Segment selection for fusion and artificial disc replacement in the hybrid surgical treatment of noncontiguous cervical spondylosis: a finite element analysis
Introduction: The treatment of skip-level cervical degenerative disease (CDD) with no degenerative changes observed in the intervening segment (IS) is complicated. This research aims to provide a reference basis for selecting treatment approaches for noncontiguous CDD.Methods: To establish accurate...
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Frontiers Media S.A.
2024-04-01
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| Series: | Frontiers in Bioengineering and Biotechnology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fbioe.2024.1345319/full |
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| author | Xiangyao Sun Xiangyao Sun Xiangyao Sun Jiang Huang Jiang Huang Qingming Zhang Qingming Zhang Li Cao Li Cao Yuqi Liu Zelong Song Zelong Song Wei Tang Siyuan Sun Juyong Wang Juyong Wang |
| author_facet | Xiangyao Sun Xiangyao Sun Xiangyao Sun Jiang Huang Jiang Huang Qingming Zhang Qingming Zhang Li Cao Li Cao Yuqi Liu Zelong Song Zelong Song Wei Tang Siyuan Sun Juyong Wang Juyong Wang |
| author_sort | Xiangyao Sun |
| collection | DOAJ |
| description | Introduction: The treatment of skip-level cervical degenerative disease (CDD) with no degenerative changes observed in the intervening segment (IS) is complicated. This research aims to provide a reference basis for selecting treatment approaches for noncontiguous CDD.Methods: To establish accurate finite element models (FEMs), this study included computed tomography (CT) data from 21 patients with CDD (10 males and 11 females) for modeling. The study primarily discusses four cross-segment surgical approaches: upper (C3/4) anterior cervical discectomy and fusion (ACDF) and lower (C5/6) cervical disc arthroplasty (CDA), FA model; upper CDA (C3/4) and lower ACDF (C5/6), AF model; upper ACDF (C3/4) and lower ACDF (C5/6), FF model; upper CDA (C3/4) and lower CDA (C5/6), AA model. An initial axial load of 73.6 N was applied at the motion center using the follower load technique. A moment of 1.0 Nm was applied at the center of the C2 vertebra to simulate the overall motion of the model. The statistical analysis was conducted using STATA version 14.0. Statistical significance was defined as a p value less than 0.05.Results: The AA group had significantly greater ROM in flexion and axial rotation in other segments compared to the FA group (p < 0.05). The FA group consistently exhibited higher average intervertebral disc pressure in C2/3 during all motions compared to the AF group (p < 0.001); however, the FA group displayed lower average intervertebral disc pressure in C6/7 during all motions (p < 0.05). The AA group had lower facet joint contact stresses during extension in all segments compared to the AF group (p < 0.05). The FA group exhibited significantly higher facet joint contact stresses during extension in C2/3 (p < 0.001) and C6/7 (p < 0.001) compared to the AF group.Discussion: The use of skip-level CDA is recommended for the treatment of non-contiguous CDD. The FA construct shows superior biomechanical performance compared to the AF construct. |
| first_indexed | 2024-04-24T14:25:51Z |
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| language | English |
| last_indexed | 2024-04-24T14:25:51Z |
| publishDate | 2024-04-01 |
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| spelling | doaj.art-9175ea72979d42b8b41ae8b98f9cace12024-04-03T04:57:22ZengFrontiers Media S.A.Frontiers in Bioengineering and Biotechnology2296-41852024-04-011210.3389/fbioe.2024.13453191345319Segment selection for fusion and artificial disc replacement in the hybrid surgical treatment of noncontiguous cervical spondylosis: a finite element analysisXiangyao Sun0Xiangyao Sun1Xiangyao Sun2Jiang Huang3Jiang Huang4Qingming Zhang5Qingming Zhang6Li Cao7Li Cao8Yuqi Liu9Zelong Song10Zelong Song11Wei Tang12Siyuan Sun13Juyong Wang14Juyong Wang15Department of Orthopaedics, Xuanwu Hospital, Capital Medical University, Beijing, ChinaNational Clinical Research Center for Geriatric Diseases, Beijing, ChinaBeijing Glitzern Technology Co., Ltd., Beijing, ChinaDepartment of Orthopaedics, Xuanwu Hospital, Capital Medical University, Beijing, ChinaNational Clinical Research Center for Geriatric Diseases, Beijing, ChinaDepartment of Orthopaedics, Xuanwu Hospital, Capital Medical University, Beijing, ChinaNational Clinical Research Center for Geriatric Diseases, Beijing, ChinaDepartment of Orthopaedics, Xuanwu Hospital, Capital Medical University, Beijing, ChinaNational Clinical Research Center for