Neck pain as a result of chronic cervical spine injury is one of the most common musculoskeletal complaints, especially for an aging workforce where neck pain can become a significant occupational issue leading to lost work time and productivity. As the average age of retirement increases it becomes important to modify the design of appropriate protective equipment and activities for older individuals, but more information is needed about the biomechanics of these activities to properly engineer solutions. Currently, there is no method to assess cervical spine kinematics in real time for human subjects in the course of their workplace and other activities and interests. While CT and MRI are considered the best imaging modalities to evaluate the pathoanatomy contributing to neck pain, excessive size and power requirements limit the ability of these technologies to assess cervical spine kinematics and intervertebral disc displacements in real time for human subjects. We propose to develop a stereographic ultrasound system that can provide portable, robust, dynamic, real-time imaging of the cervical spine in an active aging population to determine the biomechanics of occupational activities and to measure the rigid body kinematics of contiguous vertebrae and intervertebral disc displacements. The alignment and co-registration of images from dual ultrasound transducers, combined with an assumption of rigid body motion will be used to calculate the motion of contiguous cervical vertebrae. Initially we will validate the accuracy and reliability of the rigid body motion data and intervertebral disc displacements measured by the stereographic ultrasound system using isolated human cadaver cervical spine segments mounted in a servo-hydraulic, multi-axial testing machine subjected to representative dynamic forces and moments. This will be followed by testing intact human cadavers subjected to dynamic flexion/extension, lateral tilt and axial rotation moments applied to the head and neck. The rigid body motion data and intervertebral disc displacements measured using ultrasound will be compared to the same data measured using plane radiography. In-vivo cervical spine kinematics and intervertebral disc displacements measured using stereographic ultrasound and dynamic MRI will be compared in human volunteers as they flex/extend, rotate and tilt their head and neck. Finally in-vivo stereographic ultrasound data will be acquired in healthy volunteers subjected to simulated inertial loads typically encountered during the occupational activities of an active aging population to establish the ability of ultrasound to evaluate the biomechanical mechanisms contributing to cervical spine injury and chronic neck pain. .

Public Health Relevance

Currently, there is no method to assess dynamic spine motion in-vivo as a result of repetitive forces applied to the cervical spine leading to neck injury that would occur in the workplace, especially for an aging workforce where neck pain can become a significant occupational issue leading to lost work time and productivity. As the average age of retirement increases it becomes important to modify the design of appropriate protective equipment and activities for older individuals, but more information is needed about the biomechanics of these activities to properly engineer solutions. Developing an inexpensive, portable and safe technique that can characterize the biomechanical etiology of cervical spine injury in an aging population without exposing subjects to radiation or requiring expensive MRI technology will have important societal benefits and could fundamentally change health recommendations to active seniors and design requirements for protective equipment in the workplace that would limit dynamic exposures in an active aging population.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Individual Predoctoral NRSA for M.D./Ph.D. Fellowships (ADAMHA) (F30)
Project #
5F30AG040931-03
Application #
8534684
Study Section
Special Emphasis Panel (ZRG1-F15-P (20))
Program Officer
Joseph, Lyndon
Project Start
2011-09-19
Project End
2015-09-18
Budget Start
2013-09-19
Budget End
2014-09-18
Support Year
3
Fiscal Year
2013
Total Cost
$47,232
Indirect Cost
Name
Harvard University
Department
None
Type
Schools of Medicine
DUNS #
047006379
City
Boston
State
MA
Country
United States
Zip Code
02115