Cervical Spine Research Articles

Do class III obese patients achieve similar outcomes and satisfaction to nonobese patients following surgery for cervical myelopathy? A QOD study.

The aim of this study was to compare the rate of achievement of the minimal clinically important difference (MCID) in patient-reported outcomes (PROs) and satisfaction between cervical spondylotic myelopathy (CSM) patients with and without class III obesity who underwent surgery. The authors analyzed patients from the 14 highest-enrolling sites in the prospective Quality Outcomes Database CSM cohort. Patients were dichotomized based on whether or not they were obese (class III, BMI ≥ 35 kg/m2). PROs including visual analog scale (VAS) neck and arm pain, Neck Disability Index (NDI), modified Japanese Orthopaedic Association (mJOA), EQ-5D, and North American Spine Society patient satisfaction scores were collected at baseline and 24 months after cervical spine surgery. Of the 1141 patients with CSM who underwent surgery, 230 (20.2%) were obese and 911 (79.8%) were not. The 24-month follow-up rate was 87.4% for PROs. Patients who were obese were younger (58.1 ± 12.1 years vs 61.2 ± 11.6 years, p = 0.001), more frequently female (57.4% vs 44.9%, p = 0.001), and African American (22.6% vs 13.4%, p = 0.002) and had a lower education level (high school or less: 49.1% vs 40.8%, p = 0.002) and a higher American Society of Anesthesiologists grade (2.7 ± 0.5 vs 2.5 ± 0.6, p < 0.001). Clinically at baseline, the obese group had worse neck pain (VAS score: 5.7 ± 3.2 vs 5.1 ± 3.3), arm pain (VAS score: 5.4 ± 3.5 vs 4.8 ± 3.5), disability (NDI score: 42.7 ± 20.4 vs 37.4 ± 20.7), quality of life (EQ-5D score: 0.54 ± 0.22 vs 0.56 ± 0.22), and function (mJOA score: 11.6 ± 2.8 vs 12.2 ± 2.8) (all p < 0.05). At the 24-month follow-up, however, there was no difference in the change in PROs between the two groups. Even after accounting for relevant covariates, no significant difference in achievement of MCID and satisfaction was observed between the two groups at 24 months. Despite the class III obese group having worse baseline clinical presentations, the two cohorts achieved similar rates of satisfaction and MCID in PROs. Class III obesity should not preclude and/or delay surgical management for patients who would otherwise benefit from surgery for CSM.

Inverse kinematics in cervical spine models: Effects of scaling and model degrees of freedom for extension and flexion movements

Intervertebral kinematics can affect model-predicted loads and strains in the spine; therefore knowledge of expected vertebral kinematics error is important for understanding the limitations of model predictions. This study addressed how different kinematic models of the neck affect the prediction of intervertebral kinematics from markers on the head and trunk. Eight subjects executed head and neck extension-flexion motion with simultaneous motion capture and biplanar dynamic stereo-radiography (DSX) of vertebrae C1-C7. A generic head and neck model in OpenSim was scaled by marker data, and three versions of the model were used with an inverse kinematics solver. The models differed according to the number of independent degrees of freedom (DOF) between the head and trunk: 3 rotational DOF with constraints defining intervertebral kinematics as a function of overall head-trunk motion; 24DOF with 3 independent rotational DOF at each level, skull-T1; 48DOF with 3 rotational and 3 translational DOF at each level. Marker tracking error was lower for scaled models compared to generic models and decreased as model DOF increased. The largest mean absolute error (MAE) was found in extension-flexion angle and anterior-posterior translation at C1-C2, and superior-inferior translation at C2-C3. Model scaling and complexity did not have a statistically significant effect on most error metrics when corrected for multiple comparisons, but ranges of motion were significantly different from DSX in some cases. This study evaluated model kinematics in comparison to gold standard radiographic data and provides important information about intervertebral kinematics error that are foundational to model validity.

