Kinematic Analysis of the Cervical Cord and Cervical Canal by Dynamic Neck Motion

Study DesignNormal cervical sagittal length patterns were measured by magnetic resonance imaging (MRI).PurposeThe aim of this study was to evaluate the relationship of sagittal length patterns between the cervical cord and the cervical canal in flexion-extension kinematics.Overview of LiteratureCervical dynamic factors sometimes cause a cervical spondylotic myelopathy in elderly subjects and an overstretching myelopathy in juvenile subjects. Previous studies showed the length changing of the cervical cord in flexion and extension. However, there is no detailed literature about the relationship between cervical vertebral motion and cord distortion yet.MethodsSixty-two normal subjects (28 male and 34 female, 42.1±8.5 years old) without neck motion disturbances and abnormalities on cervical X-ray and MRI were enrolled in this study.ResultsThe cervical cord length was significantly longer in flexion and significantly shorter in extension in all cervical cord sagittal lines. The cervical canal length pattern was also the same as the cervical cord. The elongation of the cervical cord and canal was the largest at the site of the posterior cervical canal and the shortest at the anterior canal site. The positions of the cerebellar tonsils were verified at each neck position.ConclusionsThe posterior elements of the cervical canal were most affected by neck motion. Movement directions of the upper cervical cord were verified among the various neck positions