Cervical non-fusion using biomimetic artificial disc and vertebra complex: technical innovation and biomechanics analysis

Journal of Orthopaedic Surgery and Research

Zhongwei Sun¹  Xinyu Wei²  Yibin Wang³  Zhijing Wen³  Teng Lu³  Pengzhen Gu³  Hui Dong³  Jialiang Li³  Haopeng Li³  Pengrong OuYang³  Xijing He³  Ning Liu⁴ 

[1] Department of Engineering Mechanics, School of Civil Engineering, Southeast University, Nanjing, China;Department of Health Management, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi Province, China;Department of Orthopedics, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi Province, China;Department of Orthopedics, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi Province, China;Department of Spine Surgery, Hanzhong Central Hospital, Hanzhong, Shaanxi Province, China;

关键词: Biomechanics;    Finite element analysis;    Cervical vertebrae;    Adjacent segment disease;    Range of motion;    Prostheses and implants;   

DOI  :  10.1186/s13018-022-03012-9

来源: Springer

【 摘 要 】

BackgroundChanges in spinal mobility after vertebral fusion are important factors contributing to adjacent vertebral disease (ASD). As an implant for spinal non-fusion, the motion-preserving prosthesis is an effective method to reduce the incidence of ASD, but its deficiencies hamper the application in clinical. This study designs a novel motion-preserving artificial cervical disc and vertebra complex with an anti-dislocation mechanism (MACDVC-AM) and verifies its effect on the cervical spine.MethodsThe MACDVC-AM was designed on the data of healthy volunteers. The finite element intact model, fusion model, and MACDVC-AM model were constructed, and the range of motion (ROM) and stress of adjacent discs were compared. The biomechanical tests were performed on fifteen cervical specimens, and the stability index ROM (SI-ROM) were calculated.ResultsCompared with the intervertebral ROMs of the intact model, the MACDVC-AM model reduced by 28–70% in adjacent segments and increased by 26–54% in operated segments, but the fusion model showed the opposite result. In contrast to the fusion model, the MACDVC-AM model diminished the stress of adjacent intervertebral discs. In biomechanical tests, the MACDVC-AM group showed no significant difference with the ROMs of the intact group (p > 0.05). The SI-ROM of the MACDVC-AM group is negative but close to zero and showed no significant difference with the intact group (p > 0.05).ConclusionsThe MACDVC-AM was successfully designed. The results indicate that the MACDVC-AM can provide physiological mobility and stability, reduce adjacent intervertebral compensatory motion, and alleviate the stress change of adjacent discs, which contributes to protect adjacent discs and reduce the occurrence of ASD.

【 授权许可】

CC BY