The biomechanical effect of preexisting different types of disc herniation in cervical hyperextension injury
Abstract Objective Preexisting severe cervical spinal cord compression is a significant risk factor in cervical hyperextension injury, and the neurological function may deteriorate after a slight force to the forehead. There are few biomechanical studies regarding the influence of pathological facto...
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| Format: | Article |
| Language: | English |
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BMC
2021-08-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-021-02677-y |
| _version_ | 1797999744739442688 |
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| author | Jian-jie Wang Meng-lei Xu Hui-zi Zeng Liang-dong Zheng Shi-jie Zhu Chen Jin Zhi-li Zeng Li-ming Cheng Rui Zhu |
| author_facet | Jian-jie Wang Meng-lei Xu Hui-zi Zeng Liang-dong Zheng Shi-jie Zhu Chen Jin Zhi-li Zeng Li-ming Cheng Rui Zhu |
| author_sort | Jian-jie Wang |
| collection | DOAJ |
| description | Abstract Objective Preexisting severe cervical spinal cord compression is a significant risk factor in cervical hyperextension injury, and the neurological function may deteriorate after a slight force to the forehead. There are few biomechanical studies regarding the influence of pathological factors in hyperextension loading condition. The aim of this study is to analyze the effects of preexisting different types of cervical disc herniation and different degrees of compression on the spinal cord in cervical hyperextension. Method A 3D finite element (FE) model of cervical spinal cord was modeled. Local type with median herniation, local type with lateral herniation, diffuse type with median herniation, and diffuse type with lateral herniation were simulated in neutral and extention positions. The compressions which were equivalent to 10%, 20%, 30%, and 40% of the sagittal diameter of the spinal cord were modeled. Results The results of normal FE model were consistent with those of previous studies. The maximum von Mises stresses appeared in the pia mater for all 32 loading conditions. The maximum von Mises stresses in extension position were much higher than in neutral position. In most cases, the maximum von Mises stresses in diffuse type were higher than in local type. Conclusion Cervical spinal cord with preexisting disc herniation is more likely to be compressed in hyperextension situation than in neutral position. Diffuse type with median herniation may cause more severe compression with higher von Mises stresses concentrated at the anterior horn and the peripheral white matter, resulting in acute central cord syndrome from biomechanical point of view. |
| first_indexed | 2024-04-11T11:09:36Z |
| format | Article |
| id | doaj.art-5c42eed048f041b1b4ecf3d8b305032e |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-11T11:09:36Z |
| publishDate | 2021-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-5c42eed048f041b1b4ecf3d8b305032e2022-12-22T04:27:49ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2021-08-011611910.1186/s13018-021-02677-yThe biomechanical effect of preexisting different types of disc herniation in cervical hyperextension injuryJian-jie Wang0Meng-lei Xu1Hui-zi Zeng2Liang-dong Zheng3Shi-jie Zhu4Chen Jin5Zhi-li Zeng6Li-ming Cheng7Rui Zhu8Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Orthopaedic Department of Tongji Hospital, Tongji University School of MedicineKey Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Orthopaedic Department of Tongji Hospital, Tongji University School of MedicineKey Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Orthopaedic Department of Tongji Hospital, Tongji University School of MedicineKey Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Orthopaedic Department of Tongji Hospital, Tongji University School of MedicineKey Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Orthopaedic Department of Tongji Hospital, Tongji University School of MedicineKey Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Orthopaedic Department of Tongji Hospital, Tongji University School of MedicineKey Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Orthopaedic Department of Tongji Hospital, Tongji University School of MedicineKey Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Orthopaedic Department of Tongji Hospital, Tongji University School of MedicineKey Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Orthopaedic Department of Tongji Hospital, Tongji University School of MedicineAbstract Objective Preexisting severe cervical spinal cord compression is a significant risk factor in cervical hyperextension injury, and the neurological function may deteriorate after a slight force to the forehead. There are few biomechanical studies regarding the influence of pathological factors in hyperextension loading condition. The aim of this study is to analyze the effects of preexisting different types of cervical disc herniation and different degrees of compression on the spinal cord in cervical hyperextension. Method A 3D finite element (FE) model of cervical spinal cord was modeled. Local type with median herniation, local type with lateral herniation, diffuse type with median herniation, and diffuse type with lateral herniation were simulated in neutral and extention positions. The compressions which were equivalent to 10%, 20%, 30%, and 40% of the sagittal diameter of the spinal cord were modeled. Results The results of normal FE model were consistent with those of previous studies. The maximum von Mises stresses appeared in the pia mater for all 32 loading conditions. The maximum von Mises stresses in extension position were much higher than in neutral position. In most cases, the maximum von Mises stresses in diffuse type were higher than in local type. Conclusion Cervical spinal cord with preexisting disc herniation is more likely to be compressed in hyperextension situation than in neutral position. Diffuse type with median herniation may cause more severe compression with higher von Mises stresses concentrated at the anterior horn and the peripheral white matter, resulting in acute central cord syndrome from biomechanical point of view.https://doi.org/10.1186/s13018-021-02677-yCervical hyperextension injurySpinal cordDisc herniationFinite element |
| spellingShingle | Jian-jie Wang Meng-lei Xu Hui-zi Zeng Liang-dong Zheng Shi-jie Zhu Chen Jin Zhi-li Zeng Li-ming Cheng Rui Zhu The biomechanical effect of preexisting different types of disc herniation in cervical hyperextension injury Journal of Orthopaedic Surgery and Research Cervical hyperextension injury Spinal cord Disc herniation Finite element |
| title | The biomechanical effect of preexisting different types of disc herniation in cervical hyperextension injury |
| title_full | The biomechanical effect of preexisting different types of disc herniation in cervical hyperextension injury |
| title_fullStr | The biomechanical effect of preexisting different types of disc herniation in cervical hyperextension injury |
| title_full_unstemmed | The biomechanical effect of preexisting different types of disc herniation in cervical hyperextension injury |
| title_short | The biomechanical effect of preexisting different types of disc herniation in cervical hyperextension injury |
| title_sort | biomechanical effect of preexisting different types of disc herniation in cervical hyperextension injury |
| topic | Cervical hyperextension injury Spinal cord Disc herniation Finite element |
| url | https://doi.org/10.1186/s13018-021-02677-y |
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