• Matthijs A
• Matthijs OCG
• Windisch GC
• Kerner AM
• Streitmayer BG
• Sizer PS
• Brismée JM

• Atlanto-Axial Joint
• Cervical Vertebrae / physiology
• Flexion
• Open Access Document
• Range of Motion, Articular
• Tomography, X-Ray Computed / methods

Objective: The purpose of this study was to assess (1) intrarater reliability of cervical rotation in the transverse plane (CRTP) range of motion (ROM) in the cervical neutral position and at the end-ROM right cervical lateral flexion position using computed tomography (CT) scans and (2) segmental (C0-C7) CRTP ROM in cervical neutral and end-ROM cervical lateral flexion positions to determine whether CRTP in prepositioned cervical lateral flexion mainly assesses C1-C2 mobility.

Methods: In this cadaveric investigation, Thiel-embalmed cadaveric specimens were used to assess (1) intrarater reliability of C1-C2 segmental CRTP in neutral and end-ROM cervical lateral flexion positions using CT scans and (2) total available CRTP and cervical segmental contribution in cervical neutral and end-ROM cervical lateral flexion prepositions.

Results: Ten cadavers aged 80.8 ± 12.2 years were used. CT scan measurements showed high intrarater reliability with an intraclass correlation coefficient (3,1) ≥0.99. End-ROM cervical lateral flexion prepositioning decreased the total available CRTP by 44% compared with CRTP in a neutral position (P ≤ .01). In end-ROM cervical lateral flexion prepositioning, 89% of the total available CRTP occurred at C1-C2, 10% at C0-C1, and only 1% at C2-C7. Hence, cervical lateral flexion prepositioning almost excluded all cervical disc segments for CRTP.

Conclusions: Cervical lateral flexion prepositioning prioritizes C1-C2 movement assessment during cervical axial rotation by reducing motion in the other cervical segments.

Author keywords: Atlanto-Axial Joint; Cervical Vertebrae; Range of motion; Rotation; Spine. 

This abstract is reproduced with the permission of the publisher; full text is available by subscription. Click on the above link for free full text at the publisher's site.