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BMC Musculoskeletal Disorders

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Open Access 01-12-2021 | Research article

A biomechanical analysis of four anterior cervical techniques to treating multilevel cervical spondylotic myelopathy: a finite element study

Authors: Zhonghai Li, Hui Liu, Ming Yang, Wentao Zhang

Published in: BMC Musculoskeletal Disorders | Issue 1/2021

Abstract

Background

The decision to treat multilevel cervical spondylotic myelopathy (MCSM) remains controversial. The purpose of this study is to compare the biomechanical characteristics of the intervertebral discs at the adjacent segments and internal fixation, and to provide scientific experimental evidence for surgical treatment of MCSM.

Methods

An intact C2-C7 cervical spine model was developed and validated. Four additional models were developed from the fusion model, including multilevel anterior cervical discectomy and fusion (mACDF), anterior cervical corpectomy and fusion (ACCF), hybrid decompression and fusion (HDF), and mACDF with cage alone (mACDF-CA). Biomechanical characteristics on the plate and the disc of adjacent levels (C2/3, C6/7) were comparatively analyzed.

Results

Of the four models, stress on the upper (C2/3) adjacent intervertebral disc was the lowest in the mACDF-CA group and highest in the ACCF group. Stress on the intervertebral discs at adjacent segments was higher for the upper C2/3 than the lower C6/7 intervertebral disc. In all models, the mACDF-CA group had the lowest stress on the intervertebral disc, while the ACCF group had the highest stress. In the three surgical models with titanium plate fixation (mACDF, ACCF, and HDF), the ACCF group had the highest stress at the titanium plate-screw interface, while the mACDF group had the lowest stress.

Conclusion

Among the four anterior cervical reconstructive techniques for MCSM, mACDF-CA makes little effect on the adjacent disc stress, which might reduce the incidence of adjacent segment degeneration (ASD) after fusion. However, the accompanying risk of the increased incidence of cage subsidence should never be neglected.

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Title: A biomechanical analysis of four anterior cervical techniques to treating multilevel cervical spondylotic myelopathy: a finite element study
Authors: Zhonghai Li
Hui Liu
Ming Yang
Wentao Zhang
Publication date: 01-12-2021
Publisher: BioMed Central
Published in: BMC Musculoskeletal Disorders / Issue 1/2021
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/s12891-021-04150-7

At a glance: The STEP trials

Springer Medicine

A biomechanical analysis of four anterior cervical techniques to treating multilevel cervical spondylotic myelopathy: a finite element study

Abstract

Background

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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