undefined.


METHODS
We studied 164 patients with symptomatic neck pain. The cervical intervertebral discs were graded by spine surgeons according to the degenerative grading system (Grades I to V). All radiologic data from kinetic MRIs were recorded on a computer for subsequent measurements. All measurements and calculations for translational motion and angular variation of each segment were automatically performed by a computer analyzer.


RESULTS
The translational motion in discs with Grade II degeneration (mild degeneration) increased to Grade III degeneration (higher degeneration). However, the translational motion and angular variation significantly decreased for the Grade V (severe degeneration). For patients with relatively low grades of degeneration, Grades I and II discs, the C4-C5 and C5-C6 segmental units contributed the majority of total angular mobility of the spine. However, for the severely degenerated segments, Grade V discs, the contributions of the C4-C5 and C5-C6 U significantly decreased.


CONCLUSIONS
The changes that occur with disc degeneration progress from the normal state to an unstable phase with higher mobility and subsequently to an ankylosed stage. This study evaluated the contribution of different levels to the changes in overall motion that occur with degeneration.
Miyazaki
Masashi
M
Department of Orthopaedic Surgery, University of California at Los Angeles, Los Angeles, CA, USA.
Hong
Soon Woo
SW
Yoon
Seung Hwan
SH
Zou
Jun
J
Tow
Benjamin
B
Alanay
Ahmet
A
Abitbol
Jean-Jacques
JJ
Wang
Jeffrey C
JC
D001696:Biomechanical Phenomena / Q000379:methods; D002574:Cervical Vertebrae / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007405:Intervertebral Disc Displacement / Q000145:classification / Q000175:diagnosis* / Q000503:physiopathology; D007593:Joint Instability / Q000473:pathology / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D009068:Movement; D019547:Neck Pain / Q000175:diagnosis* / Q000503:physiopathology; D015588:Observer Variation; D018583:Pliability; D016059:Range of Motion, Articular; D015203:Reproducibility of Results