Cervical Spine Movement Sequencing During Flexion-Extension

Static flexion-extension x-rays are the most common clinical tool used to assess abnormal motion of the cervical spine. Despite their widespread use (over 168,000 cases per year), the clinical efficacy of flexion-extension radiographs of the cervical spine has yet to be proven¹. Limitations of static flexion-extension x-rays include data collection during static positions that may not accurately represent dynamic behavior, and the fact that data is collected at end range of motion positions, not in more frequently encountered mid-range positions. Consequently, static x-rays may not reveal movement abnormalities that occur during activities of daily living and lead to pain and degeneration. Therefore, it may be advantageous to analyze cervical spine kinematic data collected during dynamic, functional movements performed through an entire range of motion (not just the endpoints). Furthermore, the literature confirms there is substantial variability in “normal” range of motion and translation during flexion-extension¹, making it difficult to reliably identify abnormal motion. Therefore, it may also be beneficial to evaluate alternative motion parameters that may reliably identify abnormal motion.