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Published in: Journal of Orthopaedic Surgery and Research 1/2019

Open Access 01-12-2019 | Research article

The appropriate hybrid surgical strategy in three-level cervical degenerative disc disease: a finite element analysis

Authors: Y. M. Xie, Y. C. Zheng, S. J. Qiu, K. Q. Gong, Y. Duan

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2019

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Abstract

Objective

The purpose of this FE study was to analyze the biomechanical characteristics of different HS strategies used in the treatment of three-level CDDD (one-level CDA and two-level ACDF).

Methods

We validated the FE model of an intact cervical spine established by transferring the data, collected by 3D CT scan, to the FE software ABAQUS and comparing these data with the data from published studies. Then, the FE model of hybrid surgery was reconstructed to analyze the range of motion (ROM), facet joint force, and stress distribution on an ultrahigh molecular weight polyethylene (UHMWPE) core.

Results

The current cervical FE model was able to measure the biomechanical changes in a follow-up hybrid surgery simulation. The total ROM of the cervical HS models was substantially decreased compared with the total ROM of the intact group, and the M2 (C3/4 ACDF, C4/5 CDA, and C5/6 ACDF) model had the closest total ROM to the intact group, but the facet joint force adjacent to the treatment levels showed very little difference among them. The stress distribution showed noticeable similarity: two flanks were observed in the center core, but the inlay of M2 was more vulnerable.

Conclusions

Through the comparison of ROM, the facet joint force after CDA, and the stress distribution of the prosthesis, we find that M2 model has a better theoretical outcome, especially in preserving the maximum total ROM.
Literature
1.
go back to reference Gibson J, Nouri A, Krueger B, Lakomkin N, Nasser R, Gimbel D, Cheng J. Degenerative cervical myelopathy: a clinical review. Yale J Biol Med. 2018;91:43–8.PubMedPubMedCentral Gibson J, Nouri A, Krueger B, Lakomkin N, Nasser R, Gimbel D, Cheng J. Degenerative cervical myelopathy: a clinical review. Yale J Biol Med. 2018;91:43–8.PubMedPubMedCentral
3.
go back to reference Jackson RJ, Davis RJ, Hoffman GA, Bae HW, Hisey MS, Kim KD, Gaede SE, Nunley PD. Subsequent surgery rates after cervical total disc replacement using a Mobi-C Cervical Disc Prosthesis versus anterior cervical discectomy and fusion: a prospective randomized clinical trial with 5-year follow-up. J Neurosurg Spine. 2016;24:734–45. https://doi.org/10.3171/2015.8.Spine15219.CrossRefPubMed Jackson RJ, Davis RJ, Hoffman GA, Bae HW, Hisey MS, Kim KD, Gaede SE, Nunley PD. Subsequent surgery rates after cervical total disc replacement using a Mobi-C Cervical Disc Prosthesis versus anterior cervical discectomy and fusion: a prospective randomized clinical trial with 5-year follow-up. J Neurosurg Spine. 2016;24:734–45. https://​doi.​org/​10.​3171/​2015.​8.​Spine15219.CrossRefPubMed
7.
14.
go back to reference Kumaresan S, Yoganandan N, Pintar FA. Finite element analysis of the cervical spine: a material property sensitivity study. Clin Biomech (Bristol, Avon). 1999;14:41–53.CrossRef Kumaresan S, Yoganandan N, Pintar FA. Finite element analysis of the cervical spine: a material property sensitivity study. Clin Biomech (Bristol, Avon). 1999;14:41–53.CrossRef
15.
go back to reference Yoganandan N, Kumaresan S, Pintar FA. Geometric and mechanical properties of human cervical spine ligaments. J Biomech Eng. 2000;122:623–9.CrossRef Yoganandan N, Kumaresan S, Pintar FA. Geometric and mechanical properties of human cervical spine ligaments. J Biomech Eng. 2000;122:623–9.CrossRef
16.
go back to reference Goel VK, Clausen JD. Prediction of load sharing among spinal components of a C5-C6 motion segment using the finite element approach. Spine (Phila Pa 1976). 1998;23:684–91.CrossRef Goel VK, Clausen JD. Prediction of load sharing among spinal components of a C5-C6 motion segment using the finite element approach. Spine (Phila Pa 1976). 1998;23:684–91.CrossRef
18.
go back to reference Yoganandan N, Kumaresan SC, Voo L, Pintar FA, Larson SJ. Finite element modeling of the C4-C6 cervical spine unit. Med Eng Phys. 1996;18:569–74.CrossRef Yoganandan N, Kumaresan SC, Voo L, Pintar FA, Larson SJ. Finite element modeling of the C4-C6 cervical spine unit. Med Eng Phys. 1996;18:569–74.CrossRef
19.
go back to reference Yoganandan N, Kumaresan S, Pintar FA. Biomechanics of the cervical spine part 2. Cervical spine soft tissue responses and biomechanical modeling. Clin Biomech (Bristol, Avon). 2001;16:1–27.CrossRef Yoganandan N, Kumaresan S, Pintar FA. Biomechanics of the cervical spine part 2. Cervical spine soft tissue responses and biomechanical modeling. Clin Biomech (Bristol, Avon). 2001;16:1–27.CrossRef
21.
go back to reference Hisey MS, Bae HW, Davis R, Gaede S, Hoffman G, Kim K, Nunley PD, Peterson D, Rashbaum R, Stokes J. Multi-center, prospective, randomized, controlled investigational device exemption clinical trial comparing Mobi-C Cervical Artificial Disc to anterior discectomy and fusion in the treatment of symptomatic degenerative disc disease in the cervical spine. Int J Spine Surg. 2014;8. https://doi.org/10.14444/1007.CrossRef Hisey MS, Bae HW, Davis R, Gaede S, Hoffman G, Kim K, Nunley PD, Peterson D, Rashbaum R, Stokes J. Multi-center, prospective, randomized, controlled investigational device exemption clinical trial comparing Mobi-C Cervical Artificial Disc to anterior discectomy and fusion in the treatment of symptomatic degenerative disc disease in the cervical spine. Int J Spine Surg. 2014;8. https://​doi.​org/​10.​14444/​1007.CrossRef
22.
go back to reference Moroney SP, Schultz AB, Miller JA, Andersson GB. Load-displacement properties of lower cervical spine motion segments. J Biomech. 1988;21:769–79.CrossRef Moroney SP, Schultz AB, Miller JA, Andersson GB. Load-displacement properties of lower cervical spine motion segments. J Biomech. 1988;21:769–79.CrossRef
23.
go back to reference Panjabi MM, Crisco JJ, Vasavada A, Oda T, Cholewicki J, Nibu K, Shin E. Mechanical properties of the human cervical spine as shown by three-dimensional load-displacement curves. Spine (Phila Pa 1976). 2001;26:2692–700.CrossRef Panjabi MM, Crisco JJ, Vasavada A, Oda T, Cholewicki J, Nibu K, Shin E. Mechanical properties of the human cervical spine as shown by three-dimensional load-displacement curves. Spine (Phila Pa 1976). 2001;26:2692–700.CrossRef
Metadata
Title
The appropriate hybrid surgical strategy in three-level cervical degenerative disc disease: a finite element analysis
Authors
Y. M. Xie
Y. C. Zheng
S. J. Qiu
K. Q. Gong
Y. Duan
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Journal of Orthopaedic Surgery and Research / Issue 1/2019
Electronic ISSN: 1749-799X
DOI
https://doi.org/10.1186/s13018-019-1502-5

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