Single‐level cervical disc arthroplasty in the spine with reversible kyphosis: A finite element study
Abstract Background Our previous studies found the single‐level cervical disc arthroplasty (CDA) might be a feasible treatment for the patients with reversible kyphosis (RK). Theoretically, the change of cervical alignment from lordosis to RK comes with the biomechanical alteration of prostheses and...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2022-06-01
|
| Series: | JOR Spine |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/jsp2.1194 |
| _version_ | 1828326766499856384 |
|---|---|
| author | Xu Hu Majiao Jiang Ying Hong Xin Rong Kangkang Huang Hao Liu Dan Pu Beiyu Wang |
| author_facet | Xu Hu Majiao Jiang Ying Hong Xin Rong Kangkang Huang Hao Liu Dan Pu Beiyu Wang |
| author_sort | Xu Hu |
| collection | DOAJ |
| description | Abstract Background Our previous studies found the single‐level cervical disc arthroplasty (CDA) might be a feasible treatment for the patients with reversible kyphosis (RK). Theoretically, the change of cervical alignment from lordosis to RK comes with the biomechanical alteration of prostheses and cervical spine. However, the biomechanical data of CDA in the spine with RK have not been reported. This study aimed at establishing finite element (FE) models to (1) explore the effects of RK on the biomechanics of artificial cervical disc; (2) investigate the biomechanical differences of single‐level anterior cervical discectomy and fusion (ACDF) and CDA in the cervical spine with RK. Methods The FE models of the cervical spine with lordosis and RK were constructed, then three single‐level surgical models were developed: (1) RK + ACDF; (2) RK + CDA; (3) lordosis + CDA. A 73.6‐N follower load combined with 1 N·m moment was applied at the C2 vertebra to produce cervical motion. Results At the surgical level, “lordosis + CDA” had the greatest ROM (except for flexion) while “RK + ACDF” had the minimum ROM. However, at adjacent levels, the ROM of “RK + ACDF” increased by 4.05% to 38.04% in comparison to “RK + CDA.” “RK + ACDF” had the greatest prosthesis interface stress, while the maximum prosthesis interface stress of “RK + CDA” was at least 2.15 times higher than “lordosis + CDA.” Similarly, “RK + ACDF” had the greatest intradiscal pressure (IDP) at adjacent levels, while the IDP of “RK + CDA” was 1.6 to 6.7 times higher than “lordosis + CDA.” At the surgical level, “RK + CDA” had the greatest facet joint stress (except for extension), which was 1.9 to 11.2 times higher than “lordosis + CDA.” At the adjacent levels, “RK + CDA” had the greatest facet joint stress (except for extension), followed by “RK + ACDF” and “lordosis + CDA” in descending order. Conclusions RK significantly changed the biomechanics of CDA, which is demonstrated by the decreased ROM and the significantly increased prosthesis interface stress, IDP, and facet joint stress in the “RK + CDA” model. Compared with ACDF, CDA overall exhibited a better biomechanical performance in the cervical spine with RK, with the increased ROM of surgical level and facet joint stress and the decreased ROM of adjacent levels, prosthesis interface stress, and IDP. |
| first_indexed | 2024-04-13T19:46:04Z |
| format | Article |
| id | doaj.art-24912d655b444d6ba3ba73ffd762aba4 |
| institution | Directory Open Access Journal |
| issn | 2572-1143 |
| language | English |
| last_indexed | 2024-04-13T19:46:04Z |
| publishDate | 2022-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | JOR Spine |
| spelling | doaj.art-24912d655b444d6ba3ba73ffd762aba42022-12-22T02:32:44ZengWileyJOR Spine2572-11432022-06-0152n/an/a10.1002/jsp2.1194Single‐level cervical disc arthroplasty in the spine with reversible kyphosis: A finite element studyXu Hu0Majiao Jiang1Ying Hong2Xin Rong3Kangkang Huang4Hao Liu5Dan Pu6Beiyu Wang7Department of Orthopedics, Orthopedic Research Institute West China Hospital, Sichuan University Chengdu Sichuan Province ChinaDepartment of Anesthesia and Operation Center, West China School of Nursing West China Hospital, Sichuan University Chengdu Sichuan Province ChinaDepartment of Anesthesia and Operation Center, West China School of Nursing West China Hospital, Sichuan University Chengdu Sichuan Province ChinaDepartment of Orthopedics, Orthopedic Research Institute West China Hospital, Sichuan University Chengdu Sichuan Province ChinaDepartment of Orthopedics, Orthopedic Research Institute West China Hospital, Sichuan University Chengdu Sichuan Province ChinaDepartment of Orthopedics, Orthopedic Research Institute West China Hospital, Sichuan University Chengdu Sichuan Province ChinaClinic Skill Center West China Hospital, Sichuan