Flexion and traction effect on C5-C6 foraminal space

Abstract

Objective: To determine the effects of cervical flexion and traction on foraminal volume and isthmus area at the C5-C6 foraminal space in cadavers.

Design: This study evaluated the foraminal space at C5-C6 in cadaver specimens during flexion and traction of the cervical spine.

Setting: An orthopedic biomechanics laboratory and department of radiology of a university medical center.

Patients or other participants: Nine cadaver cervical spines, C1 through T3, were used in the study. Superficial tissues were dissected, preserving the ligaments.

Interventions: Proximal and distal portions of the cadaver spines were potted using bone cement. Spines were mounted and imaged with computed tomography in neutral position, 15 degrees of flexion, and maximum flexion with and without 25lbs of axial traction.

Main outcome measures: The areas and volumes of the foramen were measured and calculated.

Results: Flexion alone significantly increased the foraminal volume and isthmus area at C5-C6. Traction resulted in little additional change.

Conclusions: For cervical spines with mild to moderate degenerative changes at C5-C6, cervical flexion with or without traction produces significant increases in foraminal volume and area at the foraminal isthmus.