Skip to main content
Erschienen in: Surgical and Radiologic Anatomy 2/2012

01.03.2012 | Original Article

Morphometry of the synovial folds of the lateral atlanto-axial joints: the anatomical basis for understanding their potential role in neck pain

verfasst von: Alexandra L. Webb, Hamid Rassoulian, Barry S. Mitchell

Erschienen in: Surgical and Radiologic Anatomy | Ausgabe 2/2012

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Intra-articular synovial folds of the cervical spine are considered to be a potential source of neck pain and disability. The purpose of the present study was to devise and validate a method to determine the normal morphometry of the synovial folds as a basis for understanding their functional and clinical significance.

Methods

Nine cadaver cervical spines were sectioned in the sagittal plane. The presence of the synovial folds at the lateral atlanto-axial joints was determined and their morphology described. Depth of projection, cross-sectional area and volume of the ventral and dorsal synovial folds of the right and left lateral atlanto-axial joints were measured from sagittal sections and compared. The relationship between synovial fold dimensions and subject age and cartilage degeneration were determined. Repeat measurements were made for the calculation of method reliability, and the water displacement method was used to determine method validity.

Results

There was a trend for ventral synovial folds to be larger than dorsal synovial folds. There was no correlation between synovial fold dimensions and age and extent of cartilage degeneration. Measurement reliability ranged from intraclass correlation coefficient 0.95–1.00 (intra-observer), 0.95–1.00 (test–retest) and 0.61–1.00 (inter-observer). Limits of agreement for the sectional and water displacement methods for the measurement of synovial fold volume were −1.04 ± 3.35 mm3.

