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학제간연구 과학기술학 뇌인지과학 기술정책 기타 복합학

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논문 기본 정보

자료유형
학술저널
저자정보
Purushothaman Yuvaraj (Medical College of Wisconsin Milwaukee WI USA) Choi Hoon (Medical College of Wisconsin Milwaukee WI USA) Yoganandan Narayan (Medical College of Wisconsin Milwaukee WI USA) Jebaseelan Davidson (Vellore Institute of Technology (Chennai Campus) Chennai India) Baisden Jamie (Medical College of Wisconsin Milwaukee WI USA) Kurpad Shekar (Medical College of Wisconsin Milwaukee WI USA)
저널정보
대한척추외과학회 Asian Spine Journal Asian Spine Journal Vol.15 No.3
발행연도
2021.1
수록면
283 - 293 (11page)

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Study Design: The study examined and compared four artificial cervical disks using validated finite element models. Purpose: To compare and contrast the biomechanical behavior of four artificial cervical disks by determining the external (range of motion) and internal (facet force and intradiscal pressure) responses following cervical disc arthroplasty (CDA) and to elucidate any device design effects on cervical biomechanics. Overview of Literature: Despite CDA’s increasing popularity most studies compare the CDA procedure with anterior cervical discectomy and fusion. There is little comparative evaluation of different artificial disks and, therefore, little understanding of how varying disk designs may influence spinal biomechanics. Methods: A validated C2–T1 finite element model was subjected to flexion-extension. CDAs were simulated at the C5–C6 level with the Secure-C, Mobi-C, Prestige LP, and Prodisc C prosthetic disks. We used a hybrid loading protocol to apply sagittal moments. Normalized motions at the index and adjacent levels, and intradiscal pressures and facet column loads were also obtained. Results: The ranges of motion at the index level increased after CDA. The Mobi-C prosthesis demonstrated the highest amount of flexion, followed by the Secure-C, Prestige LP, and Prodisc C. The Secure-C demonstrated the highest amount of extension, followed by the Mobi-C, Prodisc C, and Prestige LP. The motion decreased at the rostral and caudal adjacent levels. Facet forces increased at the index level and decreased at the rostral and caudal adjacent levels following CDA. Intradiscal pressures decreased at the adjacent levels for the Mobi-C, Secure-C, and Prodisc C. Conversely, the use of the Prestige LP increased intradiscal pressure at both adjacent levels. Conclusions: While all artificial disks were useful in restoring the index level motion, the Secure-C and Mobi-C translating abilities allowed for lower intradiscal pressures at the adjacent segments and may be the driving mechanism for minimizing adjacent segment degenerative arthritic changes. The facet joint integrity should also be considered in the clinical decision-making process for CDA selection.
#Adjacent level motions #Angular kinematics #Total disc replacement #Discectomy #Index level biomechanics #Finite element model

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참고문헌 (27)

참고문헌 신청
Smith GW / 1958 / The treatment of certain cervical-spine disorders by anterior removal of the intervertebral disc and interbody fusion / J Bone Joint Surg Am 40(A):607~624 google schola Hilibrand AS / 1999 / Radiculopathy and myelopathy at segments adjacent to the site of a previous anterior cervical arthrodesis / J Bone Joint Surg Am 81:519~528 google schola Hilibrand AS / 2004 / Adjacent segment degeneration and adjacent segment disease: the consequences of spinal fusion? / Spine J 4(6Suppl):190S~194S google schola Rao RD / 2016 / Radiographic changes in the cervical spine following anterior arthrodesis : a longterm analysis of 166 patients / J Bone Joint Surg Am 98:1606~1613 google schola Burkus JK / 2014 / Clinical and radiographic analysis of an artificial cervical disc : 7-year follow-up from the Prestige prospective randomized controlled clinical trial : clinical article / J Neurosurg Spine 21:516~528 google schola

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