RT Journal Article
SR Electronic
T1 Assessment of Cervical and Lumbar Kinematics in Simulated Open and Closed Kinetic Chain
JF International Journal of Spine Surgery
JO Int J Spine Surg
FD International Society for the Advancement of Spine Surgery
SP 51
OP 59
DO 10.14444/8382
VO 17
IS 1
A1 Amirouche, Farid
A1 Dolan, Martine
A1 Pradhan, Sonia
A1 Mikhael, Mark
A1 Monsef, Jad Bou
YR 2023
UL https://www.ijssurgery.com/content/17/1/51.abstract
AB Background The pelvic girdle and spine vertebral column work as a long chain influenced by pelvic tilt. This study aims to assess the effect of open and closed chain anterior pelvic tilt (APT) or posterior pelvic tilt (PPT) on cervical and lumbar spine kinematics using an in vitro cadaveric spine model.Methods Three human cadaveric spines with intact pelvis were suspended with the skull fixed in a metal frame. Optotrak 3-dimensional motion system captured coordinates of pin markers at 24 different points for real-time tracking of cervical and lumbar regions. Additional geometric parameters were measured to calculate pelvic incidence and pelvic tilt. A force-torque digital gauge applied consistent force to standardize the acetabular or sacral axis’ APT and PPT during simulated open- and closed-chain movements, respectively.Results In closed-chain PPT, significant differences in relative intervertebral decompression were noted between spinal levels C2/C3 (4.85 mm) and C5/C6 (1.26 mm), while compression was noted between L1/L2 (−2.54 mm) and L5/S1 (−11.84 mm) and between L3/L4 (−2.78 mm) and L5/S1 (−11.84 mm) (P < 0.05). Displacement during closed-chain PPT was significantly greater than during open-chain PPT for cervical and lumbar spines. In closed-chain APT, significant differences in relative intervertebral decompression were noted between spinal levels L1/L2 (2.87 mm) and L5/S1 (24.48 mm) and between L3/L4 (2.94 mm) and L5/S1 (24.48 mm) (P < 0.05). Pelvic incidence remained the same as the pelvis tilted anterior and posterior.Conclusions In PPT, open-chain pelvic tilts did not produce as much cervical and lumbar intervertebral displacement compared with closed-chain pelvic tilts. In contrast, APT saw fewer differences between open- and closed-chain tilting. There was a reciprocal relationship between pelvic tilt and sacral slope, producing a constant pelvic incidence throughout all pelvic tilt angles.Clinical Relevance The results of this study may help determine how a patient’s pelvic tilt is causing pain and using that knowledge to guide rehabilitation of stabilizing muscles. The data produced here may also be helpful in determining which rehabilitation exercises may be more difficult or prone to injury for patients with either excessive anterior or posterior pelvic tilt.Level of Evidence 5.