University Chengdu Sichuan ChinaDepartment of Orthopedics, Orthopedic Research Institute West China Hospital, Sichuan University Chengdu Sichuan Province ChinaAbstract Background Our previous studies found the single‐level cervical disc arthroplasty (CDA) might be a feasible treatment for the patients with reversible kyphosis (RK). Theoretically, the change of cervical alignment from lordosis to RK comes with the biomechanical alteration of prostheses and cervical spine. However, the biomechanical data of CDA in the spine with RK have not been reported. This study aimed at establishing finite element (FE) models to (1) explore the effects of RK on the biomechanics of artificial cervical disc; (2) investigate the biomechanical differences of single‐level anterior cervical discectomy and fusion (ACDF) and CDA in the cervical spine with RK. Methods The FE models of the cervical spine with lordosis and RK were constructed, then three single‐level surgical models were developed: (1) RK + ACDF; (2) RK + CDA; (3) lordosis + CDA. A 73.6‐N follower load combined with 1 N·m moment was applied at the C2 vertebra to produce cervical motion. Results At the surgical level, “lordosis + CDA” had the greatest ROM (except for flexion) while “RK + ACDF” had the minimum ROM. However, at adjacent levels, the ROM of “RK + ACDF” increased by 4.05% to 38.04% in comparison to “RK + CDA.” “RK + ACDF” had the greatest prosthesis interface stress, while the maximum prosthesis interface stress of “RK + CDA” was at least 2.15 times higher than “lordosis + CDA.” Similarly, “RK + ACDF” had the greatest intradiscal pressure (IDP) at adjacent levels, while the IDP of “RK + CDA” was 1.6 to 6.7 times higher than “lordosis + CDA.” At the surgical level, “RK + CDA” had the greatest facet joint stress (except for extension), which was 1.9 to 11.2 times higher than “lordosis + CDA.” At the adjacent levels, “RK + CDA” had the greatest facet joint stress (except for extension), followed by “RK + ACDF” and “lordosis + CDA” in descending order. Conclusions RK significantly changed the biomechanics of CDA, which is demonstrated by the decreased ROM and the significantly increased prosthesis interface stress, IDP, and facet joint stress in the “RK + CDA” model. Compared with ACDF, CDA overall exhibited a better biomechanical performance in the cervical spine with RK, with the increased ROM of surgical level and facet joint stress and the decreased ROM of adjacent levels, prosthesis interface stress, and IDP.https://doi.org/10.1002/jsp2.1194anterior cervical discectomy and fusionbiomechanicscervical disc arthroplastyfinite element analysisreversible kyphosis |
| spellingShingle | Xu Hu Majiao Jiang Ying Hong Xin Rong Kangkang Huang Hao Liu Dan Pu Beiyu Wang Single‐level cervical disc arthroplasty in the spine with reversible kyphosis: A finite element study JOR Spine anterior cervical discectomy and fusion biomechanics cervical disc arthroplasty finite element analysis reversible kyphosis |
| title | Single‐level cervical disc arthroplasty in the spine with reversible kyphosis: A finite element study |
| title_full | Single‐level cervical disc arthroplasty in the spine with reversible kyphosis: A finite element study |
| title_fullStr | Single‐level cervical disc arthroplasty in the spine with reversible kyphosis: A finite element study |
| title_full_unstemmed | Single‐level cervical disc arthroplasty in the spine with reversible kyphosis: A finite element study |
| title_short | Single‐level cervical disc arthroplasty in the spine with reversible kyphosis: A finite element study |
| title_sort | single level cervical disc arthroplasty in the spine with reversible kyphosis a finite element study |
| topic | anterior cervical discectomy and fusion biomechanics cervical disc arthroplasty finite element analysis reversible kyphosis |
| url | https://doi.org/10.1002/jsp2.1194 |
| work_keys_str_mv | AT xuhu singlelevelcervicaldiscarthroplastyinthespinewithreversiblekyphosisafiniteelementstudy AT majiaojiang singlelevelcervicaldiscarthroplastyinthespinewithreversiblekyphosisafiniteelementstudy AT yinghong singlelevelcervicaldiscarthroplastyinthespinewithreversiblekyphosisafiniteelementstudy AT xinrong singlelevelcervicaldiscarthroplastyinthespinewithreversiblekyphosisafiniteelementstudy AT kangkanghuang singlelevelcervicaldiscarthroplastyinthespinewithreversiblekyphosisafiniteelementstudy AT haoliu singlelevelcervicaldiscarthroplastyinthespinewithreversiblekyphosisafiniteelementstudy AT danpu singlelevelcervicaldiscarthroplastyinthespinewithreversiblekyphosisafiniteelementstudy AT beiyuwang singlelevelcervicaldiscarthroplastyinthespinewithreversiblekyphosisafiniteelementstudy |