Geriatric Diseases, Beijing, ChinaDepartment of Emergency, Xuanwu Hospital, Capital Medical University, Beijing, ChinaNankai University School of Medicine, Nankai University, Tianjin, ChinaDepartment of Orthopaedics, The PLA General Hospital, Beijing, ChinaBeijing Glitzern Technology Co., Ltd., Beijing, ChinaDepartment of Interdisciplinary, Life Science, Purdue University, West Lafayette, IN, United StatesDepartment of Orthopaedics, Xuanwu Hospital, Capital Medical University, Beijing, ChinaNational Clinical Research Center for Geriatric Diseases, Beijing, ChinaIntroduction: The treatment of skip-level cervical degenerative disease (CDD) with no degenerative changes observed in the intervening segment (IS) is complicated. This research aims to provide a reference basis for selecting treatment approaches for noncontiguous CDD.Methods: To establish accurate finite element models (FEMs), this study included computed tomography (CT) data from 21 patients with CDD (10 males and 11 females) for modeling. The study primarily discusses four cross-segment surgical approaches: upper (C3/4) anterior cervical discectomy and fusion (ACDF) and lower (C5/6) cervical disc arthroplasty (CDA), FA model; upper CDA (C3/4) and lower ACDF (C5/6), AF model; upper ACDF (C3/4) and lower ACDF (C5/6), FF model; upper CDA (C3/4) and lower CDA (C5/6), AA model. An initial axial load of 73.6 N was applied at the motion center using the follower load technique. A moment of 1.0 Nm was applied at the center of the C2 vertebra to simulate the overall motion of the model. The statistical analysis was conducted using STATA version 14.0. Statistical significance was defined as a p value less than 0.05.Results: The AA group had significantly greater ROM in flexion and axial rotation in other segments compared to the FA group (p < 0.05). The FA group consistently exhibited higher average intervertebral disc pressure in C2/3 during all motions compared to the AF group (p < 0.001); however, the FA group displayed lower average intervertebral disc pressure in C6/7 during all motions (p < 0.05). The AA group had lower facet joint contact stresses during extension in all segments compared to the AF group (p < 0.05). The FA group exhibited significantly higher facet joint contact stresses during extension in C2/3 (p < 0.001) and C6/7 (p < 0.001) compared to the AF group.Discussion: The use of skip-level CDA is recommended for the treatment of non-contiguous CDD. The FA construct shows superior biomechanical performance compared to the AF construct.https://www.frontiersin.org/articles/10.3389/fbioe.2024.1345319/fullcervical degenerative diseaseinterior cervical discectomyadjacent segment diseasecervical disc arthroplastyhybrid surgeryfinite element analysis |
| spellingShingle | Xiangyao Sun Xiangyao Sun Xiangyao Sun Jiang Huang Jiang Huang Qingming Zhang Qingming Zhang Li Cao Li Cao Yuqi Liu Zelong Song Zelong Song Wei Tang Siyuan Sun Juyong Wang Juyong Wang Segment selection for fusion and artificial disc replacement in the hybrid surgical treatment of noncontiguous cervical spondylosis: a finite element analysis Frontiers in Bioengineering and Biotechnology cervical degenerative disease interior cervical discectomy adjacent segment disease cervical disc arthroplasty hybrid surgery finite element analysis |
| title | Segment selection for fusion and artificial disc replacement in the hybrid surgical treatment of noncontiguous cervical spondylosis: a finite element analysis |
| title_full | Segment selection for fusion and artificial disc replacement in the hybrid surgical treatment of noncontiguous cervical spondylosis: a finite element analysis |
| title_fullStr | Segment selection for fusion and artificial disc replacement in the hybrid surgical treatment of noncontiguous cervical spondylosis: a finite element analysis |
| title_full_unstemmed | Segment selection for fusion and artificial disc replacement in the hybrid surgical treatment of noncontiguous cervical spondylosis: a finite element analysis |
| title_short | Segment selection for fusion and artificial disc replacement in the hybrid surgical treatment of noncontiguous cervical spondylosis: a finite element analysis |
| title_sort | segment selection for fusion and artificial disc replacement in the hybrid surgical treatment of noncontiguous cervical spondylosis a finite element analysis |
| topic | cervical degenerative disease interior cervical discectomy adjacent segment disease cervical disc arthroplasty hybrid surgery finite element analysis |
| url | https://www.frontiersin.org/articles/10.3389/fbioe.2024.1345319/full |
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