Biomechanical effects of hybrid constructions in the treatment of noncontinuous cervical spondylopathy: a finite element analysis

Journal of Orthopaedic Surgery and Research

Research Article

Wei Tang¹  Yunqiang Chen¹  Yuqi Liu²  Siyuan Sun³  Yang Zhang⁴  Shibao Lu⁵  Jiang Huang⁵  Qingming Zhang⁵  Juyong Wang⁵  Li Cao⁵  Xiangyao Sun⁶  Zelong Song⁷ 

[1] Beijing Glitzern Technology Co., Ltd, 100077, Beijing, China;Department of Emergency, Xuanwu Hospital, Capital Medical University, 100053, Beijing, China;Department of Interdisciplinary, Life Science, Purdue University, 47907, West Lafayette, IN, USA;Department of Orthopaedics, The Seventh Medical Center of PLA General Hospital, 100191, Beijing, China;Department of Orthopaedics, Xuanwu Hospital Capital Medical University, 100053, Beijing, China;National Clinical Research Center for Geriatric Diseases, 100053, Beijing, China;Department of Orthopaedics, Xuanwu Hospital Capital Medical University, 100053, Beijing, China;National Clinical Research Center for Geriatric Diseases, 100053, Beijing, China;Beijing Glitzern Technology Co., Ltd, 100077, Beijing, China;Nankai University School of Medicine, Nankai University, 300071, Tianjin, China;Department of Orthopaedics, The PLA General Hospital, 100000, Beijing, China;

关键词: Hybrid construction;    Total disc replacement;    Anterior cervical discectomy and fusion;    Noncontinuous cervical spondylopathy;    Biomechanics;   

DOI  :  10.1186/s13018-023-03537-7

 received in 2022-07-04, accepted in 2023-01-12,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundHybrid construction (HC) may be an ideal surgical strategy than noncontinuous total disc replacement (TDR) and noncontinuous anterior cervical discectomy and fusion (ACDF) in the treatment of noncontinuous cervical spondylopathy. However, there is still no consensus on the segmental selection for ACDF or TDR in HC. The study aims to analyse the effects of different segment selection of TDR and ACDF on cervical biomechanical characteristics after HC surgery.MethodsTwelve FEMs of C2–C7 were constructed based on CT images of 12 mild cervical spondylopathy volunteers. Two kinds of HC were introduced in our study: Fusion-arthroplasty group (Group 1), upper-level (C3/4) ACDF, and lower-level TDR (C5/6); Arthroplasty-fusion group (Group 2), upper-level (C3/4) TDR and lower-level ACDF (C5/6). The follow-load technique was simulated by applying an axial initial load of 73.6 N through the motion centre of FEM. A bending moment of 1.0 Nm was applied to the centre of C2 in all FEMs. Statistical analysis was carried out by SPSS 26.0. The significance threshold was 5% (P < 0.05).ResultsIn the comparison of ROMs between Group 1 and Group 2, the ROM in extension (P = 0.016), and lateral bending (P = 0.038) of C4/5 were significantly higher in Group 1 group. The average intervertebral disc pressures at C2/3 in all directions were significantly higher in Group 1 than those in Group 2 (P < 0.005). The average contact forces in facet joints of C2/3 (P = 0.007) were significantly more than that in Group 2; however, the average contact forces in facet joints of C6/7 (P < 0.001) in Group 1 group were significantly less than that in Group 2.ConclusionsArthroplasty-fusion is preferred for intervertebral disc degeneration in adjacent upper segments. Fusion-arthroplasty is preferred for patients with lower intervertebral disc degeneration or lower posterior column degeneration.Trial registration: This research was registered in Chinese Clinical Trial Registry (ChiCTR1900020513).

【 授权许可】

CC BY   
© The Author(s) 2023

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