Cervical spine motion in the sagittal plane: kinematic and geometric parameters

The kinematic function of the cervical spine has been examined previously by means of cineradiography or a sequence of lateral X-rays, usually of a flexion-extension range of motion. Interpretation of these studies, however, presents difficulties. One of the major problems is how to extract information from the X-ray images which is not only explicit, quantitative and accurate, but which is also diagnostically useful. Another problem is that as one increases the number of steps of motion between full flexion and full extension to obtain a more detailed examination, one also increases the amount of radiation exposure and the bulk of the data. Reported here is a technique which uses one lateral-view X-ray for each of five neck positions: full flexion, full extension, and three intermediate positions. From each set of X-rays, various parameters are derived to describe two types of data: kinematic (angles and centers of rotation), and geometric (pattern of curvature). This technique has been shown capable of identifying functional abnormalities in patients with neck pain who have no structural abnormalities detectable by X-ray. Further experience will be useful in better defining various types of functional abnormalities.