THE IMPORTANCE OF LIGAMENT PROPERTIES IN CERVICAL SPINE KINEMATICS: A FINITE ELEMENT STUDY

Rotation of the cervical spine beyond its normal range of motion is a leading cause of fall-related spinal cord injuries (SCIs) in older adults. This rotation is constrained, in part, by the spinal ligaments. The experimentally measured properties of these ligaments are tabulated in literature, including sex- specific properties; however, their influence on the rotation kinematics of the cervical spine has not been compared. We examined how different mechanical properties of spinal ligaments, including sex- specific properties, affected the rotational kinematics of the cervical spine using finite element analysis (FEA). Ligament properties most influenced the rotation of the lower cervical spine, with increased ligament stiffness reducing rotation. Ligament deformation remained mostly in the toe region of their force-displacement curves, emphasizing the need to incorporate non-linear ligament behavior in FEA. Predictions made using one set of experimental properties (Property 1) better-matched experimental kinematic data. Using sex-specific properties had a moderate effect (6% in extension, − 3% in flexion) on rotation, with a greater impact on extension. Ligament properties also affected the segmental distribution of rotation, causing a variability of 3–21% at different levels. We emphasized the need to incorporate tailored approaches to FEA to obtain clinically relevant results when modeling flexion/extension rotation.