Ventral Slot Surgery for Management of Ganglioneuroma and IVDD in a Cat

Abstract A Shorthair castrated 8-year-old tomcat was brought to a veterinary hospital for slowly progressive onset of tetraplegia developing within last 14 days. The clinical and blood examinations at admission showed no abnormalities, the neurological examination showed severe cervical pain and tetraplegia with lower motor neuron deficits on thoracic limbs and normal withdrawal with increased patellar reflexes on pelvic limbs. Deep pain perception was present on all four limbs. The neuroanatomic localisation was C6-T2 lesion. Magnetic resonance imaging of the cervical spine demonstrated severe spondylosis deformans, degeneration of multiple IVD, and ventral extradural right sided spinal cord compression at the level C7-T1. Mildly hyperintense on T2-weighted and STIR, mildly hypointense on T1-weighted pre-contrast, and homogeneously contrast-enhancing mass on T1-weighted post-contrast images was observed at this area. This article describes an interesting case of a tumor in a cat localised in the cervicothoracic spinal segment extradurally compressing the spinal cord and causing severe neurological dysfunction. These clinical symptoms were successfully treated through a ventral slot surgery, the tumor was well circumscribed and comfortably removable through this approach. This rare tumor is considered benign and prognosis is favourable after surgical removal due to its non-invasive growth pattern. After surgery, the cat was observed continuously for a few months and the recovery was sufficient with no recurrence of neurological symptoms by now. This case is worth attention mainly because, despite the serious clinical presentation, it has a good long term prognosis and does not require a complex surgical approach.

Observational Study of the Clinical Impact of E-scooter Injuries at a Major Trauma Centre.

Background Due to the increased use of e-scooters in the UK, associated injuries have increased, and its cost has increased as well. Worldwide data on injuries related to e-scooter use are relatively limited, owing to the short duration since their first introduction to the public. Aim There has been an increase in using e-scooters as a method of transport recently. It was noticed that the severity and frequency of its injuries are increasing as well. This study focuses on the frequency of e-scooter-associated injuries, especially open fractures, and to evaluate its burden on the health system. Methods Data on e-scooter injuries were extracted from our trauma database from November 2017 to July 2022. Patients' notes and images were reviewed. Outcome measures were the type of injuries: site of bony fractures, closed vs. open fracture (using Anderson and Gustilo classification), number of operations, complications, and length of hospital stay. Results The number of patients enrolled was 104. The mean age was 34.3 years, and 78.8% (n = 82) were male. The main mechanism of injury was riding (91%, n = 95) vs. hitting by an e-scooter (9%, n = 9). Injured patients were more likely not to wear helmets (82% of total injured patients). Patients with bony injuries were 65.4% (n = 68), with 22.1% (n = 15) of them being open fractures. The most common bony injuries were lower limb-only fractures at 45.6% (n = 31), then upper limb-only injuries at 39.7% (n = 27). Combined upper and lower limb cases were 8.8% (n = 6), and pelvic injuries were 5.9% (n = 4). Head and neck injuries composed 23.1% (n = 24) of the reported injuries, including intracranial haemorrhages (9.6%, n = 10), extensive traumatic brain injury (3.8%, n = 4), haematoma/lacerations (3.8%, n = 4), cervical spine fractures (1.9%, n = 2), and skull fractures (1.9%, n = 2). The mean duration of hospital stay was 8.6 days, and 9.6% (n = 10) of patients needed intensive therapy unit(ITU) admission. The number of patients presented as trauma calls was 55.8% (n = 58). Patients who needed surgical intervention either under orthopaedics or other specialties were 52.9% (n = 55) and 21.2% (n = 22) of total patients had complications either due to surgical intervention or a long hospital stay. Conclusion E-scooter riding can lead to serious injuries that can end with limb- or life-threatening conditions. The most common demographic characteristics were adults in their early 30s. There should be more emphasis on wearing protective gear like wrist and elbow guards in addition to helmets. Future prospective studies with larger cohorts across multiple regions and hospitals are necessary to truly characterize the nature and cost of e-scooter injuries.

