Stiffness Matters

Peterson, Joshua; Chlebek, Carolyn; Clough, Ashley M; Wells, Alexandra K.; Ledet, Eric H.

doi:10.1097/brs.0000000000002643

Cited by 14 publications

(3 citation statements)

References 20 publications

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“…While results from this study suggest that anthropometric characteristics and muscle activation do not influence on the difference between the forces at the patient-table and clinician-patient interfaces, other potential influencing factors such as kyphosis degree and tissue stiffness should be investigated. Indeed, it has been described that structures with higher stiffness stress-shield adjacent tissues during movement [ 36 ] and future studies are planned to elucidate this. Most importantly, this study highlights the significance of the specific methods to measure the force-time characteristics during manual therapies as well as the limitations of comparing studies that use different methods of force measurement.…”

Section: Discussionmentioning

confidence: 99%

Assessing forces during spinal manipulation and mobilization: factors influencing the difference between forces at the patient-table and clinician-patient interfaces

et al. 2020

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Background Spinal manipulative therapy (SMT) and mobilization (MOB) effects are believed to be related to their force characteristics. Most previous studies have either measured the force at the patient-table interface or at the clinician-patient interface. The objectives of this study were to determine 1) the difference between the force measured at the patient-table interface and the force applied at the clinician-patient interface during thoracic SMT and MOB, and 2) the influence of the SMT/MOB characteristics, participants’ anthropometry and muscle activity (sEMG) on this difference. Methods An apparatus using a servo-linear motor executed 8 SMT/MOB at the T7 vertebrae in 34 healthy adults between May and June 2019. SMT and MOB were characterized by a 20 N preload, total peak forces of 100 N or 200 N, and thrust durations of 100 ms, 250 ms, 1 s or 2 s. During each trial, thoracic sEMG, apparatus displacement as well as forces at the patient-table interface and the clinician-patient interface were recorded. The difference between the force at both interfaces was calculated. The effect of SMT/MOB characteristics on the difference between forces at both interfaces and correlations between this difference and potential influencing factors were evaluated. Results Force magnitudes at the patient-table interface were, in most trials, greater than the force at the clinician-patient interface (up to 135 N). SMT/MOB characteristics (total peak force, thrust duration and rate of force application) affected the difference between forces at both interfaces (all p-values< 0.05). No factor showed significant correlations with the difference between forces at both interfaces for the 8 SMT/MOB. Conclusions The results revealed that the force measured at the patient-table interface is greater than the applied force at the clinician-patient interface during thoracic SMT and MOB. By which mechanism the force is amplified is not yet fully understood.

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Section: Discussionmentioning

confidence: 99%

Assessing forces during spinal manipulation and mobilization: factors influencing the difference between forces at the patient-table and clinician-patient interfaces

et al. 2020

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“…Although the application of the screw‐plate system for anterior cervical fixation showed good clinical results, 2,3 other postoperative complications may occur, including spinal injury, plate displacement, screw loosening and plate or screw fracture. Hence, the revision of the surgeries has been increased 4,5 .…”

Section: Introductionmentioning

confidence: 99%

Clinical Efficacy Analysis of the New PRUNUS Spine Plate System for Anterior Cervical Spine Surgery

Zhao

et al. 2023

Orthopaedic Surgery

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BACKGROUND To observed and evaluated the clinical e cacy of a new type cervical anterior screw plate system development for anterior cervical surgery.Methods 27 patients with cervical spine disease treated with new PRUNUS nail plate internal xation were selected as observation group, and 29 patients treated with conventional cervical anterior screw xation were selected as the control group. Cervical stability, internal xation position and bone graft fusion were evaluated according to imaging data. The operative time, intraoperative blood loss, cervical Cobb angle, VAS scores, and JOA scores were compared between the two groups. Spinal function scores and neurological improvement rates were used to evaluate the clinical e cacy of the new PRUNUS spine plate.Results There were statistical differences in operation time and blood loss between the two groups (P<0.05). The difference in Cobb angle, JOA score and improvement rate, VAS score before and after surgery in two groups were statistically signi cant (P<0.05), but no signi cant differences between two groups (P>0.05). ConclusionThe new PRUNUS spine plate system can be applied to the anterior cervical spine surgery, and its clinical e cacy was similar to the traditional cervical anterior plate. But PRUNUS simpli ed the operation process, especially for the osteoporosis patients.

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“…Şimşek et al [7], for example, designed a hinged quadrilateral cervical plate to reduce the potential of screw loosening and fracture due to bending of the spine. Peterson et al [8], on the other hand, examined the relationship between cervical plate stiffness and fusion using quadrilateral cervical plate of varying stiffness. Conversely, Mackiewicz et al [9] explored the differences in the stability of different types of plates after a singlesegment ACDF surgery; namely static trapezoidal Casper cervical plate, quadrilateral Casper cervical plate, and dynamic cervical plate.…”

Section: Introductionmentioning

confidence: 99%

Comparison of biomechanical performance of single-level triangular and quadrilateral profile anterior cervical plates

Cao

Wang

2021

PLoS ONE

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The quadrilateral anterior cervical plate (ACP) is used extensively in anterior cervical discectomy and fusion (ACDF) to reconstruct the stability of the cervical spine and prevent cage subsidence. However, there have been no comparison studies on the biomechanical performance of quadrilateral ACP and triangular ACP. The objective of this study is to investigate the functional outcomes of quadrilateral ACP and triangular ACP usage in ACDF surgery. In this study, a finite element model of intact C1-C7 segments was established and verified. Additionally, two implant systems were built; one using triangle anterior cervical plates (TACP) and another using quadrilateral orion anterior cervical plate (QACP). Both models were then compared in terms of their postoperative biomechanical performance, under normal and excessive motion. Compared to QACP, the peak stress of the TACP screws and plates occurred at 359.2 MPa and 97.2 MPa respectively and were the highest during over extension exercises. Alternately, compared to TACP, the endplate peak stress and the cage displacement of QACP were the largest at over extension, with values of 7.5 MPa and 1.2 mm, respectively. Finally, the average stress ratio of bone grafts in TACP was relatively high at 31.6%. In terms of biomechanical performance, TACP can share the load more flexibly and reduce the risks of cage subsidence and slippage but the screws have high peak stress value, thereby increasing the risk of screw slippage and fracture. This disadvantage must be considered when designing a TACP based implant for a potential patient.

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Stiffness Matters

Abstract: N/A.

Cited by 14 publications

References 20 publications

Assessing forces during spinal manipulation and mobilization: factors influencing the difference between forces at the patient-table and clinician-patient interfaces

Assessing forces during spinal manipulation and mobilization: factors influencing the difference between forces at the patient-table and clinician-patient interfaces

Clinical Efficacy Analysis of the New PRUNUS Spine Plate System for Anterior Cervical Spine Surgery

Comparison of biomechanical performance of single-level triangular and quadrilateral profile anterior cervical plates

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