The biomechanical impact of facet tropism on the intervertebral disc and facet joints in the cervical spine

Xiao, Rong; Wang, Beiyu; Ding, Chen; Deng, Yuxiao; Chen, Hua; Meng, Yang; Yan, Weijie; Líu, Hao

doi:10.1016/j.spinee.2017.07.009

Cited by 50 publications

(65 citation statements)

References 28 publications

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“…The finite element models (FEMs) of the cervical spine (C2-C7) were built according to the method reported by Rong et al [14]. The models were constructed based on the CT images (a 0.75 mm thickness and a 0.69-mm interval, SOMATOM Definition AS+, Siemens, Germany) of 8 mild CDDD volunteers (4 male and 4 females).…”

Section: Geometry Modelsmentioning

confidence: 99%

“…The ratio of annulus fibrosus and nucleus pulposus in the intervertebral disc was 6:4; annulus fibers, which comprised 19% of the total annulus fibrosus volume, were developed with an inclination (15 to 30°) to the transverse plane [15]. The distance of the upper and lower facet articular surfaces was 0.5 mm; the facet articular surfaces were covered with articular cartilage layer; the surface to surface contact was set to nonlinear [14]. The five intervertebral ligaments, the ALL, the PLL, the ligamentum flavum (LF), the interspinous ligaments (ILs), and capsular ligaments (CLs), were modeled as tension-only truss elements and attached to the corresponding vertebrae.…”

Section: Materials Propertiesmentioning

confidence: 99%

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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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Section: Geometry Modelsmentioning

confidence: 99%

Section: Materials Propertiesmentioning

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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“…In literature, Rong et al, demonstrated that biomechanical forces such as flexion-extension via increasing intradiscal pressure may cause disc degeneration in the facet tropism model, especially at C5-C6 level. 17 Lumbar facet joints have an important place in the control of the movement of the spine. 18 Our study is the first study evaluating FJT and rotational movements at lumbar level.…”

Section: Discussionmentioning

confidence: 99%

The assessment of pain, flexibility and daily activity level in the patients who had facet tropism

2020

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Background:The aim of this study to investigate the relationship between asymmetric angular value in lumbar facet joints and pain, flexibility and daily activity level. Methods: The study included 51 patients with complaint of low back pain (LBP) and underwent lumbar magnetic resonance imaging. Facet joint angle measurements of L4-L5 and L5-S1 were measured. Visual analogue scale (VAS) was used for severity of pain. Joint range of motions (ROM) was measured via goniometry. Body extensibility measurements were performed via body hyperextension test. The Nottingham health profile scale was used to assess daily activity level of individuals. Results:The VAS values of patients with tropism were significantly higher (p=0.016). There wasn't significance difference in ROM and flexibility (p=0.784). In patient group with facet tropism, there was limit of lateral flexion towards the side where the facet joint angle was larger than the control group (p=0.002). There was no significant difference between daily activity levels of both groups (p=0.755). Conclusions: Pain severity of facet tropism patients is higher. Patients with facet tropism had lateral flexion restriction. In the light of these findings, when the lateral flexion limitation is detected in individuals with complaints of pain without discopathy, it's necessary to make MR measurements in differential diagnosis by considering facet joint tropism, and to plan physiotherapy and rehabilitation programs. As a result, tropism should be questioned in patients suffering from LBP and limited lateral flexion. There is need for studies in which different evaluation and treatment methods are applied for tropism.

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“…There were four cases (30.8%) of ASDis at C2/3 and eight cases (61.5%) of ASDis at C3/4. Increased contact and pressure during treatment or adjacent levels of facet joints may lead to micro-damage of the facet joint and eventually accelerate the degradation of the adjacent segment facet joint [30,31].…”

Section: Slac Requires Laminectomy and C2 Laminoplasty-domementioning

confidence: 99%

Longitudinal spinous-splitting laminoplasty with coral bone for the treatment of cervical adjacent segment degenerative disease: A 5-year follow-up study

Wang

Tian

et al. 2020

Preprint

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Background: To analyze the causes of cervical adjacent segment degenerative disease (ASDis), explore the surgical results of longitudinal spinous-splitting laminoplasty with coral bone (SLAC) during cervical reoperation, and accumulate data on reoperation with SLAC in a primary hospital.Methods: We conducted a retrospective study. From 1998 to 2014, 52 patients underwent cervical reoperation for ASDis using SLAC at our hospital. Among them, 39 were treated with anterior cervical fusion and internal fixation in the first operation (anterior cervical corpectomy with fusion [ACCF], n=24; anterior cervical discectomy and fusion [ACDF], n=11; and cervical disc arthroplasty [CDA], n=4).Results: In patients who underwent an anterior cervical approach in the first instance, ASDis was significantly higher in the C3/4 gap than in other gaps. In the ACCF group, the lateral radiograph of the cervical spine revealed that the distance between the anterior cervical plate and adjacent segment disc in15 cases (62.5%) was <5 mm, and five cases (12.8%) had internal fixation screws that broke into the annulus of the adjacent segment. After the first SLAC, ASDis occurred in C2/3 and C3/4 in four (30.8%) and eight cases (61.5%), respectively. Post-reoperation, all cases were follow-up for >5 (average, 6.2) years. Comparing pre-reoperation and last follow-up values, the mean Japanese Orthopedic Association score was 10.2±1.5 versus15.5±0.7 (P=0.03), neck disability index was 26.2 versus13.6 points (P=0.01), upper-limb visual analog scale (VAS) score was 6.1 versus2.6 points (P=0.04), and neck and shoulder VAS score was 6.6 versus 2.1 points (P=0.03).Conclusions: ASDis was primarily caused by 1) a distance of <5 mm between the anterior cervical plate and adjacent segment disc and 2) the screw breaking through the adjacent segmental annulus. SLAC proved to be a simple technique, with clear local anatomy and satisfactory clinical results.

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The biomechanical impact of facet tropism on the intervertebral disc and facet joints in the cervical spine

Cited by 50 publications

References 28 publications

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

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

The assessment of pain, flexibility and daily activity level in the patients who had facet tropism

Longitudinal spinous-splitting laminoplasty with coral bone for the treatment of cervical adjacent segment degenerative disease: A 5-year follow-up study

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