Subaxial Cervical Intradiscal Pressure and Segmental Kinematics Following Atlantoaxial Fixation in Different Angles

Liu, Qi; Guo, Qunfeng; Yang, Jun; Zhang, Peng; Xu, Tianming; Cheng, Xiaofei; Chen, Jinshui; Guan, Huapeng; Ni, Bin

doi:10.1016/j.wneu.2015.09.025

Cited by 35 publications

(37 citation statements)

References 24 publications

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“…3. The predicted ROMs for all levels were compared with those in previous biomechanical and FE analysis studies [25–27]. The ROMs of the intact model at C2/3, C3/4, C4/5, C5/6 and C6/7 were 4.25°, 6.59°, 7.47°, 7.36° and 4.94°, respectively, in flexion; 3.19°, 4.62°, 6.21°, 5.25° and 4.18°, respectively, in extension; 5.17°, 5.46°, 5.66°, 4.12° and 3.83°, respectively, in lateral bending; and 2.11°, 3.12°, 4.39°, 3.65° and 2.02°, respectively, in axial rotation.…”

Section: Resultsmentioning

confidence: 99%

Biomechanics following skip-level cervical disc arthroplasty versus skip-level cervical discectomy and fusion: a finite element-based study

Meng

Wang

et al. 2019

BMC Musculoskelet Disord

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BackgroundModerately increased motion at the intermediate segment (IS) after skip-level fusion may accelerate disc degeneration. However, limited biomechanical data are available that examine the effects on the IS following cervical disc arthroplasty (CDA). The purpose of this study is to investigate the biomechanical changes in the IS of the cervical spine after skip-level fusion or skip-level arthroplasty.MethodsA finite element model of a healthy cervical spine (C2-C7) was constructed. Two surgical models were developed: (1) skip-level fusion at C3/4 and C5/6 and (2) skip-level arthroplasty at C3/4 and C5/6. A 75-N follower load and 1.0-N·m moments were applied to the top of the C2 vertebra to produce flexion, extension, lateral bending and axial rotation in the intact model. The end-points in each direction corresponding to the intact model were applied to the surgical models under displacement-control protocols.ResultsThe ranges of motion (ROMs) of the fusion model were markedly decreased at the operated levels, while the corresponding ROMs of the arthroplasty model were similar to those of the intact spine in all directions. In the fusion model, the ROMs of the IS (C4/5) were markedly increased in all directions. The ROMs in the arthroplasty model were similar to those in the intact spine, and the ROMs of untreated segments were evenly increased. In the fusion model, the intradiscal pressure and facet contact force at were C4/5 remarkably increased and unevenly distributed among the unfused segments. In the arthroplasty model, the IS did not experience additive stress.ConclusionThe IS does not experience additive ROM or stress in the intervertebral disc or facet joints after skip-level arthroplasty, which has fewer biomechanical effects on the IS than does skip-level fusion. This study provides a biomechanical rationale for arthroplasty in treating patients with skip-level cervical degenerative disc disease.

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Section: Resultsmentioning

confidence: 99%

Biomechanics following skip-level cervical disc arthroplasty versus skip-level cervical discectomy and fusion: a finite element-based study

Meng

Wang

et al. 2019

BMC Musculoskelet Disord

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“…ROMs of our FEMs in flexion-extension, lateral bending, and axial rotation were compared with the data from previous studies [8,[18][19][20]. The ROMs of the intact FEMs at C2/3, C3/4, C4/5, C5/6, and C6/7 were 4.11°± 0.75°, 5.22°± 1.10°, 5.74°± 1.08°, 5.70°± 1.11°, and 4.39°± 0.94°, respectively, in flexion; 3.24°± 0.79°, 4.23°± 1.03°, 4.65°± 1.01°, and 4.04°± 1.03°, respectively, in extension; 5.15°± 0.85°, 4.84°± 1.15°, 4.73°± 1.29°, 3.42°± 0.77°, and 2.63°± 0.58°, respectively, in lateral bending; and 2.04°± 0.83°, 2.97°± 0.79°, 3.73°± 0.67°, 3.14°± 0.62°, and 2.20°± 0.93°, respectively, axial rotation (Fig.…”

Section: Validation Of the Intact Femsmentioning

confidence: 99%

Biomechanical comparison of noncontiguous cervical disc arthroplasty and noncontiguous cervical discectomy and fusion in the treatment of noncontinuous cervical degenerative disc disease: a finite element analysis

