Three dimensional in vivo movement of cervical vertebrae during functional loadin

功能负荷过程中颈椎的三维体内运动

• 批准号: 8033682
• 负责人: William J. Anderst
• 金额: $ 7.2万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-04-21 至 2013-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8033682
• 关键词: Affect; Age; Anterior; Articular Range of Motion; Cervical; Cervical spine; Clinical; Data; Data Collection; Diagnosis; Diagnostic; Disease; Functional disorder; Height; Image; Intervention; Intervertebral disc structure; Joints; Knowledge; Lateral; Lead; Magnetic Resonance Imaging; Measurement; Measures; Mechanics; Modeling; Motion; Movement; Muscle; Neck; Operative Surgical Procedures; Outcome; Pain; Patients; Pattern; Positioning Attribute; Public Health; Questionnaires; Relative (related person); Reporting; Rotation; Spinal; Staging; Stress; Surface; Surgeon; Surveys; Symptoms; System; Techniques; Testing; Time; Torsion; Translations; Vertebral column; base; bone; disability; functional restoration; improved; in vivo; intervertebral disk degeneration; kinematics; millimeter; operation; spine bone structure; tool

DESCRIPTION (provided by applicant): Project Summary Anterior cervical fusion surgery effectively restores function and alleviates pain due to degenerative spine disease. However, the degeneration of motion segments adjacent to the fused cervical vertebrae (adjacent segment disease) is a concern for patients and surgeons. It has been proposed that mechanical factors, including excessive stress applied to adjacent motion segments, drive the progression of adjacent segment disease. Improved understanding of these mechanical factors associated with adjacent segment disease can best be obtained through collecting data in vivo during a variety of functional loading tasks. We propose to study the effects of cervical fusion on adjacent segment motion using a unique biplane radiographic imaging system capable of characterizing in vivo motion during functional loading. The biplane radiographic system will collect x-ray data at 50 frames per second as subjects perform cervical flexion/extension, lateral bending and axial rotation movements. Three-dimensional bone motion will be accurately measured using both a dynamic RSA technique (bead-based tracking) and a validated markerless technique (model-based tracking). Anterior cervical fusion subjects will perform movement tests two times following surgery (6-9 months and 24 months post-surgery) to assess changes in overall vertebral motion (bone kinematics) and changes in relative motion between vertebral endplates (arthrokinematics) over time. Data collection during movement will allow us to quantify the dynamic stability/instability of the cervical spine throughout the range of motion. Arthrokinematic measurements of vertebral endplates will allow us to infer mechanical loading conditions applied to intervertebral discs (compression, shear, torsion) during functional loading. Fusion subject's vertebral movements will be compared to asymptomatic, age-matched control subject's vertebral movements. The proposed study will be the first to record precise, three-dimensional, in vivo movement of cervical vertebrae in asymptomatic subjects and anterior fusion patients. The first aim of the study is to identify specific kinematic and arthrokinematic measurements that differentiate between asymptomatic subjects and single- level anterior fusion patients during in vivo functional loading. The second aim is to identify changes in cervical vertebrae kinematics and arthrokinematics over time in the fusion patients. Finally, changes in fusion group kinematics and arthrokinematics will be correlated with patient outcome survey results and standard clinical measures of degenerative disc disease/spinal instability in order to relate abnormal vertebral movement to patient symptoms and clinical findings. Knowledge acquired from this study may lead to improved diagnosis and treatment for patients afflicted with degenerative spine disease. PUBLIC HEALTH RELAVANCE: Project Narrative It has been reported that between 16% (Ishihara, 2004) and 25% (Hilibrand, 1999) of patients who have surgery to alleviate degenerative spine disease have new disease within 10 years of the operation. Abnormal spine movement following surgery may increase stress on adjacent portions of the spine and cause further spine degeneration. This project aims to identify abnormal neck bone movement that may be associated with degenerative spine disease following spine surgery.

