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학제간연구 과학기술학 뇌인지과학 기술정책 기타 복합학

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논문 기본 정보

자료유형
학술저널
저자정보
저널정보
대한골다공증학회 OSTEOPOROSIS OSTEOPOROSIS 제13권 제1호
발행연도
2015.1
수록면
45 - 54 (10page)

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The purpose of this study were to constructed multi-level cervical spine finite element (FE) model and to investigate changes in load distribution and range of motion (ROM) at index level and adjacent levels at immediately after anterior cervical discectomy and fusion (ACDF) and after full bony union using constrained and semi-constrained cervical plate systems(dynamic plate, variable screw). A FE model of intact cervical spine (C3-6) was created from computer tomography (CT) images of the healthy adult (male, 26 years, no pathologies). The post-op FE models (C5-6 with ACDF, cage with bone graft) were constructed by modifying a intact cervical FE model. Four different configurations of the model were considered: Type 1-Rigid plate+Fixed screw, Type II-Rigid plate+Variable screw, Type III-Dynamic plate+ Fixed screw, Type IV-Dynamic plate+Variable screw. The bone-cage and bone screw interface behavior were accomplished via 'tie' contact condition and friction coefficient of 0.2 to assume fusion and non-fusion, respectively. The inferior endplate of C6 vertebral body was constrained in all directions. Loading condition used hybrid protocol with follower load of 73.6N at superior endplate of C3 vertebral body. In non-fusion cases, load at the bone graft increased from Type I to IV (2.3→6.8%, flexion; 2.9→7.6%, extension) while plate load was reduced (91.4→75.7%, 89.4→71.8%, respectively) and the rest went through the facets. Similar trend was observed in fusion cases at bone graft/fusion (6.4→12.4%, 7.4→10.4%) and plate (83.3→71.3%, 80.6→67.2%). As compared to the intact spine, ROM of Type IV was most similar to those of the intact spine; least reduction at the index (-36%) and least increase (+7%) at the adjacent level. This was followed by Type III, II, and I and this trend was more evident in non-fusion cases than after fusion. With more degree of freedom (Type I→Type IV), the load sharing became more favorable for bony union across the graft/cage area. Simultaneously, excessive changes in motion at the index and adjacent levels were reduced. These biomechanical changes could contribute to promoting fusion process. Our study predicted more biomechanically sound characteristics of semi-constrained cervical plate system as compared to the conventional constrained system in terms of load sharing and motion kinematics.
#Cervical spine #Cervical plate system #Bone graft #Load sharing #Range of motion

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참고문헌 (23)

참고문헌 신청
Calamaz M / 2008 / A new material model for 2D numerical simulation of serrated chip formation when machining titanium alloy Ti-6Al-4V / International Journal of Machine Too google schola Dubois CM / 2007 / Static versus dynamic plating for multilevel anterior cervical discectomy and fusion / Spine J 7 : 188 ~ 193 google schola Faizan A / 2012 / Do design variations in the artificial disc influence cervical spine biomechanics? A finite element investigation / Eur Spine J 21 (Suppl) : 653 ~ 662 google schola Fogel GR / 2010 / In vitro evaluation of stiffness and load sharing in a two-level corpectomy: comparison of static and dynamic cervical plates / Spine J 10 : 417 ~ 421 google schola Galbusera F / 2008 / Cervical spine biomechanics following implantation of a disc prosthesis / Med Eng Phys 30 : 1127 ~ 1133 google schola

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