Home | About JCVJS | Editorial board | Ahead of print | Current Issue | Archives | Instructions | Subscribe | Advertise | Contact us |   Login 
Journal of Craniovertebral Junction and Spine
Search Articles   
    
Advanced search   
 
ORIGINAL ARTICLE
Year : 2022  |  Volume : 13  |  Issue : 3  |  Page : 278-287

Total disc replacement alters the biomechanics of cervical spine based on sagittal cervical alignment: A finite element study


1 Department of Bioengineering and Orthopaedics Surgery, Engineering Center for Orthopaedic Research Excellence, College of Engineering and Medicine, The University of Toledo, Toledo, Ohio, USA
2 Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, Ube, Japan
3 Spine and Orthopedic Center, West Boca Medical Center, Florida Atlantic University, Boca Raton, Florida, USA

Correspondence Address:
Vijay K Goel
Department of Bioengineering and Orthopaedics Surgery, Engineering Center for Orthopaedic Research Excellence, College of Engineering and Medicine, The University of Toledo, 5046 NI, MS 303, Toledo 43606, Ohio
USA
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jcvjs.jcvjs_21_22

Rights and Permissions

Introduction: The correlation between cervical alignment and clinical outcome of total disc replacement (TDR) surgery is arguable. We believe that this conflict exists because the parameters that influence the biomechanics of the cervical spine are not well understood, specifically the effect of TDR on different cervical alignments. Methods: A validated osseo-ligamentous model from C2-C7 was used in this study. The C2-C7 Cobb angle of the base model was modified to represent: lordotic (−10°), straight (0°), and kyphotic (+10°) cervical alignment. The TDR surgery was simulated at the C5-C6 segment. The range of motion (ROM), intradiscal pressure, annular stresses, and facet loads were computed for all the models. Results: The ROM results demonstrated kyphotic alignment after TDR surgery to be the most mobile when compared to intact base model (41% higher in flexion–extension, 51% higher in lateral bending, and 27% higher in axial rotation) followed by straight and lordotic alignment, respectively. The annular stresses for the kyphotic alignment when compared to intact base model were higher at the index level (33% higher in flexion–extension and 48% higher in lateral bending) compared to other alignments. The lordotic model demonstrated higher facet contact forces at the index level (75% higher in extension than kyphotic alignment, 51% higher in lateral bending than kyphotic alignment, and 78% higher in axial rotation than kyphotic alignment) when compared among the three alignment models. Conclusion: Preoperative cervical alignment should be an integral part of surgical planning for TDR surgery as different cervical alignments may significantly alter the postsurgical outcomes.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed216    
    Printed2    
    Emailed0    
    PDF Downloaded24    
    Comments [Add]    

Recommend this journal