• Taylor Brown, Charles A Reitman, Lyndon Nguyen, and John A Hipp.
• Department of Orthopedic Surgery, Baylor College of Medicine, Houston, TX, USA.
• Spine. 2005 Sep 1; 30 (17): E503-8.

Study DesignCompare intervertebral motion after incremental damage to posterior cervical structures in whole cadavers to motion in asymptomatic subjects.ObjectiveDetermine if damage to the posterior structures of the cervical spine can be detected by quantitative analysis of flexion-extension radiographs.Summary Of Background DataSimulated damage to the posterior structures of the cervical spine can change intervertebral motion, if intervertebral motion before damage is known. It is not known if intervertebral motion measured from flexion-extension radiographs can be used to detect damage to the posterior structures if motion before damage is not known.MethodsIncremental injury to posterior ligaments and facet joints was simulated in 12 whole cadavers. Intervertebral motion was measured from flexion-extension images using validated and clinically applicable software. Measurements were compared to previously published measurements for asymptomatic subjects.ResultsExtensive damage could be simulated in all the cervical spines without intervertebral motion exceeding the 95% confidence limits for asymptomatic subjects. After sectioning all posterior ligaments, destroying both facet joints, and then sectioning the posterior longitudinal ligaments, intervertebral motion exceeded the 95% confidence intervals in 69% of the cadavers. Intervertebral shear decreased with incremental damage to posterior structures.ConclusionsRadiographic assessment of the cervical spine may not be sufficient to exclude even extensive damage to the posterior structures of the cervical spine.

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