Conclusions

A reliable method for quantifying synovial fold dimensions was devised. The results of this study provide a basis for the determination and diagnosis of pathologies affecting the synovial folds.
Literatur
1.
Zurück zum Zitat Bland JM, Altman DG (1999) Measuring agreement in method comparison studies. Stat Methods Med Res 8:135–160PubMedCrossRef Bland JM, Altman DG (1999) Measuring agreement in method comparison studies. Stat Methods Med Res 8:135–160PubMedCrossRef
2.
Zurück zum Zitat Chang H, Found EM, Clark CR, Goel VK, Gang CS (1992) Meniscus-like synovial fold in the atlanto-axial (C1–C2) joint. J Spinal Disord 5:227–231PubMedCrossRef Chang H, Found EM, Clark CR, Goel VK, Gang CS (1992) Meniscus-like synovial fold in the atlanto-axial (C1–C2) joint. J Spinal Disord 5:227–231PubMedCrossRef
3.
Zurück zum Zitat Chevrot A, Cermakova E, Vallee C, Chancelier MD, Chemla N, Rousselin B, Langer-Cherbit A (1995) C1–2 arthrography. Skeletal Radiol 24:425–429PubMedCrossRef Chevrot A, Cermakova E, Vallee C, Chancelier MD, Chemla N, Rousselin B, Langer-Cherbit A (1995) C1–2 arthrography. Skeletal Radiol 24:425–429PubMedCrossRef
4.
5.
Zurück zum Zitat Engel R, Bogduk N (1982) The menisci of the lumbar zygapophysial joints. J Anat 135:795–809PubMed Engel R, Bogduk N (1982) The menisci of the lumbar zygapophysial joints. J Anat 135:795–809PubMed
6.
Zurück zum Zitat Evans DW (2002) Mechanisms and effects of spinal high-velocity, low-amplitude thrust manipulation: previous theories. J Manipulative Physiol Ther 25:251–262PubMedCrossRef Evans DW (2002) Mechanisms and effects of spinal high-velocity, low-amplitude thrust manipulation: previous theories. J Manipulative Physiol Ther 25:251–262PubMedCrossRef
7.
Zurück zum Zitat Fletcher G, Haughton VM, Ho KC, Yu SW (1990) Age-related changes in the cervical facet joints: studies with cryomicrotomy, MR, and CT. Am J Roentgenol 154:817–820 Fletcher G, Haughton VM, Ho KC, Yu SW (1990) Age-related changes in the cervical facet joints: studies with cryomicrotomy, MR, and CT. Am J Roentgenol 154:817–820
8.
Zurück zum Zitat Friedrich KM, Trattnig S, Millington SA, Friedrich M, Groschmidt K, Pretterklieber ML (2007) High-field magnetic resonance imaging of meniscoids in the zygapophyseal joints of the human cervical spine. Spine 32:244–248PubMedCrossRef Friedrich KM, Trattnig S, Millington SA, Friedrich M, Groschmidt K, Pretterklieber ML (2007) High-field magnetic resonance imaging of meniscoids in the zygapophyseal joints of the human cervical spine. Spine 32:244–248PubMedCrossRef
9.
Zurück zum Zitat Friedrich KM, Reiter G, Pretterklieber ML, Pinker K, Friedrich M, Trattnig S, Salomonowitz E (2008) Reference data for in vivo magnetic resonance imaging properties of meniscoids in the cervical zygapophyseal joints. Spine 33:E778–E783PubMedCrossRef Friedrich KM, Reiter G, Pretterklieber ML, Pinker K, Friedrich M, Trattnig S, Salomonowitz E (2008) Reference data for in vivo magnetic resonance imaging properties of meniscoids in the cervical zygapophyseal joints. Spine 33:E778–E783PubMedCrossRef
10.
Zurück zum Zitat Giles LG (1986) Lumbo-sacral and cervical zygapophyseal joint inclusions. Man Med 2:89–92 Giles LG (1986) Lumbo-sacral and cervical zygapophyseal joint inclusions. Man Med 2:89–92
11.
Zurück zum Zitat Ibatullin IA, Zaitseva RL, Chudnovskii NA, Chudnovskaia MN (1987) Structure and histo-topography of meniscoid structures of the atlanto-occipital and atlanto-axial joints. Arkh Anat Gistol Embriol 92:30–38PubMed Ibatullin IA, Zaitseva RL, Chudnovskii NA, Chudnovskaia MN (1987) Structure and histo-topography of meniscoid structures of the atlanto-occipital and atlanto-axial joints. Arkh Anat Gistol Embriol 92:30–38PubMed
12.
Zurück zum Zitat Inami S, Kaneoka K, Hayashi K, Ochiai N (2000) Types of synovial fold in the cervical facet joint. J Orthop Sci 5:475–480PubMedCrossRef Inami S, Kaneoka K, Hayashi K, Ochiai N (2000) Types of synovial fold in the cervical facet joint. J Orthop Sci 5:475–480PubMedCrossRef
13.
Zurück zum Zitat Inami S, Shiga T, Tsujino A, Yabuki T, Okado N, Ochiai N (2001) Immunohistochemical demonstration of nerve fibers in the synovial fold of the human cervical facet joint. J Orthop Res 19:593–596PubMedCrossRef Inami S, Shiga T, Tsujino A, Yabuki T, Okado N, Ochiai N (2001) Immunohistochemical demonstration of nerve fibers in the synovial fold of the human cervical facet joint. J Orthop Res 19:593–596PubMedCrossRef
14.
Zurück zum Zitat Jonsson H Jr, Bring G, Rauschning W, Sahlstedt B (1991) Hidden cervical spine injuries in traffic accident victims with skull fractures. J Spinal Disord 4:251–263PubMedCrossRef Jonsson H Jr, Bring G, Rauschning W, Sahlstedt B (1991) Hidden cervical spine injuries in traffic accident victims with skull fractures. J Spinal Disord 4:251–263PubMedCrossRef
15.
Zurück zum Zitat Kawabe N, Hirotani H, Tanaka O (1989) Pathomechanism of atlantoaxial rotatory fixation in children. J Pediatr Orthop 9:569–574PubMedCrossRef Kawabe N, Hirotani H, Tanaka O (1989) Pathomechanism of atlantoaxial rotatory fixation in children. J Pediatr Orthop 9:569–574PubMedCrossRef
16.
