NUCCA Biomechanics

By Takanobu Nakaseko

Review of Misalignment Types

Type1 Misalignment

Characteristics

- C1 laterality on the same side of

angular rotation

- Contralateral acute angle

- Skull is parallel to vertical axis

- C1 is above parallel

Side of Laterality

Type2 Misalignment

Characteristics

- C1 laterality on the opposite side of

angular rotation

- Ipsilateral acute angle

- Skull is tipped toward vertical axis

- C1 remains fairly horizontal

- Laterality produced mainly by skull

Side of Laterality

Mainly by

Skull

Type3 Misalignment

Characteristics

- C1 laterality on the same side of

skull tipping

- No angular rotation

- C1 remains fairly horizontal

- Laterality produced by skull tipping

Side of Laterality

Directly by Skull

Type4 Misalignment

Characteristics

- C1 laterality on the same side of

angular rotation

- Contralateral acute angle

- Skull is tilted away from vertical axis

- C1 is above parallel

Side of Laterality

SUMMARY

Acute Angle

Cause

Type 1 Contralateral C1 Sideslip

Type 2 Ipsilateral Head tilt

Type 3 - Head tilt

Type 4 ContralateralC1 sideslip / Head tilt

How to Correct Misalignment?

Combination of the Head piece placement and Triceps pull

Patient placement is extremely crucial!

Using 3-D Xray (Lateral, Nasium, Vertex) to analyze how to set the patient on the table and specific correction vector.

Head Piece

Mastoid Process

Mechanism of Head PieceSkull COG on the B

Mechanism of Head PieceSkull COG on the C

Mechanism of Head PieceSkull COG on the A

C/A?

Condylar circle over Axial circle C/A is the specific vector which allows

both condylar circle and axial circle to rotate the same distance, but different speed.

C/A is unique to each individual Can be calculated. C/A=(A-C)/2

C/A?

C/A?

C/A?

C/A?

Type 1

The vector is always higher than C/A in order to affect lower angle.

Type 2&3

The vector is always lower than C/A in order to affect head tilt.

Type 4

The vector is close to C/A because both lower angle and head tilt should be corrected at the same time.

Type 1 Correction

Type 1 Correction

Type 2 Correction

Type 2 Correction

Type 3 Correction

Type 3 Correction

Type 4 Correction

Type 4 Correction