Artificial Cervical Vertebra and Intervertebral Complex Replacement through the Anterior Approach in Animal Model: A Biomechanical and In Vivo Evaluation of a Successful Goat Model

Qin, Jie; He, Xijing; Wang, Dong; Pan, Qi; Guo, Lei; Huang, Sihua; Cai, Xuan; Li, Haopeng; Wang, Rui

doi:10.1371/journal.pone.0052910

Cited by 24 publications

(19 citation statements)

References 28 publications

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“…To maintain the dynamic function of the intervertebral space and reconstruct the vertebral height, we designed an artificial cervical vertebra and intervertebral complex (ACVC), and in 2012, we established a goat model to analyze the biomechanics of the prosthesis 16 . Recently, other motion-preserved prostheses have been developed 17 , 18 .…”

Section: Discussionmentioning

confidence: 99%

“…First, the movement of the cervical vertebra from C 3 to C 7 is a coupled motion that is closely related to the facet joint 21 , and the cervical ROM of each direction after ADVS implantation is unequal to that of the intact cervical spine. Because there is a 45° angle between the sagittal and horizontal planes of the facet joint, cervical lateral bending is often accompanied by axial rotation 22 , 23 16 . When the cervical spine bends to the left, for example, the lower left zygopophysis of the upper vertebra will move down along the upper left zygopophysis of the lower vertebra, shifting the right side of the upper vertebra forward.…”

Section: Discussionmentioning

confidence: 99%

“…In our study, the facet joint of the C 5 vertebra was still intact after ADVS implantation; thus, the ROM of the non-fusion group could not be maintained at 12° in flexion/extension and lateral bending. Second, the instant center of rotation (ICR) should also be considered, as it has been proposed for evaluating the quality of spine movement 24 . The path of the ICR during dynamic motion has been reported as moving superiorly with each successive motion segment from C 2−3 to C 6−7 24 .…”

Section: Discussionmentioning

confidence: 99%

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Artificial disc and vertebra system: a novel motion preservation device for cervical spinal disease after vertebral corpectomy

Dong¹,

Lü²,

Teng³

et al. 2015

Clinics

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OBJECTIVE:To determine the range of motion and stability of the human cadaveric cervical spine after the implantation of a novel artificial disc and vertebra system by comparing an intact group and a fusion group.METHODS:Biomechanical tests were conducted on 18 human cadaveric cervical specimens. The range of motion and the stability index range of motion were measured to study the function and stability of the artificial disc and vertebra system of the intact group compared with the fusion group.RESULTS:In all cases, the artificial disc and vertebra system maintained intervertebral motion and reestablished vertebral height at the operative level. After its implantation, there was no significant difference in the range of motion (ROM) of C3–7 in all directions in the non-fusion group compared with the intact group (p>0.05), but significant differences were detected in flexion, extension and axial rotation compared with the fusion group (p<0.05). The ROM of adjacent segments (C3−4, C6−7) of the non-fusion group decreased significantly in some directions compared with the fusion group (p<0.05). Significant differences in the C4-6 ROM in some directions were detected between the non-fusion group and the intact group. In the fusion group, the C4−6 ROM in all directions decreased significantly compared with the intact and non-fusion groups (p<0.01). The stability index ROM (SI-ROM) of some directions was negative in the non-fusion group, and a significant difference in SI-ROM was only found in the C4−6 segment of the non-fusion group compared with the fusion group.CONCLUSION:An artificial disc and vertebra system could restore vertebral height and preserve the dynamic function of the surgical area and could theoretically reduce the risk of adjacent segment degeneration compared with the anterior fusion procedure. However, our results should be considered with caution because of the low power of the study. The use of a larger sample should be considered in future studies.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Artificial disc and vertebra system: a novel motion preservation device for cervical spinal disease after vertebral corpectomy

Dong¹,

Lü²,

Teng³

et al. 2015

Clinics

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“…This experiment utilized young goats aged between 24 and 36 months. The goat spine is similar to the human spine in many aspects, including the structure and biomechanics of the thoracic and lumbar vertebrae [ 21 , 22 ]. There are 12 dorsal and 6–8 lumbar vertebrae in goats.…”

Section: Discussionmentioning

confidence: 99%

Relationship between Spinal Cord Volume and Spinal Cord Injury due to Spinal Shortening

