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Updated: Jun 17, 2026

Precision Measurements and Parametric Models of Vertebral Endplates
Published on: September 17, 2019
Segmental percentage contributions of cervical spine during different motion ranges of flexion and extension
Shyi-Kuen Wu1, Li-Chieh Kuo, Haw-Chang H Lan
1Department of Physical Therapy, HungKuang University, Taichung, Taiwan.
Study Design:
A blind, repeated-measure design was employed in the study.
Objective:
To quantitatively measure the percentage contribution of segmental angular motion during different motion ranges of cervical flexion-extension for clinical applications and better understanding of cervical biomechanics.
Summary Of Background Data:
Restriction of cervical motion is a major symptom in patients suffering from neck injuries or pathologies. Although segmental angular motion alternation is a criterion for the detection of neck related impairments, the percentage contribution throughout cervical movements is not well understood.
Methods:
A total of 384 image sequences during cervical flexion-extension obtained from 48 healthy adult subjects were analyzed with a precise image protocol using dynamic videofluoroscopic techniques.
Results:
The middle cervical spines demonstrated significantly greater angular percentage contributions at C3/4 (29.89%) and C4/5 (37.14%) angles during the initial 1/3 flexion movement; whereas the lower cervical spines revealed statistically greater angular contributions (C5/6: 22.57% to 29.45%; C6/7: 28.80% to 37.42%) from the middle to final 1/3 ranges of flexion movement (P<0.001). With regard to cervical extension motion, the majority of segmental percentage contributions statistically shifted initially from C5/6 level (30.21%) to C4/5 (24.96%) and C5/6 (26.12%) levels, and finally to the C3/4 (27.55%) and C4/5 (29.77%) segments (P<0.001).
Conclusions:
The segmental percentage contributions in this study might imply that the cervical flexion movement initially relied more on the middle cervical segments and later on the lower ones, whereas a motion pattern trend from lower to middle segments was observed during cervical extension.
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