Biomechanical effects on the intermediate segment of noncontiguous hybrid surgery with cervical disc arthroplasty and anterior cervical discectomy and fusion: a finite element analysis

Wu, Tingkui; Meng, Yang; Líu, Hao; Wang, Beiyu; Hong, Ying; Xiao, Rong; Ding, Chen; Chen, Hua

doi:10.1016/j.spinee.2019.02.004

Cited by 36 publications

(72 citation statements)

References 42 publications

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“…The IVD consisted of annulus fibrosus and nucleus pulposus with the volume ratio to be 6:4. The IVD was considered as an elastic material referring to the previous studies ( Wu et al, 2019 ; Li et al, 2021 ). The endplates were constructed as a shell with the thickness of 0.5 mm.…”

Section: Methodsmentioning

confidence: 99%

Biomechanical Evaluation of Different Surgical Approaches for the Treatment of Adjacent Segment Diseases After Primary Anterior Cervical Discectomy and Fusion: A Finite Element Analysis

Chen

Wang

et al. 2021

Front. Bioeng. Biotechnol.

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Symptomatic adjacent segment disease (ASD) is a common challenge after anterior cervical discectomy and fusion (ACDF). The objective of this study was to compare the biomechanical effects of a second ACDF and laminoplasty for the treatment of ASD after primary ACDF. We developed a finite element (FE) model of the C2-T1 based on computed tomography images. The FE models of revision surgeries of ACDF and laminoplasty were simulated to treat one-level and two-level ASD after primary ACDF. The range of motion (ROM) and intradiscal pressure (IDP) of the adjacent segments, and stress in the cord were analyzed to investigate the biomechanical effects of the second ACDF and laminoplasty. The results indicated that revision surgery of one-level ACDF increased the ROM and IDP at the C2–C3 segment, whereas two-level ACDF significantly increased the ROM and IDP at the C2–C3 and C7-T1 segments. Furthermore, no significant changes in the ROM and IDP of the laminoplasty models were observed. The stress in the cord of the re-laminoplasty model decreased to some extent, which was higher than that of the re-ACDF model. In conclusion, both ACDF and laminoplasty can relieve the high level of stress in the spinal cord caused by ASD after primary ACDF, whereas ACDF can achieve better decompression effect. Revision surgery of the superior ACDF or the superior and inferior ACDF after the primary ACDF increased the ROM and IDP at the adjacent segments, which may be the reason for the high incidence of recurrent ASD after second ACDF.

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Section: Methodsmentioning

confidence: 99%

Biomechanical Evaluation of Different Surgical Approaches for the Treatment of Adjacent Segment Diseases After Primary Anterior Cervical Discectomy and Fusion: A Finite Element Analysis

Chen

Wang

et al. 2021

Front. Bioeng. Biotechnol.

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“…This fusion can let the operation segment lose physiological mobility. Several previous biomechanical studies also demonstrated that the fusion of the operation segment could increase the intradiscal pressure or hypermobility in adjacent levels. The pattern of intervertebral fusion made ACDF potentially accelerate the degeneration of adjacent segments and increase the incidence of adjacent segment disease (ASD), which many long‐term follow‐up studies also proved.…”

Section: Introductionmentioning

confidence: 97%

Comparison of 10‐year Outcomes of Bryan Cervical Disc Arthroplasty for Myelopathy and Radiculopathy

