• Musculoskelet Sci Pract · Apr 2020

    Effect of alar ligament transection in side-bending stress test: A cadaveric study.

    • César Hidalgo-García, Ana I Lorente, Jacobo Rodríguez-Sanz, Miguel Tricás-MorenoJoséJResearching Unit of Physiotherapy, University of Zaragoza, Spain., Mathias Simon, Mario Maza-Frechín, Carlos Lopez-de-Celis, John Krauss, and Albert Pérez-Bellmunt.
    • Researching Unit of Physiotherapy, University of Zaragoza, Spain. Electronic address: hidalgo@unizar.es.
    • Musculoskelet Sci Pract. 2020 Apr 1; 46: 102110.

    BackgroundThe 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.ObjectiveTo simulate the effect of alar ligament transection in the side bending stress test for an in vitro validation.DesignIn vitro study.MethodsAfter 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.ResultsThe 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.ConclusionThis 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.Copyright © 2020 Elsevier Ltd. All rights reserved.

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