Zurück zum Zitat Kos J, Wolf J (1972) Die “menisci” der zwischenwirbelgelenke und ihre mogliche rolle bei wirbelblockierung. Man Med 10:105–114 Kos J, Wolf J (1972) Die “menisci” der zwischenwirbelgelenke und ihre mogliche rolle bei wirbelblockierung. Man Med 10:105–114
17.
Zurück zum Zitat Kos J, Hert J, Sevcik P (2002) Meniscoids of the intervertebral joints. Acta Chir Orthop Traumatol Cech 69:149–157PubMed Kos J, Hert J, Sevcik P (2002) Meniscoids of the intervertebral joints. Acta Chir Orthop Traumatol Cech 69:149–157PubMed
18.
Zurück zum Zitat Mercer S, Bogduk N (1993) Intra-articular inclusions of the cervical synovial joints. Br J Rheumatol 32:705–710PubMedCrossRef Mercer S, Bogduk N (1993) Intra-articular inclusions of the cervical synovial joints. Br J Rheumatol 32:705–710PubMedCrossRef
19.
Zurück zum Zitat Mercer SR, Bogduk N (2001) Joints of the cervical vertebral column. J Orthop Sports Phys Ther 31:174–182PubMed Mercer SR, Bogduk N (2001) Joints of the cervical vertebral column. J Orthop Sports Phys Ther 31:174–182PubMed
20.
Zurück zum Zitat Penning L, Wilmink JT (1987) Rotation of the cervical spine. A CT study in normal subjects. Spine 12:732–738PubMedCrossRef Penning L, Wilmink JT (1987) Rotation of the cervical spine. A CT study in normal subjects. Spine 12:732–738PubMedCrossRef
21.
Zurück zum Zitat Schonstrom N, Twomey L, Taylor J (1993) The lateral atlanto-axial joints and their synovial folds: an in vitro study of soft tissue injuries and fractures. J Trauma 35:886–892PubMedCrossRef Schonstrom N, Twomey L, Taylor J (1993) The lateral atlanto-axial joints and their synovial folds: an in vitro study of soft tissue injuries and fractures. J Trauma 35:886–892PubMedCrossRef
22.
Zurück zum Zitat Tang XY, Liu LJ, Yang HJ, Peng MX, Liao SH (2007) Anatomic study of the synovial folds of the occipito-atlanto-axial joints. Clin Anat 20:376–381PubMedCrossRef Tang XY, Liu LJ, Yang HJ, Peng MX, Liao SH (2007) Anatomic study of the synovial folds of the occipito-atlanto-axial joints. Clin Anat 20:376–381PubMedCrossRef
23.
Zurück zum Zitat Taylor JR, Taylor MM (1996) Cervical spine injuries: an autopsy study of 109 blunt injuries. J Musculoskelet Pain 4:61–79CrossRef Taylor JR, Taylor MM (1996) Cervical spine injuries: an autopsy study of 109 blunt injuries. J Musculoskelet Pain 4:61–79CrossRef
24.
Zurück zum Zitat Uhrenholt L, Hauge E, Charles AV, Gregersen M (2008) Degenerative and traumatic changes in the lower cervical spine facet joints. Scand J Rheumatol 37:375–384PubMedCrossRef Uhrenholt L, Hauge E, Charles AV, Gregersen M (2008) Degenerative and traumatic changes in the lower cervical spine facet joints. Scand J Rheumatol 37:375–384PubMedCrossRef
25.
Zurück zum Zitat Wang Z, Yu S, Haughton VM (1989) Age-related changes in the lumbar facet joints. Clin Anat 2:55–62CrossRef Wang Z, Yu S, Haughton VM (1989) Age-related changes in the lumbar facet joints. Clin Anat 2:55–62CrossRef
26.
Zurück zum Zitat Webb AL, Darekar AA, Sampson M, Rassoulian H (2009) Synovial folds of the lateral atlantoaxial joints: in vivo quantitative assessment using magnetic resonance imaging in healthy volunteers. Spine 34:E697–E702PubMedCrossRef Webb AL, Darekar AA, Sampson M, Rassoulian H (2009) Synovial folds of the lateral atlantoaxial joints: in vivo quantitative assessment using magnetic resonance imaging in healthy volunteers. Spine 34:E697–E702PubMedCrossRef
27.
Zurück zum Zitat Webb AL, Darekar AA, Rassoulian H (2010) The influence of age, anthropometrics and range of motion on the morphometry of the synovial folds of the lateral atlanto-axial joints: a pilot study. Eur Spine J. doi:10.1007/s00586-010-1553-0 Webb AL, Darekar AA, Rassoulian H (2010) The influence of age, anthropometrics and range of motion on the morphometry of the synovial folds of the lateral atlanto-axial joints: a pilot study. Eur Spine J. doi:10.​1007/​s00586-010-1553-0
29.
Zurück zum Zitat Yoganandan N, Knowles SA, Maiman DJ, Pintar FA (2003) Anatomic study of the morphology of human cervical facet joint. Spine 28:2317–2323PubMedCrossRef Yoganandan N, Knowles SA, Maiman DJ, Pintar FA (2003) Anatomic study of the morphology of human cervical facet joint. Spine 28:2317–2323PubMedCrossRef
30.
Zurück zum Zitat Yu SW, Sether L, Haughton VM (1987) Facet joint menisci of the cervical spine: correlative MR imaging and cryomicrotomy study. Radiology 164:79–82PubMed Yu SW, Sether L, Haughton VM (1987) Facet joint menisci of the cervical spine: correlative MR imaging and cryomicrotomy study. Radiology 164:79–82PubMed
Metadaten
Titel
Morphometry of the synovial folds of the lateral atlanto-axial joints: the anatomical basis for understanding their potential role in neck pain
verfasst von
Alexandra L. Webb
Hamid Rassoulian
Barry S. Mitchell
Publikationsdatum
01.03.2012
Verlag
Springer-Verlag
Erschienen in
Surgical and Radiologic Anatomy / Ausgabe 2/2012
Print ISSN: 0930-1038
Elektronische ISSN: 1279-8517
DOI
https://doi.org/10.1007/s00276-011-0834-6

Weitere Artikel der Ausgabe 2/2012

Surgical and Radiologic Anatomy 2/2012 Zur Ausgabe

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.