Ultrasound-guided pulsed radiofrequency of the greater occipital nerve in chronic migraine; proximal approach versus distal approach, a single-blind, randomized controlled trial

Background &amp; Objective: Ultrasound-guided pulsed radiofrequency treatment of the greater occipital nerve can be used at distal and proximal levels of the greater occipital nerve in patients with chronic migraine. We aimed to evaluate the treatment efficacy, procedure duration, and pain experienced during the procedure for both methods. Methods: In the study, 60 chronic migraine patients randomly divided into two groups using a computer programme were evaluated. In the proximal group, the greater occipital nerve was accessed at the level of the 2nd cervical vertebra, while in the distal group it was accessed at the level of the protuberencia occipitalis. Patients completed the Migraine Disability Rating Scale, Visual Analogue Scale and a headache diary before treatment as well as at 1 month and 3 months afterwards. The time from the beginning of the intervention to the spread of the stimulus to the C2 dermatome during the sensory stimulation test was recorded. Patients were asked to rate their pain during the procedure using a Visual Analogue Scale. Results: The Visual Analog Scale scores and headache frequencies were significantly decreased in both the proximal group and distal group (p&lt;0.001). The procedure time was shorter (p&lt;0.001) and was less painful in the distal group (p&lt;0.001). Conclusions: In this study, we observed that pulsed radiofrequency of both distal and proximal levels of the greater occipital nerves effectively treated migraine. A shorter procedure time and superior patient tolerability make the distal stimulation the procedure of choice.

The impact of increased computer screen time during the COVID-19 pandemic on the occurrence of upper part of musculoskeletal diseases among health personnel

Health personnel who played a key role in the fight against the pandemic stayed during it burdened with increased working time using a computer. We analyzed the impact of increased computer working time during the COVID-19 pandemic on the occurrence of the upper part of musculoskeletal diseases among health personnel. The study group consisted of 418 health personnel, divided according to the time they worked at the computer during the pandemic: up to 2 h a day, from 3 to 5 h a day, and more than 6 h a day. The ICF profile analyzed symptoms of dysfunction of structures of the upper part of the musculoskeletal system (head and cervical spine, shoulder girdle, elbow joint, wrist joint). Employees working more than 6 h daily had a higher risk of developing restrictions in tone of isolated muscles and muscle groups p < 0.001), range of motion of the shoulder girdle (p < 0.001), increased tension of paraspinal muscles (p < 0.001), weakened shoulder girdle muscle strength (p < 0.001), elbow joint pain (p = 0.016), wrist joint pain (p < 0.001), coordination disorders (p = 0.004), difficulties in arm and hand use (p < 0.001), lifting and carrying objects (p = 0.008) and paraesthesia (p < 0.001) compared to those working less than 2 h daily. Additionally, working for 3–5 h and above 6 h compared to health personnel working up to 2 h was associated with a greater risk of headaches and cervical spine pain (p < 0.001), shoulder girdle pain (p < 0.001), limited mobility in the wrist joint (p = 0.003), and tremors (p < 0.001), that working below 2 h. Prolonged computer working time among health personnel during the COVID-19 pandemic is significantly associated with an increased risk of dysfunction and pain in structures of the upper part of the musculoskeletal system. Effective preventive measures are necessary to improve the functioning of the musculoskeletal system during extended periods of computer use.

“Atlas” - First cervical vertebrae: Deciphering morphological complexity, quantifying morphometry and integrating clinical perspectives

“Atlas” - First cervical vertebrae: Deciphering morphological complexity, quantifying morphometry and integrating clinical perspectives

Clinical spectrum of demyelinating disease of central nervous system and frequency of anti AQP4 and anti MOG among them: one-year single-center retrospective study

