Cervical Flexion And Extension Includes Anti-directional Cervical Joint Motion In Cervical Spondylotics Radiculopathy

Objective:The purpose of this study was to investigate the law of intervertebral reverse motion during flexion and extension of cervical spondylotic radiculopathy,and to compare with healthy people.Material and methods:A total of 20 patients(14 males and 6 females)with cervical spondylotic radiculopathy in the second hospital of Jilin University from 2018 to 2020 were included in this study.Before the experiment,the researchers trained the subjects in cervical spine uniform flexion and extension,and then used the C-arm X-ray machine(Phillips bv Libra)to take dynamic video fluoroscopy on the subjects,and uploaded the image data to the computer terminal.Free studio was used to divide the cervical flexion and extension trajectory into 10 equal parts,and the most standard cervical X-ray image was selected in each frame interval.With the help of deep learning computer model,the key points of cervical spine anatomy were captured and located dynamically,and the changes of intervertebral angle and displacement were recorded and quantified.Results : The results showed that:(1)reverse angle: in the process of flexion and extension,the reverse angle of flexion and extension accounted for 49.1 ± 4.8% and 46.0 ±5.0% of the total motion,respectively,so the proportion of reverse angle in flexion was greater than that in extension(P < 0.05).In flexion and extension,the reverse angle of upper cervical spine(C0 / C1,C1 / C2,C2 / C3)was larger than that of lower cervical spine(C4 /C5,C5 / C6,C6 / C7)(P < 0.05).In flexion movement,C1 / C2 had the highest proportion of reverse angle,while C2 / C3 and C3 / C4 had the lowest proportion.In the extension movement,the proportion of reverse angle of C0 / C1 was the highest,and that of C4 / C5 was the lowest(P < 0.05).(2)Reverse displacement: in the process of flexion and extension,the reverse displacement of flexion and extension accounted for 53.3 ± 6.0% and 46.7 ±5.8% of the total movement,respectively,so the reverse displacement of flexion was greater than that of extension(P < 0.05).In the flexion movement,the proportion of reverse displacement of upper cervical spine was less than that of lower cervical spine(P > 0.05).C3 / C4 and C4 / C5 had the highest proportion of reverse displacement,while C6 / C7 had the lowest proportion(P > 0.05).In the extension movement,the reverse displacement of the upper cervical spine was greater than that of the lower cervical spine(P < 0.05).The reverse displacement of C1 / C2 was the highest,and that of C5 / C6 was the lowest(P < 0.05).(3)Angle and displacement are not synchronous: in the process of flexion and extension,the positive and negative changes of intervertebral angle and displacement are not synchronous,that is,the reverse angle is accompanied by the positive displacement.The proportion of intervertebral reverse angle and displacement in the same direction was 51.4% ± 7.5%,and the proportion of both in the same direction of the upper cervical spine was higher than that in the lower cervical spine.Conclusion :(1)The deep learning computer model can accurately and efficiently identify the anatomical landmarks of cervical vertebra,which provides a new method for exploring the motion law of cervical spondylosis.(2)Compared with healthy people,the proportion of cervical spondylotic radiculopathy is higher,the proportion of cervical spondylotic radiculopathy is higher than that of cervical spondylotic radiculopathy,but the difference of the proportion of cervical spondylotic radiculopathy is smaller.(3)The different changes of intervertebral reverse motion may be related to the unique anatomical structure of upper cervical spine,the influence of cervical axial pain and nerve root pain on cervical muscle coordination.