Background

The rotation stress test is a pre-manipulative screening test used to examine upper cervical instability. This in vitro study simulates the clinical application of the rotation stress test before and after alar ligament transection.

Methods

After the dissection of the superficial structures to the alar ligament and the fixation of C2, ten cryopreserved upper cervical columns were manually mobilized in right and left rotation without and with right alar ligament transection. Upper cervical rotation range of motion (RoM) and mobilization torque were recorded using the Vicon motion capture system and a load cell.

Findings

Ligament transection resulted in a larger rotation range of motion in all specimens (contralateral rotation (3.6°, 12.9%) and ipsilateral rotation (4.6°, 13.7%)). The mobilization torque recorded during rotation varied among the different specimens, with a trend towards reduced torque throughout the test in contralateral rotation.

Interpretation

This study simulated the rotation stress test before and after alar ligament transection. Unilateral transection of the alar ligament revealed a bilateral increase of the upper cervical rotation. Additional in vivo studies are necessary to validate the results of this study in patients with suspicion of upper cervical instability.

中文翻译：

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韧带横断对旋转应力测试的影响：尸体研究

背景

旋转压力测试是用于检查上颈椎不稳定性的预操作筛查测试。这项体外研究模拟了韧带横切前后旋转应力测试的临床应用。

方法

在将浅表结构解剖到韧带韧带并固定C2后，手动左右移动十根冷冻保存的上颈柱，不进行和不进行右韧带横切术。使用Vicon运动捕捉系统和称重传感器记录上颈椎活动度（RoM）和动员扭矩。

发现

韧带横断导致所有样本的旋转运动范围更大（对侧旋转（3.6°，12.9％）和同侧旋转（4.6°，13.7％））。旋转过程中记录的动员扭矩在不同样本之间有所不同，在对侧旋转过程中，整个测试过程中的扭矩都有减小的趋势。

解释

本研究模拟了韧带横切前后的旋转应力测试。韧带的单侧横断显示上颈旋转的双侧增加。对于怀疑上颈椎不稳的患者，需要进行其他体内研究以验证该研究结果。