Background: Inflammatory demyelinating diseases of the central nervous system (CNS) are autoimmune conditions leading to significant neurological disability in adults. Recent classifications include myelin oligodendrocyte glycoprotein antibody associated disease (MOGAD) and neuromyelitis optica spectrum disorder (NMOSD) which pose diagnostic challenges due to overlapping clinical and radiological features. This study aimed to assess the clinical spectrum among adults and children diagnosed with CNS demyelinating diseases and to find the proportion of MOG and/or aquaporin-4 (AQP4) autoantibodies amongst them. Methods: This single-center, retrospective study examined 20 patients diagnosed with CNS demyelinating disorders between March, 2023 and February, 2024. Data pertaining to demographics, disease types, CSF analysis, MRI findings, treatment modalities, and serological profiles for anti-AQP4 and anti-MOG antibodies were collected from hospital records and evaluated. Results: Among 20 patients [median age, 34 years (IQR, 18.75); males (n=10) and females (n=10)], acute transverse myelitis (TM) was the most common demyelinating disorder at onset (60%) followed by optic neuritis (ON) (20%). CSF analysis found elevated protein levels in 53% and pleocytosis in 33% of patients. MRI findings revealed longitudinal extensive involvement in 52% of patients, predominantly affecting the cervical and dorsal spine. Serological testing identified 15% positive for anti-AQP4 and 10% for anti-MOG antibodies. MOG+ patients were significantly younger than AQP4+ patients (mean age 16.5 vs. 36.66 years, p=0.016). Both MOG+ patients were male, with 50% presenting with acute TM and 50% with acute disseminated encephalomyelitis. Among AQP4+ patients, the male-to-female ratio was 1:2, with 66.66% presenting with acute TM and 33.33% with ON. Conclusion: CNS demyelinating disorders primarily affect younger individuals, with TM as the most common initial disorder and extensive spinal involvement in cervical and dorsal regions. Serological testing identified three patients with anti-AQP4 and two with anti-MOG antibodies, providing valuable insights into the clinical spectrum of these disorders through cell-based assays.

The annoyance of singultus: a case report of a rare adverse effect after epidural steroid injection

ObjectiveCervical epidural steroid injections (ESIs) can provide effective pain management for patients suffering from chronic neck pain due to various pathological changes of the cervical spine. There are several rare adverse effects reported from interventional pain procedures, including persistent hiccups (“singultus”). Based on a limited number of cases, we propose a modified treatment algorithm for this adverse outcome (Fig. 3).Case reportSingultus has been documented as an adverse effect of interventional pain procedures, including epidural steroid, facet joint, and sacroiliac joint injections. We describe the case of a general contractor who presented to our clinic with chronic neck pain and central canal stenosis. The patient received an uncomplicated lumbar ESI in the past and was recommended for a cervical interlaminar ESI. After an uneventful C6-C7 interlaminar ESI with dexamethasone, 1% lidocaine, and normal saline the patient developed singultus. Baclofen was sent to his pharmacy, but this was unsuccessful at alleviating his hiccups. The patient was subsequently started on chlorpromazine and found relief from his symptomatology.ConclusionPersistent hiccups after ESI or interventional pain procedures can be treated with conservative measures and non-pharmacologic methods, with escalation to therapy with baclofen, gabapentin, pregabalin, metoclopramide, chlorpromazine, other antipsychotic or antidopaminergic agents, and possible dual or triple therapy if further indicated.

Causes, effects and treatment of forward head posture. Systematic literature review

The human cervical spine, with its complex structure, is designed to serve unique biomechanical functions. In addition to providing support and protection for the skull, the cervical spine also acts as a shock absorber for brain structures. Mechanically, it transfers weight and facilitates head flexion movements. To effectively carry out its function, proper alignment of the head’s posture with the body’s vertical center of gravity is necessary to minimize pressure and tension on spinal muscles. When continuous activities involving head restraint or forward bending cause an anterior translation of the head over extended periods of time, it can lead to a condition known as forward head posture (FHP). Prolonged FHP can result in injuries to muscles, tendons, and ligaments within both the cervical and lumbar regions of the spine, resulting in various health issues such as neck pain, shoulder pain or discomfort in the upper thoracic scapular segment. The aim of this study was to determine the impact, causes, and management strategies that can be implemented when forward posture occurs in individuals. The data used for this research were obtained from accredited journals such as Mendeley and PubMed. Articles were searched based on keywords related to forward head posture and then filtered according to inclusion and exclusion criteria. Ten out of 140 articles were selected as primary sources for this study. The results indicate that one significant impact of forward head posture is acute neck pain, which primarily affects an individual’s balance negatively. Known causes of forward head posture include engaging in work that involves repetitive bending or maintaining a static position where one leans their neck forwards continuously over prolonged periods. Finally, the recommended management approach when dealing with forward head posture is treatment through exercise therapy, such as Chin tuck exercise, McKenzie Neck Exercise, and Forward Head Posture Exercise.