描述（由申请人提供）： 项目摘要前宫颈融合手术有效地恢复了功能，并减轻了由于脊柱疾病的退化性疼痛。然而，与融合颈椎相邻的运动片段的变性（相邻段疾病）是患者和外科医生的关注点。已经提出，机械因素，包括适用于相邻运动段的过度压力，推动了相邻段疾病的进展。最好通过在各种功能加载任务中在体内收集数据来提高对与邻近段疾病相关的这些机械因素的了解。我们建议使用能够在功能载荷过程中表征体内运动的独特双翼射线照相成像系统来研究宫颈融合对相邻段运动的影响。双翼飞机射线照相系统将以每秒50帧的速度收集X射线数据，因为受试者执行宫颈屈曲/伸展，横向弯曲和轴向旋转运动。三维骨运动将使用动态RSA技术（基于珠子的跟踪）和经过验证的无标记技术（基于模型的跟踪）精确测量。手术后两次（手术后6-9个月和24个月）进行两次运动测试，以评估整体椎骨运动（骨运动学）的变化以及随着时间的推移椎骨终结物（关节动物）之间的相对运动的变化。运动过程中的数据收集将使我们能够在整个运动范围内量化颈椎的动态稳定性/不稳定。椎骨终结物的关节化测量将使我们能够推断出在功能载荷期间应用于椎间盘（压缩，剪切，扭转）的机械加载条件。融合受试者的椎骨运动将与无症状的，年龄匹配的对照受试者的椎骨运动进行比较。拟议的研究将是第一个记录颈椎骨和前融合患者的精确，三维的体内体内运动。该研究的第一个目的是确定特定的运动学和关节化测量值，这些测量在体内功能载荷期间区分无症状受试者和单层融合患者。第二个目的是确定融合患者随着时间的流逝而随着时间的流逝而变化的颈椎运动学和节肢动物的变化。最后，融合组运动学和关节化学的变化将与患者结果调查结果和退行性椎间盘疾病/脊柱不稳定性的标准临床指标相关，以便将异常的椎骨运动与患者症状和临床发现联系起来。从这项研究中获得的知识可能会导致患有退行性脊柱疾病的患者的诊断和治疗改善。 公共卫生照： 据报道，项目的叙述是，在手术后10年内，有16％（Ishihara，2004年）和25％（Hilibrand，1999）的患者患有手术以减轻退行性脊柱疾病的患者。手术后的脊柱运动异常可能会增加脊柱相邻部分的压力，并导致脊柱变性。该项目旨在确定脊柱手术后可能与退行性脊柱疾病有关的异常颈部骨运动。

项目成果

Sensitivity, reliability and accuracy of the instant center of rotation calculation in the cervical spine during in vivo dynamic flexion-extension.

• DOI: 10.1016/j.jbiomech.2012.11.055
• 发表时间: 2013-02-22
• 期刊: Journal of biomechanics
• 影响因子: 2.4
• 作者: Baillargeon E;Anderst WJ
• 通讯作者: Anderst WJ

In Vivo Changes in Dynamic Adjacent Segment Motion 1 Year After One and Two-Level Cervical Arthrodesis.

一级和二级颈椎融合术一年后动态相邻节段运动的体内变化。

• DOI: 10.1007/s10439-022-02964-7
• 发表时间: 2022
• 期刊: Annals of biomedical engineering
• 影响因子: 3.8
• 作者: LeVasseur,ClarissaM;Pitcairn,SamuelW;Okonkwo,DavidO;Kanter,AdamS;Shaw,JeremyD;Donaldson,WilliamF;Lee,JoonY;Anderst,WilliamJ
• 通讯作者: Anderst,WilliamJ

Assessing the biofidelity of in vitro biomechanical testing of the human cervical spine.

• DOI: 10.1002/jor.24702
• 发表时间: 2021-06
• 期刊: Journal of orthopaedic research : official publication of the Orthopaedic Research Society
• 作者: Wawrose RA;Howington FE;LeVasseur CM;Smith CN;Couch BK;Shaw JD;Donaldson WF;Lee JY;Patterson CG;Anderst WJ;Bell KM
• 通讯作者: Bell KM

Cervical motion segment percent contributions to flexion-extension during continuous functional movement in control subjects and arthrodesis patients.

• DOI: 10.1097/brs.0b013e318289378d
• 发表时间: 2013-04-20
• 期刊: Spine
• 影响因子: 3
• 作者: Anderst WJ;Donaldson WF 3rd;Lee JY;Kang JD
• 通讯作者: Kang JD

Motion path of the instant center of rotation in the cervical spine during in vivo dynamic flexion-extension: implications for artificial disc design and evaluation of motion quality after arthrodesis.

• DOI: 10.1097/brs.0b013e31828ca5c7
• 发表时间: 2013-05-01
• 期刊: Spine
• 影响因子: 3
• 作者: Anderst W;Baillargeon E;Donaldson W;Lee J;Kang J
• 通讯作者: Kang J