Medical College of Wisconsin
CTSICores SearchResearch InformaticsREDCap

A Novel Competing Risk Analysis Model to Determine the Role of Cervical Lordosis in Bony and Ligamentous Injuries. World Neurosurg 2018 Nov;119:e962-e967

Date

08/17/2018

Pubmed ID

30114533

DOI

10.1016/j.wneu.2018.08.011

Scopus ID

2-s2.0-85053033202 (requires institutional sign-in at Scopus site)   1 Citation

Abstract

OBJECTIVE: To determine role of lordosis in cervical spine injuries using a novel competing risk analysis model.

METHODS: The first subgroup of published experiments (n = 20) subjected upright human cadaver head-neck specimens to impact loading. The natural lordosis was removed. The second (n = 21) and third (n = 10) subgroups of published tests subjected inverted specimens to head impact loading. Lordosis was preserved in these 2 subgroups. Using axial force and age as variables, competing risks analysis techniques were used to determine the role of lordosis in the risk of bone-only, ligament-only, and bone and ligament injuries.

RESULTS: Bony injuries were focused more at 1 level to a straightened spine, and ligament injuries were spread around multiple levels. Age was not a significant (P < 0.05) covariate. A straightened spine had 3.23 times higher risk of bony injuries than a lordotic spine. The spine with maintained lordosis had 1.14 times higher risk of ligament injuries, and 2.67 times higher risk of bone and ligament injuries than a spine without lordosis (i.e., preflexed column).

CONCLUSIONS: Increased risk of bony injuries in a preflexed spine and ligament injuries in a lordotic spine may have implications for military personnel, as continuous use of helmets in the line of duty affects the natural curvature; astronauts, as curvatures are less lordotic after missions; and civilian patients with spondylotic myelopathy who use head protective devices, as curvatures may change over time in addition to the natural aging process.

Author List

Yoganandan N, Banerjee A, DeVogel N, Pintar FA, Baisden JL

Authors

Anjishnu Banerjee PhD Associate Professor in the Data Science Institute department at Medical College of Wisconsin
Frank A. Pintar PhD Chair, Professor in the Biomedical Engineering department at Medical College of Wisconsin
Narayan Yoganandan PhD Professor in the Neurosurgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Biomechanical Phenomena
Cadaver
Cervical Vertebrae
Humans
Ligaments
Lordosis
Models, Statistical
Retrospective Studies
Risk Assessment
Spinal Injuries