Sun

Zhang

et al. 2020

J Orthop Surg Res

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Background: Biomechanical characteristics of noncontinuous ACDF and noncontinuous CDA in the treatment of noncontinuous cervical degenerative disc disease were still unclear. The aim of this research is to compare the differences between these two kinds of treatment methods and to verify the effectiveness of Prodisc-C in noncontinuous CDA. Methods: Eight FEMs of the cervical spine (C2-C7) were built based on CT images of 8 mild CDDD volunteers. In the arthroplasty group, we inserted Prodisc-C at C3/4 and C5/6. In the fusion group, CoRoent® Contour and NuVasive® Helix ACP were implanted at C3/4 and C5/6. Initial loads of 75 N were used to simulate the head weight and muscle forces. The application of 1.0 N m moment on the top on the C2 vertebra was used to create motion in all directions. Statistical analyses were performed using STATA version 14.0 (Stata Corp LP, College Station, Texas, USA). Statistical significance was set at P < 0.05. Results: The IDPs in C2/3 (P < 0.001, P = 0.005, P < 0.001, P < 0.001), C4/5 (P < 0.001), and C6/7 (P < 0.001) of the intact group were significantly less than that in the fusion group in flexion, extension, lateral bending, and axial rotation, respectively. In addition, the IDPs in C2/3 (P < 0.001, P = 0.001, P < 0.001, P < 0.001), C4/5 (P < 0.001), and C6/7 (P < 0.001) of the arthroplasty group were significantly less than that in the fusion group in flexion, extension, lateral bending, and axial rotation, respectively. Contact forces of facet joints in C2/3 (P = 0.010) in the arthroplasty group was significantly less than that in the intact group. Contact forces of facet joints in C2/3 (P < 0.001), C4/5 (P < 0.001), and C6/7 (P < 0.001) in the arthroplasty group was significantly less than that in the fusion group. Contact forces of facet joints in C2/3 (P < 0.001), C4/5 (P < 0.001), and C6/7 (P < 0.001) in the intact group were significantly less than that in the fusion group.

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“…In Figure 2, the predicted IDPs at C3-C6 disk levels are compared with the experimental results at the lower cervical spine region, during various head movements. 41 The predicted IDPs seemed to be overestimated under the head lateral bending (RMSE = 0.0592 MPa, R 2 = 0.8221) and axial rotation (RMSE = 0.0512 MPa, R 2 = 0.9161) movements. By contrast, underestimated values were acquired by the model, during the head flexion/extension (RMSE = 0.0412 MPa, R 2 = 0.8249).…”

Section: Model Validationmentioning

confidence: 82%

“…In this study, significant correlations were confirmed between the predicted IDPs and the experimental results during the head motion. 41 Moreover, the small RMSEs suggest that the discrepancy between the predicted and measured values should be acceptable (Figure 2). However, it is worth to mention that further validation against real-time dynamic in vivo loading patterns is necessary.…”

Section: Discussionmentioning

confidence: 97%

Prediction of in vivo lower cervical spinal loading using musculoskeletal multi-body dynamics model during the head flexion/extension, lateral bending and axial rotation

Diao

Hua

Zhang

2018

Proc Inst Mech Eng H

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Cervical spine diseases lead to a heavy economic burden to the individuals and societies. Moreover, frequent post-operative complications mean a higher risk of neck pain and revision. At present, controversy still exists for the etiology of spinal diseases and their associated complications. Knowledge of in vivo cervical spinal loading pattern is proposed to be the key to answer these questions. However, direct acquisition of in vivo cervical spinal loading remains challenging. In this study, a previously developed cervical spine musculoskeletal multi-body dynamics model was utilized for spinal loading prediction. The in vivo dynamic segmental contributions to head motion and the out-of-plane coupled motion were both taken into account. First, model validation and sensitivity analysis of different segmental contributions to head motion were performed. For model validation, the predicted intervertebral disk compressive forces were converted into the intradiskal pressures and compared with the published experimental measurements. Significant correlations were found between the predicted values and the experimental results. Thus, the reliability and capability of the cervical spine model was ensured. Meanwhile, the sensitivity analysis indicated that cervical spinal loading is sensitive to different segmental contributions to head motion. Second, the compressive, shear and facet joint forces at C3-C6 disk levels were predicted, during the head flexion/extension, lateral bending and axial rotation. Under the head flexion/extension movement, asymmetric loading patterns of the intervertebral disk were obtained. In comparison, symmetrical typed loading patterns were found for the head lateral bending and axial rotation movements. However, the shear forces were dramatically increased during the head excessive extension and lateral bending. Besides, a nonlinear correlation was seen between the facet joint force and the angular displacement. In conclusion, dynamic cervical spinal loading was both intervertebral disk angle-dependent and level-dependent. Cervical spine musculoskeletal multi-body dynamics model provides an attempt to comprehend the in vivo biomechanical surrounding of the human head-neck system.

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Subaxial Cervical Intradiscal Pressure and Segmental Kinematics Following Atlantoaxial Fixation in Different Angles

Cited by 35 publications

References 24 publications

Biomechanics following skip-level cervical disc arthroplasty versus skip-level cervical discectomy and fusion: a finite element-based study

Biomechanics following skip-level cervical disc arthroplasty versus skip-level cervical discectomy and fusion: a finite element-based study

Biomechanical comparison of noncontiguous cervical disc arthroplasty and noncontiguous cervical discectomy and fusion in the treatment of noncontinuous cervical degenerative disc disease: a finite element analysis

Prediction of in vivo lower cervical spinal loading using musculoskeletal multi-body dynamics model during the head flexion/extension, lateral bending and axial rotation

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