Flexion and extension structural properties and strengths for male cervical spine segments

Abstract New vehicle safety standards are designed to limit the amount of neck tension and extension seen by out-of-position motor vehicle occupants during airbag deployments. The criteria used to assess airbag injury risk are currently based on volunteer data and animal studies due to a lack of bending tolerance data for the adult cervical spine. This study provides quantitative data on the flexion–extension bending properties and strength on the male cervical spine, and tests the hypothesis that the male is stronger than the female in pure bending. An additional objective is to determine if there are significant differences in stiffness and strength between the male upper and lower cervical spine. Pure-moment flexibility and failure testing was conducted on 41 male spinal segments (O–C2, C4–C5, C6–C7) in a pure-moment test frame and the results were compared with a previous study of females. Failures were conducted at approximately 90 N-m/s. In extension, the male upper cervical spine (O–C2) fails at a moment of 49.5 (s.d. 17.6) N-m and at an angle of 42.4° (s.d. 8.0°). In flexion, the mean moment at failure is 39.0 (s.d. 6.3°) N-m and an angle of 58.7° (s.d. 5.1°). The difference in strength between flexion and extension is not statistically significant. The difference in the angles is statistically significant. The upper cervical spine was significantly stronger than the lower cervical spine in both flexion and extension. The male upper cervical spine was significantly stiffer than the female and significantly stronger than the female in flexion. Odontoid fractures were the most common injury produced in extension, suggesting a tensile mechanism due to tensile loads in the odontoid ligamentous complex.