Unique biomechanical signatures of Bryan, Prodisc C, and Prestige LP cervical disc replacements: a finite element modelling study

Choi, Hyo-Sang; Purushothaman, Yuvaraj; Baisden, Jamie; Yoganandan, Narayan

doi:10.1007/s00586-019-06113-y

Cited by 31 publications

(25 citation statements)

References 32 publications

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“…We used a validated finite element model of the C2-T1 portion of the spinal column [8,9]. The model included the following components: (1) cancellous core and cortical shell of the vertebral bodies, their posterior elements, i.e., laminae, pedicles and spinous processes, and the dens of the axis; (2) intervertebral disk annular fibers, ground substance, and nucleus pulposus; and (3) anterior and posterior longitudinal ligaments, joint capsules of the lateral mass, ligamentum flavum, and interspinous ligaments.…”

Section: Intact Spinal Columnmentioning

confidence: 99%

A Comparison Study of Four Cervical Disk Arthroplasty Devices Using Finite Element Models

et al. 2021

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Study Design: The study examined and compared four artificial cervical disks using validated finite element models.Purpose: To compare and contrast the biomechanical behavior of four artificial cervical disks by determining the external (range of motion) and internal (facet force and intradiscal pressure) responses following cervical disc arthroplasty (CDA) and to elucidate any device design effects on cervical biomechanics.Overview of Literature: Despite CDA’s increasing popularity most studies compare the CDA procedure with anterior cervical discectomy and fusion. There is little comparative evaluation of different artificial disks and, therefore, little understanding of how varying disk designs may influence spinal biomechanics.Methods: A validated C2–T1 finite element model was subjected to flexion-extension. CDAs were simulated at the C5–C6 level with the Secure-C, Mobi-C, Prestige LP, and Prodisc C prosthetic disks. We used a hybrid loading protocol to apply sagittal moments. Normalized motions at the index and adjacent levels, and intradiscal pressures and facet column loads were also obtained.Results: The ranges of motion at the index level increased after CDA. The Mobi-C prosthesis demonstrated the highest amount of flexion, followed by the Secure-C, Prestige LP, and Prodisc C. The Secure-C demonstrated the highest amount of extension, followed by the Mobi-C, Prodisc C, and Prestige LP. The motion decreased at the rostral and caudal adjacent levels. Facet forces increased at the index level and decreased at the rostral and caudal adjacent levels following CDA. Intradiscal pressures decreased at the adjacent levels for the Mobi-C, Secure-C, and Prodisc C. Conversely, the use of the Prestige LP increased intradiscal pressure at both adjacent levels.Conclusions: While all artificial disks were useful in restoring the index level motion, the Secure-C and Mobi-C translating abilities allowed for lower intradiscal pressures at the adjacent segments and may be the driving mechanism for minimizing adjacent segment degenerative arthritic changes. The facet joint integrity should also be considered in the clinical decision-making process for CDA selection.

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Section: Intact Spinal Columnmentioning

confidence: 99%

A Comparison Study of Four Cervical Disk Arthroplasty Devices Using Finite Element Models

et al. 2021

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“…Cervical artificial disc replacement aims to prevent adjacent segment degeneration by restoring intervertebral disc mobility in degenerative segmental motion. The Prestige LP prosthesis was chosen because of its current global popularity and because it is similar to most ball-in-socket sliding articulations used today (Choi et al, 2020). The Prestige LP is an open two-piece, semi-constrained design with metal-on-metal ball-in-socket articulation.…”

Section: Discussionmentioning

confidence: 99%

Biomechanical Analysis of Cervical Artificial Disc Replacement Using Cervical Subtotal Discectomy Prosthesis

Lv²,

Wang

et al. 2021

Front. Bioeng. Biotechnol.