Han

Zhang

et al. 2019

Orthopaedic Surgery

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Objective: To evaluate the long-term efficacy of Bryan cervical disc arthroplasty in the treatment of myelopathy patients compared with radiculopathy patients. Methods:This study is a prospective study. Sixty-six patients (38 patients in myelopathy group and 28 patients in radiculopathy group) who were treated with Bryan cervical disc arthroplasty between 2004 and 2007 and followed for 10 years were included in this study. The Japanese Orthopaedic Association (JOA) score, neck disability index (NDI), and Odom's criteria were used to evaluate the clinical outcomes. X-ray, computed tomography (CT), and magnetic resonance imaging (MRI) were used to evaluate the radiographic outcomes including the global range of motion (ROM), segmental ROM, and segment alignment before the surgery and at last follow-up. The incidence of segmental kyphosis, segmental mobility lost, and the grade of paravertebral ossification (PO) were also evaluated at last follow-up. Results:The JOA score and NDI improved in both groups. Thirty-three of 38 patients in myelopathy group and all patients in radiculopathy group reported good or excellent outcomes according to Odom's criteria. The segmental ROM was (9.5 AE 4.4 ) before surgery and maintained at (9.0 AE 5.5 ) at last follow-up in myelopathy group. The segmental ROM was (9.5 AE 4.6 ) and (9.0 AE 5.3 ) before surgery and at last follow-up in radiculopathy group, respectively. The Bryan prosthesis remained mobile at last follow-up for 30 patients (78.9%) in the myelopathy group and 22 patients (78.6%) in the radiculopathy group. Of the patients in the myelopathy group, 21.1% developed segmental kyphosis, as did 21.4% of patients in the radiculopathy group. The incidence of PO and high-grade PO was 92.1 and 28.9% in the myelopathy group, and was 92.9 and 32.1% in the radiculopathy group. There was no significant difference between both groups.Conclusions: Bryan cervical disc arthroplasty was an effective and safe technique in treating patients with myelopathy. The clinical and radiographic outcomes in the myelopathy group were similar to those in the radiculopathy group at the 10-year follow-up.

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“…The cortical bone and endplate were assumed as 0.5 mm thin bony shells. The nucleus pulposus was defined as a non-compressible material, and the volume rate between nucleus pulposus and annulus ground was 4:6 ( Wu et al, 2019 ; Hua et al, 2020 ; Sang et al, 2021 ). The annulus fibers accounted for approximately 20% of ground volume, and they were circumferential around the surface of the annulus ground at an angle of approximately 15°–45° with respect to the endplate horizontal plane ( Mo et al, 2015 ).…”

Section: Methodsmentioning

confidence: 99%

Comparative Analysis of the Biomechanical Characteristics After Different Minimally Invasive Surgeries for Cervical Spondylopathy: A Finite Element Analysis

Zhang

et al. 2021

Front. Bioeng. Biotechnol.

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Minimally invasive surgeries, including posterior endoscopic cervical foraminotomy (PECF), microsurgical anterior cervical foraminotomy (MACF), anterior transdiscal approach of endoscopic cervical discectomy (ATd-ECD), and anterior transcorporeal approach of endoscopic cervical discectomy (ATc-ECD), have obtained positive results for cervical spondylotic radiculopathy. Nonetheless, there is a lack of comparison among them regarding their biomechanical performance. The purpose of this study is to investigate the biomechanical changes of operated and adjacent segments after minimally invasive surgeries compared to a normal cervical spine. A three-dimensional model of normal cervical vertebrae C3–C7 was established using finite element analysis. Afterwards, four surgical models (PECF, MACF, ATd-ECD, and ATc-ECD) were constructed on the basis of the normal model. Identical load conditions were applied to simulate flexion, extension, lateral bending, and axial rotation of the cervical spine. We calculated the range of motion (ROM), intradiscal pressure (IDP), annulus fibrosus pressure (AFP), uncovertebral joints contact pressure (CPRESS), and facet joints CPRESS under different motions. For all circumstances, ATc-ECD was close to the normal cervical spine model, whereas ATd-ECD significantly increased ROM and joints CPRESS and decreased IDP in the operated segment. PECF increased more the operated segment ROM than did the MACF, but the MACF obtained maximum IDP and AFP. Except for ATc-ECD, the other models increased joints CPRESS of the operated segment. For adjacent segments, ROM, IDP, and joints CPRESS showed a downward trend in all models. All models showed good biomechanical stability. With their combination biomechanics, safety, and conditions of application, PECF and ATc-ECD could be appropriate choices for cervical spondylotic radiculopathy.

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Biomechanical effects on the intermediate segment of noncontiguous hybrid surgery with cervical disc arthroplasty and anterior cervical discectomy and fusion: a finite element analysis

Cited by 36 publications

References 42 publications

Biomechanical Evaluation of Different Surgical Approaches for the Treatment of Adjacent Segment Diseases After Primary Anterior Cervical Discectomy and Fusion: A Finite Element Analysis

Biomechanical Evaluation of Different Surgical Approaches for the Treatment of Adjacent Segment Diseases After Primary Anterior Cervical Discectomy and Fusion: A Finite Element Analysis

Comparison of 10‐year Outcomes of Bryan Cervical Disc Arthroplasty for Myelopathy and Radiculopathy

Comparative Analysis of the Biomechanical Characteristics After Different Minimally Invasive Surgeries for Cervical Spondylopathy: A Finite Element Analysis

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