Musculoskeletal Modeling of the Suboccipital Spine: Kinematics Analysis, Muscle Lengths, and Muscle Moment Arms During Axial Rotation and Flexion Extension

Study Design. In vitro and modeling study of upper cervical spine (UCS) three-dimensional (3D) kinematics and muscle moment arm (MA) during axial rotation (AR) and flexion extension (FE). Objective. To create musculoskeletal models with movement simulation including helical axis (HA) and muscle features. Summary of Background Data. Integration of various kinematics and muscle data into specific-specimen 3D anatomical models with graphical representation of HA and muscle orientation and MA is not reported for the UCS musculoskeletal system. Methods. Kinematics, anatomical, and computed tomographic imaging data were sampled in 10 anatomical specimens. Using technical markers and anatomical landmarks digitizing, spatial position of segments was computed for five discrete positions of AR and FE using a 3D digitizer. To obtain musculoskeletal model simulation, a registration method was used to combine collected data. Processing was performed using orientation vector and HA computation and suboccipital muscle features (i.e., length and MA) relative to motion angle. Results. Range of motion and coupling were in agreement with previous in vitro studies. HA (i.e., location and orientation) showed low variation at the occipitoaxial and atlantoaxial levels for FE and AR, respectively. The main orientation of the HA was vertical at C1–C2 during AR and horizontal at C0–C1 during FE. For muscles MA, absolute peak value (ranging from 20 to 40 mm) occurred at different poses depending on the analyzed muscle and motion. Poor magnitude was found for obliquus capitis inferior and rectus capitis posterior minor in FE and AR, respectively. Conclusion. On the basis of previous methods, we developed a protocol to create UCS musculoskeletal modeling with motion simulation including HA and suboccipital muscles representation. In this study, simultaneous segmental movement displaying with HA and muscles features was shown to be feasible.

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