César Hidalgo-García1, Ana I Lorente2, Jacobo Rodríguez-Sanz3, José Miguel Tricás-Moreno3, Mathias Simon4, Mario Maza-Frechín2, Carlos Lopez-de-Celis5, John Krauss6, Albert Pérez-Bellmunt4. 1. Researching Unit of Physiotherapy, University of Zaragoza, Spain. Electronic address: hidalgo@unizar.es. 2. Impact Laboratory, Aragón Institute of Engineering Research, University of Zaragoza, Spain. 3. Researching Unit of Physiotherapy, University of Zaragoza, Spain. 4. Anatomy Unit, Department of Basic Areas, Universitat Internacional de Catalunya (Barcelona), Spain. 5. Anatomy Unit, Department of Basic Areas, Universitat Internacional de Catalunya (Barcelona), Spain; Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Barcelona, Spain. 6. School of Health Sciences, Oakland University, Rochester, MI, USA.
Abstract
BACKGROUND: The side-bending stress test is a pre-manipulative screening test for assessing upper cervical instability. To our knowledge, there is no study that simulates the clinical application of side bending stress test before and after alar ligament transection with fixation of C2. OBJECTIVE: To simulate the effect of alar ligament transection in the side bending stress test for an in vitro validation. DESIGN: In vitro study. METHODS: After the dissection of the superficial structures to the alar ligament and the fixation of C2, ten cryopreserved upper cervical spines were manually mobilized in right and left lateral flexion with and without right alar ligament transection. Upper cervical lateral flexion range of motion and mobilization force were measured with the Vicon motion capture system and a load cell respectively. RESULTS: The right alar ligament transection increased the upper cervical spine (UCS) range of motion (ROM) in both side bendings (1.30°±1.54° and 1.88°±1.51° increase for right and left side bending respectively). As an average, with standardized forces of 2N, 4N and 6N, right alar ligament transection increased both right and left lateral flexion UCS ROM. CONCLUSION: This in vitro study simulates the clinical application of the side bending stress test with intact and right transected alar ligament. Unilateral transection of the alar ligament revealed a predominantly bilateral increase in upper cervical side bending and variability in the mobilization force applied during the test.
BACKGROUND: The side-bending stress test is a pre-manipulative screening test for assessing upper cervical instability. To our knowledge, there is no study that simulates the clinical application of side bending stress test before and after alar ligament transection with fixation of C2. OBJECTIVE: To simulate the effect of alar ligament transection in the side bending stress test for an in vitro validation. DESIGN: In vitro study. METHODS: After the dissection of the superficial structures to the alar ligament and the fixation of C2, ten cryopreserved upper cervical spines were manually mobilized in right and left lateral flexion with and without right alar ligament transection. Upper cervical lateral flexion range of motion and mobilization force were measured with the Vicon motion capture system and a load cell respectively. RESULTS: The right alar ligament transection increased the upper cervical spine (UCS) range of motion (ROM) in both side bendings (1.30°±1.54° and 1.88°±1.51° increase for right and left side bending respectively). As an average, with standardized forces of 2N, 4N and 6N, right alar ligament transection increased both right and left lateral flexion UCS ROM. CONCLUSION: This in vitro study simulates the clinical application of the side bending stress test with intact and right transected alar ligament. Unilateral transection of the alar ligament revealed a predominantly bilateral increase in upper cervical side bending and variability in the mobilization force applied during the test.
Authors: Jacobo Rodríguez-Sanz; Miguel Malo-Urriés; María Orosia Lucha-López; Jaime Corral-de-Toro; Vanessa González-Rueda; Carlos López-de-Celis; Albert Pérez-Bellmunt; César Hidalgo-García Journal: Life (Basel) Date: 2022-05-11
Authors: César Hidalgo-García; Ana I Lorente; Carlos López-de-Celis; Orosia Lucha-López; Miguel Malo-Urriés; Jacobo Rodríguez-Sanz; Mario Maza-Frechín; José Miguel Tricás-Moreno; John Krauss; Albert Pérez-Bellmunt Journal: Sci Rep Date: 2021-05-25 Impact factor: 4.379