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Ex Vivo and In Vitro Determination of the Axial Rotational Axis of the Human Thoracic Spine

Molnár, Szabolcs, MD*; Manó, Sándor; Kiss, László, MD; Csernátony, Zoltán, MD, MSc, PhD

doi: 10.1097/01.brs.0000250183.97746.51
Anatomy
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Study Design. Different geometrical and biomechanical evaluations were performed to determine the axial rotational axis of the thoracic spine.

Objective. Our research group has been dealing with the determination of the axial rotational axis of the thoracic spine. Here, we would like to present the geometrical and experimental results of our trials. With our experiments, we are trying to evaluate the contradictions of the related literature.

Summary of Background Data. In the present state, we know quite a lot about the biomechanics of healthy and pathologic spines. Nevertheless, for a seemingly simple question like the position of the axial rotation of the thoracic spine, the literature gives contradicting results. During correction of a scoliotic deformity, when trying to correct the pathologic rotation, not knowing the physiologic rotation can be hazardous.

Methods. We wanted to clarify this question, so we examined the thoracic spine in many different ways. First, we examined the problem from a geometrical point of view then we modeled the different rotational axes by studying the change in volume of the spinal canal. Finally, we used cadaver spines that we rotated and examined with radiographs and digital pictures.

Results. Based on the results, we made the following establishments: most of the center points fell on the anterior half of the vertebral body or into the spinal canal, basically on the midsagittal axis of the vertebra. The rib cage has a significant effect on the place of the axis. After removing the ribs, the axis of axial rotation moved forward.

Conclusions. After evaluating the results, we determined that the most likely place for the rotational axis is on the median-sagittal plane, in the anterior portion of the spinal canal.

The literature gives contradicting results for the position of the axial rotational axis of the thoracic spine. We wanted to clarify this question, so we examined the thoracic spine in different ways. We determined that the place is on the median-sagittal plane, in the anterior portion of the spinal canal.

From the *Department of Orthopaedics, Polyclinic of the Hospitaller Brothers of St. John of God in Budapest, Budapest; and †Department of Orthopaedic Surgery, University of Debrecen, Medical and Health Science Centre, Debrecen, Hungary.

Acknowledgment date: March 23, 2006. First revision date: June 28, 2006. Acceptance date: August 9, 2006.

The manuscript submitted does not contain information about medical device(s)/drug(s).

Foundation funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

Address correspondence and reprint requests to Szabolcs Molnár, MD, Polyclinic of the Hospitaller Brothers of St. John of God in Budapest, Department of Orthopaedics, 17-19 Frankel Leó St. Budapest, Hungary 1027; E-mail: sz0798@freemail.hu; dodoka@interware.hu

© 2006 Lippincott Williams & Wilkins, Inc.