An unilateral double fenestration of the right external jugular vein: a rare variant.

This report presents a rare anatomical variation, double fenestration of the External jugular vein on the right side. During the routine dissection of a male cadaver aged 60 years, we observed a unilateral large double fenestration of the External jugular vein on the right side. After its formation from the posterior division of the retromandibular and posterior auricular veins, External jugular vein descended in the posterior triangle of neck. Here, it divided into medial, intermediate, and lateral veins that united again before draining into the subclavian vein. Lateral vein was the largest (7.2cm) and intermediate and medial veins were measuring 6.4cm each. Two large fenestrations, measuring 5.8cm each, arranged like a "double bubble" were seen in the External jugular vein extending from fourth to sixth cervical (C4 to C6) vertebrae. The medial branch of supraclavicular nerve was seen passing superficial to the distal part of External jugular vein. On the left side, the course of External jugular vein showed a standard pattern. Surgeons must be acquainted with the varied anatomy of the superficial neck veins to prevent major bleeding during operative procedures, including carotid endarterectomy, flap operations, & central venous catheterisation.

Sosialisasi Neck Stretching Exercise Yang Benar Pada Ibu-Ibu di Sanggar Senam Prima Colomadu

Neck pain is a medical symptom or condition that is generally caused by pressure on the soft tissues, bones, or joints of the cervical spine and or other adjacent structures. In some cases, neck pain may also be caused by diseases of the neck or other underlying parts of the body. Risk factors for neck pain include poor posture, accidents, injuries and degenerative diseases may be the cause of neck pain in a person. Other causes such as infections in the lining (membranes) of the brain (meningitis), osteoarthritis, and fibromyalgia can be considered. Neck pain caused by muscle tension usually goes away on its own within a few days and only requires conservative treatment in the form of exercise, stretching, physical therapy, massage. Some forms of neck pain require professional medical care, including prescribing medications, physical therapy and other treatments. In severe cases, surgery may be necessary to manage neck pain. On May 19, 2022, we carried out Independent Community Service in Krobyongan Village, Gawanan, Colomadu District, Karanganyar Regency, Central Java (Sanggar Prima) with the theme of simple ways to overcome neck stiffness while working. Starting the counseling activity with neck pain material, how to overcome neck stiffness while working and exemplifying the movements, a question and answer session and ending by distributing snacks and questionnaires. The purpose of this activity is to increase knowledge on how to prevent neck pain and how to overcome neck stiffness while working at the prima colomadu studio. The method of implementing community service by: lectures, discussions, and providing simple tips and exercises.

Cervical Myelopathy from the Overshunting of Cerebrospinal Fluid: Miyazaki Syndrome

This case report details Miyazaki Syndrome in a patient who is status post right frontal strata ventriculoperitoneal shunt (VP). This condition results from the overshunting of cerebrospinal fluid (CSF), leading to intracranial hypotension and epidural venous dilation (1). Increased fluid within the venous plexus can compress the cervical spine, resulting in myelopathy (1). Neurosurgeons who consistently manage intracranial shunts should be knowledgeable about this uncommon pathology.