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Background: Anterior cervical discectomy and fusion (ACDF) sacrifices segmental mobility, which can lead to the acceleration of adjacent segment degeneration. The challenge has promoted cervical artificial disc replacement (CADR) as a substitute for ACDF. However, CADR has revealed a series of new issues that are not found in ACDF, such as hypermobility, subsidence, and wear phenomenon. This study designed a cervical subtotal discectomy prosthesis (CSDP) consisting of a cervical disc prosthesis structure (CDP structure), cervical vertebra fixation structure (CVF structure), link structure, and locking screw, aiming to facilitate motion control and reduce subsidence. The aim of this study was to assess the biomechanics of the CSDP using finite element (FE) analysis, friction-wear test, and non-human primates implantation study.Study Design: For the FE analysis, based on an intact FE C2-C7 spinal model, a CSDP was implanted at C5-C6 to establish the CSDP FE model and compare it with the Prestige LP prosthesis (Medtronic Sofamor Danek, Minneapolis, MN, United States). The range of motion (ROM), bone-implant interface stress, and facet joint force were calculated under flexion extension, lateral bending, and axial rotation. In addition, CSDP was elevated 1 mm to mimic an improper implantation technique to analyze the biomechanics of CSDP errors in the FE model. Moreover, the friction-wear test was conducted in vitro to research CSDP durability and observe surface wear morphology and total wear volume. Finally, the CSDP was implanted into non-human primates, and its properties were evaluated and verified by radiology.Results: In the FE analysis, the ROM of the CSDP FE model was close to that of the intact FE model in the operative and adjacent segments. In the operative segment, the CSDP error FE model increased ROM in flexion extension, lateral bending, and axial rotation. The maximum stress in the CSDP FE model was similar to that of the intact FE model and was located in the peripheral cortical bone region. The facet joint force changes were minimal in extension, lateral bending, and axial rotation loads in CSDP. In the friction-wear test, after the 150-W movement simulation, both the CVF-link-junction and the CDP-link-junction had slight wear. In the CSDP non-human primate implantation study, no subsidence, dislocation, or loosening was observed.Conclusion: In the FE analysis, the biomechanical parameters of the CSDP FE model were relatively close to those of the intact FE model when compared with the Prestige LP FE model. In terms of CSDP error FE models, we demonstrated that the implantation position influences CSDP performance, such as ROM, bone-implant interface stress, and facet joint force. In addition, we performed a friction-wear test on the CSDP to prove its durability. Finally, CSDP studies with non-human primates have shown that the CSDP is effective.

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“…The annulus ground and fibre definitions that make up the annulus were modelled as detailed in a recent finite element study. 19 The material properties [Table 1] used in the study and their references have been given in Table 1.…”

Section: Methodsmentioning

confidence: 99%

Effect of heterotopic ossification after bryan-cervical disc arthroplasty on adjacent level range of motion: A finite element study

Sajja

Shruthi

et al. 2021

Journal of Clinical Orthopaedics and Trauma

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Background: Quantitative bone re-modelling theories suggest that bones adapt to mechanical loading conditions. Follow-up studies have shown that total disc replacement (TDR) modifies stress patterns in the bones, leading to heterotopic ossification (HO). Although there are a few studies on HO using finite element models (FEM), its effect on the adjacent levels and change in range of motion (ROM) have not been adequately investigated. This study interfaces the HO using bone re-modelling algorithm with a finite element solution and investigates the subsequent changes in segmental ROM. Methods: A FEM of the human cervical spine (C3eC7) was developed for this study, with material properties obtained from literature. The motion of the segments in the sagittal, frontal and transverse planes under combined loading conditions of 1 Nm moment and 73.6 N compression were validated against experimental corridors. The natural disc between the C5eC6 segment was replaced with the Bryan artificial cervical disc, and changes in sagittal ROM were compared before and after HO. The process of HO was simulated using a bone remodelling algorithm using strain energy density (SED) as the mechanical stimuli. Results and conclusion: Our study demonstrates the feasibility of using SED calculations from the flexionextension loading conditions for prediction of HO after ADR. The current findings suggest that the nature of trabecular stresses, and the subsequent rate and location of HO formation could differ based on the geometric design and nature of constraint for different artificial discs. The Bryan disc significantly reduced ROM at the implanted level in flexion. However, in extension, ROM increased at the implanted level and decreased slightly at the adjacent levels. After HO, ROM drastically reduced at the implanted level in both extension and flexion, and showed a minor increase in the adjacent levels, indicating that biomechanical behavior of high-grade HO is similar to a fused segment, thereby reducing the intended and initial motion preservation.

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Unique biomechanical signatures of Bryan, Prodisc C, and Prestige LP cervical disc replacements: a finite element modelling study

Cited by 31 publications

References 32 publications

A Comparison Study of Four Cervical Disk Arthroplasty Devices Using Finite Element Models

A Comparison Study of Four Cervical Disk Arthroplasty Devices Using Finite Element Models

Biomechanical Analysis of Cervical Artificial Disc Replacement Using Cervical Subtotal Discectomy Prosthesis

Effect of heterotopic ossification after bryan-cervical disc arthroplasty on adjacent level range of motion: A finite element study

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