Feng

Yang

et al. 2015

PLoS ONE

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Vertebral column resection is associated with a risk of spinal cord injury. In the present study, using a goat model, we aimed to investigate the relationship between changes in spinal cord volume and spinal cord injury due to spinal shortening, and to quantify the spinal cord volume per 1-mm height in order to clarify a safe limit for shortening. Vertebral column resection was performed at T10 in 10 goats. The spinal cord was shortened until the somatosensory-evoked potential was decreased by 50% from the baseline amplitude or delayed by 10% relative to the baseline peak latency. A wake-up test was performed, and the goats were observed for two days postoperatively. Magnetic resonance imaging was used to measure the spinal cord volume, T10 height, disc height, osteotomy segment height, and spinal segment height pre- and postoperatively. Two of the 10 goats were excluded, and hence, only data from eight goats were analyzed. The somatosensory-evoked potential of these eight goats demonstrated meaningful changes. With regard to neurologic function, five and three goats were classified as Tarlov grades 5 and 4 at two days postoperatively. The mean shortening distance was 23.6 ± 1.51 mm, which correlated with the d-value (post-pre) of the spinal cord volume per 1-mm height of the osteotomy segment (r = 0.95, p < 0.001) and with the height of the T10 body (r = 0.79, p = 0.02). The mean d-value (post-pre) of the spinal cord volume per 1-mm height of the osteotomy segment was 142.87 ± 0.59 mm3 (range, 142.19–143.67 mm3). The limit for shortening was approximately 106% of the vertebral height. The mean volumes of the osteotomy and spinal segments did not significantly change after surgery (t = 0.310, p = 0.765 and t = 1.241, p = 0.255, respectively). Thus, our results indicate that the safe limit for shortening can be calculated using the change in spinal cord volume per 1-mm height.

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“…The average size of engineered discs is 3.1 mm in height and 7.5 mm in width, while the human lumbar disc has an average height of 11 mm and average widths in the anterior-posterior and lateral directions of 37 mm and 55 mm, respectively 68. The human cervical spine may be a more realistic target for a tissue-engineered disc replacement-not only are the mechanical demands lesser in the cervical spine, but the disc dimensions are closer to the current dimensions of engineered constructs, with a height of 5 to 6 mm and average widths in the anterior-posterior and lateral directions of 20 mm and 30 mm, respectively 69,70. Even so, this would represent a 2-fold…”

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confidence: 99%

Promise, progress, and problems in whole disc tissue engineering

Gullbrand

Smith

et al. 2018

JOR Spine

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Intervertebral disc degeneration is frequently implicated as a cause of back and neck pain, which are pervasive musculoskeletal complaints in modern society. For the treatment of end stage disc degeneration, replacement of the disc with a viable, tissue-engineered construct that mimics native disc structure and function is a promising alternative to fusion or mechanical arthroplasty techniques. Substantial progress has been made in the field of whole disc tissue engineering over the past decade, with a variety of innovative designs characterized both in vitro and in vivo in animal models. However, significant barriers to clinical translation remain, including construct size, cell source, culture technique, and the identification of appropriate animal models for preclinical evaluation. Here we review the clinical need for disc tissue engineering, the current state of the field, and the outstanding challenges that will need to be addressed by future work in this area. K E Y W O R D Sanimal models, biomaterials, biomechanics, disc degeneration, mesenchymal stem cells | INTRODUCTIONBack and neck pain place a significant social and economic burden on modern society, affecting nearly 1 in 2 individuals annually. In the United States alone, these conditions are associated with an estimated $194 billion in yearly medical costs and lost wages. Back pain is commonly associated with degenerative disc disease, a progressive condition with complex underlying etiology, during which component tissues undergo an array of cellular and structural changes that ultimately compromises biomechanical function.Although the pathological manifestations of disc degeneration are well characterized, the underlying causes and the origins of discogenic pain are still not well understood, impeding the development of effective therapies. Current treatments for disc degeneration do not restore native disc structure and function, and thus exhibit limited long-term efficacy. Tissue engineering offers the promise of generating de novo, living structures that recapitulate the form, function, and biology of healthy host tissues with the potential to treat a variety musculoskeletal disorders, including disc degeneration. Here, we review recent progress in the field of whole disc tissue engineering as well as the barriers that will need to be addressed for the successful clinical translation of engineered discs. | INTERVERTEBRAL DISC STRUCTURE AND MECHANICAL FUNCTIONThe intervertebral discs of the spine are composite structures composed of the central nucleus pulposus (NP), the peripheral annulus fibrosus (AF), and the superior and inferior cartilaginous end plates.The extracellular matrix (ECM) of the NP is composed primarily of proteoglycans and type II collagen; the high proteoglycan content of | INTERVERTEBRAL DISC DEGENERATION AND TREATMENTDegeneration of the intervertebral discs may occur with aging or following injury. While the exact pathophysiology of disc degeneration remains unclear, it is known to involve a progressive cascade of cellular,...

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Artificial Cervical Vertebra and Intervertebral Complex Replacement through the Anterior Approach in Animal Model: A Biomechanical and In Vivo Evaluation of a Successful Goat Model

Cited by 24 publications

References 28 publications

Artificial disc and vertebra system: a novel motion preservation device for cervical spinal disease after vertebral corpectomy

Artificial disc and vertebra system: a novel motion preservation device for cervical spinal disease after vertebral corpectomy

Relationship between Spinal Cord Volume and Spinal Cord Injury due to Spinal Shortening

Promise, progress, and problems in whole disc tissue engineering

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