Biomechanical comparison of static and dynamic cervical plates in terms of the bone fusion, tissue degeneration, and implant behavior
Abstract Introduction Using an anterior cervical fixation device in the anterior cervical discectomy and fusion (ACDF) has evolved to various systems of static and dynamic cervical plates (SCP and DCP). Dynamic cervical plates have been divided into three categories: the rotational (DCP-R), translat...
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| Format: | Article |
| Language: | English |
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BMC
2024-02-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-024-04629-8 |
| _version_ | 1827326707558776832 |
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| author | Tzu-Tsao Chung Dueng-Yuan Hueng Shang-Chih Lin |
| author_facet | Tzu-Tsao Chung Dueng-Yuan Hueng Shang-Chih Lin |
| author_sort | Tzu-Tsao Chung |
| collection | DOAJ |
| description | Abstract Introduction Using an anterior cervical fixation device in the anterior cervical discectomy and fusion (ACDF) has evolved to various systems of static and dynamic cervical plates (SCP and DCP). Dynamic cervical plates have been divided into three categories: the rotational (DCP-R), translational (DCP-T), and hybrid (DCP-H) joints. However, little studies have been devoted to systematically investigate the biomechanical differences of dynamic cervical plates. Materials and methods The biomechanical tests of load-deformation properties and failure modes between the SCP and DCP systems are implemented first by using the UHMWPE blocks as the vertebral specimens. The CT-based C2-C7 model simulates the strategies of cervical plate in ACDF surgery is developed with finite-element analyses. One intact, one SCP and two DCP systems are evaluated for their biomechanical properties of bone fusion and tissue responses. Results In the situation of biomechanical test, The mean values of the five ACDSP constructs are 393.6% for construct stiffness (p < 0.05) and 183.0% for the first yielding load (p < 0.05) less than those of the SCP groups, respectively. In the situation of finite-element analysis, the rigid-induced ASD is more severe for the SCP, followed by the DCP-H, and the DCP-R is the least. Discussion and conclusions Considering the degenerative degree of the adjacent segments and osteoporotic severity of the instrumented segments is necessary while using dynamic system. The mobility and stability of the rotational and translational joints are the key factors to the fusion rate and ASD progression. If the adjacent segments have been degenerative, the more flexible system can be adopted to compensate the constrained mobility of the ACDF segments. In the situation of the osteoporotic ACDF vertebrae, the stiffer system is recommended to avoid the cage subsidence. |
| first_indexed | 2024-03-07T14:49:21Z |
| format | Article |
| id | doaj.art-236181ea5a01452fa511c008406492c5 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-03-07T14:49:21Z |
| publishDate | 2024-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-236181ea5a01452fa511c008406492c52024-03-05T19:45:38ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2024-02-0119111210.1186/s13018-024-04629-8Biomechanical comparison of static and dynamic cervical plates in terms of the bone fusion, tissue degeneration, and implant behaviorTzu-Tsao Chung0Dueng-Yuan Hueng1Shang-Chih Lin2Graduate Institute of Applied Science and Technology, National Taiwan University of Science and TechnologyDepartment of Neurological Surgery, Tri-Service General Hospital, National Defense Medical CenterGraduate Institute of Biomedical Engineering, National Taiwan University of Science and TechnologyAbstract Introduction Using an anterior cervical fixation device in the anterior cervical discectomy and fusion (ACDF) has evolved to various systems of static and dynamic cervical plates (SCP and DCP). Dynamic cervical plates have been divided into three categories: the rotational (DCP-R), translational (DCP-T), and hybrid (DCP-H) joints. However, little studies have been devoted to systematically investigate the biomechanical differences of dynamic cervical plates. Materials and methods The biomechanical tests of load-deformation properties and failure modes between the SCP and DCP systems are implemented first by using the UHMWPE blocks as the vertebral specimens. The CT-based C2-C7 model simulates the strategies of cervical plate in ACDF surgery is developed with finite-element analyses. One intact, one SCP and two DCP systems are evaluated for their biomechanical properties of bone fusion and tissue responses. Results In the situation of biomechanical test, The mean values of the five ACDSP constructs are 393.6% for construct stiffness (p < 0.05) and 183.0% for the first yielding load (p < 0.05) less than those of the SCP groups, respectively. In the situation of finite-element analysis, the rigid-induced ASD is more severe for the SCP, followed by the DCP-H, and the DCP-R is the least. Discussion and conclusions Considering the degenerative degree of the adjacent segments and osteoporotic severity of the instrumented segments is necessary while using dynamic system. The mobility and stability of the rotational and translational joints are the key factors to the fusion rate and ASD progression. If the adjacent segments have been degenerative, the more flexible system can be adopted to compensate the constrained mobility of the ACDF segments. In the situation of the osteoporotic ACDF vertebrae, the stiffer system is recommended to avoid the cage subsidence.https://doi.org/10.1186/s13018-024-04629-8Dynamic plateACDFASDFinite-element analysisCervical degeneration |
| spellingShingle | Tzu-Tsao Chung Dueng-Yuan Hueng Shang-Chih Lin Biomechanical comparison of static and dynamic cervical plates in terms of the bone fusion, tissue degeneration, and implant behavior Journal of Orthopaedic Surgery and Research Dynamic plate ACDF ASD Finite-element analysis Cervical degeneration |
| title | Biomechanical comparison of static and dynamic cervical plates in terms of the bone fusion, tissue degeneration, and implant behavior |
| title_full | Biomechanical comparison of static and dynamic cervical plates in terms of the bone fusion, tissue degeneration, and implant behavior |
| title_fullStr | Biomechanical comparison of static and dynamic cervical plates in terms of the bone fusion, tissue degeneration, and implant behavior |
| title_full_unstemmed | Biomechanical comparison of static and dynamic cervical plates in terms of the bone fusion, tissue degeneration, and implant behavior |
| title_short | Biomechanical comparison of static and dynamic cervical plates in terms of the bone fusion, tissue degeneration, and implant behavior |
| title_sort | biomechanical comparison of static and dynamic cervical plates in terms of the bone fusion tissue degeneration and implant behavior |
| topic | Dynamic plate ACDF ASD Finite-element analysis Cervical degeneration |
| url | https://doi.org/10.1186/s13018-024-04629-8 |
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