Comparison of the researched analyses evaluating the physiotherapy of the pain with a cause in the region of the cervical spine

Introduction. Neck pain is a common musculoskeletal problem. This individual and socio-economic health problem is associated with a reduction in daily activities, a reduction in labour productivity and an impact on quality of life levels. Objective. To evaluate the effectiveness of the therapy of non-specific pain originating from the cervical region in terms of the applied physiotherapy methods. Methods. 40 research articles published in 2018-2023 in journals with registration in databases Web of Science, Science Direct and Scopus were included in the research. Results. The most frequent target studied was the education of patients on ergonomics, correct posture and home exercises. The preparation phase of therapy included the administration of thermotherapy and electrotherapy – ultrasound or transcutaneous electrical nerve stimulation (TENS), classical massage, administration of non-steroidal anti-inflammatory drugs. The techniques often used were manipulation and/or mobilization, trigger and tender points therapy – acupressure, acupuncture, dry needle application. Among the therapeutic methods, the most frequently chosen are exercises in the form of pilates, yoga, Alexander technique, sensomotor training, proprioceptive neuromuscular facilitation, Jakobson progressive muscle relaxation. Reduction of painful mobility was addressed by the application of local immobilization and kineziotaping. Conclusion. According to the results of our analysis, the combination of several physiotherapy techniques and methods appears to be significantly effective for reducing pain and improving quality of life.

Denosumab in irresectable giant cell tumour of the cervical spine

Denosumab in irresectable giant cell tumour of the cervical spine

Developmental and Validation of Machine Learning Model for Prediction Complication after Cervical Spine Metastases Surgery.

This is a retrospective cohort study utilizing machine learning to predict postoperative complications in cervical spine metastases surgery. The main objective is to develop a machine learning model that accurately predicts complications following cervical spine metastases surgery. Cervical spine metastases surgery can enhance quality of life but carries a risk of complications influenced by various factors. Existing scoring systems may not include all predictive factors. Machine learning offers the potential for a more accurate predictive model by analyzing a broader range of variables. Data from January 2012 to December 2020 were retrospectively collected from medical databases. Predictive models were developed using Gradient Boosting, Logistic Regression, and Decision Tree Classifier algorithms. Variables included patient demographics, disease characteristics, and laboratory investigations. SMOTE was used to balance the dataset, and the models were assessed using AUC, F1-score, precision, recall, and SHAP values. The study included 72 patients, with a 29.17% postoperative complication rate. The Gradient Boosting model had the best performance with an AUC of 0.94, indicating excellent predictive capability. Albumin level, platelet count, and tumor histology were identified as top predictors of complications. The Gradient Boosting machine learning model showed superior performance in predicting postoperative complications in cervical spine metastases surgery. With continuous data updating and model training, machine learning can become a vital tool in clinical decision-making, potentially improving patient outcomes. Level III.

The right lymphatic duct: basic anatomy and clinical relevance.

The anatomical variability of the thoracic duct and the right lymphatic duct predisposes them to inadvertent damage following head and neck surgery thereby leading to chyle leak which is an uncommon complication with potentially significant associated morbidity. Although chyle leak is predominately associated with left-sided neck surgery, it also occurs as a complication of the right-sided neck dissection. Variable figures concerning chyle leakage after right-sided neck dissections were reported, ranging from 0 per cent to higher prevalences such as 14%, 24%, 33% and 60% of total cases of chyle leakages associated with neck surgery. The right-sided complications may implicate the right lymphatic duct and right-sided terminations of the thoracic duct into the venous system which occur in about 1-6% of humans. Other clinically relevant conditions involving the right-sided major lymphatic vessels include chyle leaks following right anterior cervical spine surgery, cysts of the right lymphatic duct and dilatation of the right lymphatic duct in the setting of recurrent cervical swelling. This article presents a review of the literature concerning the basic anatomy and the clinical relevance of the right lymphatic duct and the right-sided terminations of the thoracic duct into the venous circulation.

CNS and Thorax Injury and Associated Risks Factors in Equestrian Sports.

