Highlights
- •Atlantoaxial rotation and cervical spine rotation significantly decrease with age.
- •Females have higher values of cervical spine rotation compared to males.
- •Atlantoaxial and cervical spine rotation have different sex-based dynamics.
Abstract
BACKGROUND CONTEXT
Physiological ranges and dynamic changes of atlantoaxial rotation (ROTC1/2), total cervical spine rotation (ROTCs) and the percentage of ROTC1/2 from ROTCs (ROTCperc) for different age groups have not yet been investigated in a sufficiently sized
cohort. Furthermore, it is not clear whether demographic variables such a sex, smoking
status or diabetes affect ROTC1/2, ROTCs and ROTCperc.
PURPOSE
Obtain physiological ranges of ROTC1/2, ROTCs and ROTCperc for different age groups and determine their age-based dynamics. Investigate whether
ROTC1/2, ROTCs and ROTCperc are affected by sex, smoking status or diabetes
DESIGN
Observational cross-sectional study
PATIENT SAMPLE
Patients undergoing elective CT examinations of the head and neck region between August
2020 and January 2022.
OUTCOME MEASURES
Ranges of motion of ROTC1/2, ROTCs and ROTCperc in degrees
METHODS
A total of 308 subjects underwent dynamic rotational CT examinations of the upper
cervical spine. Patients were divided into three age categories A1 (27-49 years),
A2 (50-69 years) and A3 (≥70 years). Category A3 was further divided into B1 (70-79
years) and B2 (≥80 years). Values of ROTC1/2, ROTCs and ROTCperc were compared between all age groups, males and females, smokers and nonsmokers,
diabetics a nondiabetics. Dynamics of ROTC1/2, ROTCs related to age and sex were visualized using scatterplot and trendline models.
RESULTS
ROTC1/2 significantly decreased from group A1 (64.4°) to B2 (46.7°) as did ROTCs from A1 (131.2°) to B2 (97.6°). No significant differences of ROTperc were found between groups A1-B2 with values oscillating between 49% and 51%. Smoking
and diabetes did not significantly affect ROTC1/2, ROTCs and ROTCperc, females had significantly higher ROTCs than males. Males and females demonstrated a different dynamic of ROTC1/2 and ROTCs demonstrated by out scatterplot and trendline models.
CONCLUSIONS
Both ROTC1/2 and ROTCs significantly decrease with age, whereas ROTCperc remains stable. Females demonstrated higher ROTCs and their decrease of ROTC1/2 and ROTCs occurred in higher age groups compared to males. The functional repercussions atlantoaxial
fusion are variable based on patient age and sex and should be taken into account
prior to surgery.
Graphical abstract
Graphical Abstract
Keywords
Abbreviations:
C1/2 (Atlantoaxial), ROTC1/2 (Atlantoaxial rotation), ROTCs (total cervical spine rotation), ROTperc (percentage of atlantoaxial rotation from total cervical spine rotation), ROM (range of motion)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: May 11, 2023
Accepted:
May 8,
2023
Received in revised form:
April 28,
2023
Received:
March 19,
2023
Publication stage
In Press Journal Pre-ProofFootnotes
FDA device/drug status: Not applicable.
Author disclosures: JN: Grants: Internal Grant Agency Krajska Zdravotni a.s.- 2020-1-3 (B). JT: Grants: Internal Grant Agency Krajska Zdravotni- 2020-1-3 (B). FC: Nothing to disclose. MS: Grants: Internal Grant Agency Krajska Zdravotni a.s.- 2020-1-3 (A). JC: Nothing to disclose. PV: Grants: Internal Grant Agency Krajska Zdravotni a.s.- 2020-1-3 (B).
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