Equestrian sports continue to gain popularity in the United States and are associated with a high injury rate, especially involving the central nervous system and thorax. Due to this high rate of injury and the potential for long-term consequences associated with participation, an understanding of the unique risks of this sport is needed. To describe severe injury in equestrian sports and review the role that protective gear plays in injury mitigation. The PubMed Database was searched using the search terms "equestrian" and "horse" combined with "spinal cord injury," "head injury," "traumatic brain injury," "experience levels," and "demographics." A total of 53 papers were selected based on their relevance of epidemiology, risk factors, and management of injuries sustained during equestrian activities. Case studies, randomized controlled trials, prospective studies, and retrospective studies were all included for further review. Systematic review. Level 4. None. Injuries to the thorax, including fractures, pneumothoraces, internal organ contusions, and crush injuries, have been cited in multiple national and international trauma registries as the most prevalent injury location in equestrians; however, head and neck injuries, high cervical spine fractures, and closed head injuries are reported to be associated with the highest rates of mortality. Helmets provide protection against skull fracture and traumatic brain injury. Vests were not associated with diminished rates of spinal cord injuries; however, they may provide protection to the thorax. Riding experience also plays a role in reducing the prevalence of injury. Equestrian-related activities are associated with a high risk of injury despite protective measures. Protective gear can mitigate some injury risk but does not protect against spinal injury. Continued investigation into improving protective equipment, rider education, and preventative strategies to mitigate this risk is needed.

A mathematical model of the combination of lateral tilt and rotation of the vertebra

An important section of spinal biomechanics is the analysis of various types of movements in spinal segments, which are difficult to observe, and setting up experiments is quite complex. There are few articles devoted to this topic, and the methodological approaches outlined in these studies are so heterogeneous that they do not allow for a comparative analysis. In this situation, the abstract language of mathematics allows us to objectively answer the questions that arise. Aim of the study was to develop a mathematical model of a spinal segment to calculate the combination of rotation angles and lateral inclination of the vertebra, as well as to identify factors influencing these parameters. Material and methods. The developed mathematical model of the motion segment of the spine was used as the main tool for the study. The initial data for this model were the coordinates of the reference points of the vertebrae, which makes it possible to determine a number of parameters describing their complex structure. Using this model, the parameters of the combination of vertebral movement in the frontal and horizontal planes were calculated. Results and discussion. The developed model of the combination of movements in the spinal segment is adequate to the ideas about the nature of movements in the spinal segments. The coefficient of combination of lateral tilt and rotation of the vertebra for the cervical vertebrae is from 0.5 to 0.7, for the thoracic vertebrae from 0.3 to 0.5, and for the lumbar vertebrae from 0.0 to 0.1. Fluctuations in the value of this coefficient depend on the angle of inclination of the upper articular surfaces of the underlying vertebra. Reducing the size of the articular surfaces leads to a decrease in the magnitude of the angular movements of the vertebra, and their convergence leads to an increase in mobility in the spinal segments. A negative angle of inclination of the articular surfaces causes opposite rotation of the vertebra.

Evaluating cervical spine mobility and Fitt's law compliance: The DidRen laser test adapted for virtual reality with age and sex effects

Cervical spine mobility assessment is crucial in rehabilitation to monitor patient progress. This study introduces the DidRen VR test, a virtual reality (VR) adaptation of the conventional DidRen laser test, aimed at evaluating cervical spine mobility.We conducted a cross-sectional study involving fifty healthy participants that underwent the DidRen VR test. The satisfaction of Fitts' law within this VR adaptation was examined and we analyzed the effects of age and sex on the sensorimotor performance metrics.Our findings confirm that Fitts' law is satisfied, demonstrating a predictable relationship between movement time and the index of difficulty, which suggest that the DidRen VR test can simulate real-world conditions. A clear influence of age and sex on performance was observed, highlighting significant differences in movement efficiency and accuracy across demographics, which may necessitate personalized assessment strategies in clinical rehabilitation practices.The DidRen VR test presents an effective tool for assessing cervical spine mobility, validated by Fitts' law. It offers a viable alternative to real-world method, providing precise control over test conditions and enhanced engagement for participants. Since age and sex significantly affect sensorimotor performance, personalized assessments are essential. Further research is recommended to explore the applicability of the DidRen VR test in clinical settings and among patients with neck pain.