Biomechanical effects of spinal cord compression due to ossification of posterior longitudinal ligament and ligamentum flavum: A finite element analysis

Kim, Yoon Hyuk; Khuyagbaatar, Batbayar; Kim, Kyung-Soo

doi:10.1016/j.medengphy.2013.01.006

Cited by 27 publications

(21 citation statements)

References 27 publications

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“…Kim et al and Khuyagbaatar et al also reported von Mises stresses of 0 -400 kPa at similar compression ratios. 83,106 This is higher than the stresses we reported, but again, at a much higher amount of compression.…”

Section: Discussioncontrasting

confidence: 65%

“…86 It is interesting that all these FE models report similar strain levels even though There are FE models which address the effects of cervical myelopathy. 79,82,83,106,108 However, the majority of these, as previously mentioned, have simplified boundary conditions. Khuyagbaatar et al is the first group to incorporate comprehensive spinal canal anatomy with the spinal cord to investigate cord compression caused by the ossified posterior longitudinal ligament.…”

Section: Discussionmentioning

confidence: 99%

“…Even fewer researchers, including the study in Chapter 3, have investigated in vivo human spinal cord mechanics 12,14,15. Due to lack of animal models and human in vivo data, FE modeling of the spinal cord has been used to investigate stress and strain distributions [78][79][80][81][82][83]. 4.1.1 Previous FE Models of the Spinal CordMost cervical spinal cord FE models to date have focused on modeling the injured spinal cord.…”

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confidence: 99%

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Surgical treatment for cervical myelopathy

Stoner¹

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____________________________________________ Vincent Magnottaii To Grammy, Pop-Pop, and Mom who always stressed the importance of education, hard work, and helping others.And to Brigitta, the best sister there is.iii Genius is one percent inspiration, ninety-nine percent perspiration.-Thomas Edison I just try to help my people. -Rocco Santarelli III, age 4 iv ACKNOWLEDGEMENTS I could not have completed my graduate studies without the people mentioned here. Thank you all for supporting me through the journey. I first and foremost need to thank my adviser, Dr. Nicole Grosland. She has been the best adviser I could have hoped for. She has always been available and happy to give guidance I needed. Most importantly she's taught me not to be afraid to ask questions and realize when my FE models are good enough; perfection is not the goal, answering the research question is! I also need to thank my committee member, Dr. Vincent Magnotta, who was always willing to teach and help me understand the intricacies of MR imaging, and help me with all of my coding errors! I would also like to thank Dr. Matthew Howard and Dr. Kingsley Abode-Iyamah for all of their clinical input in this project. Being able to interact directly with you, the surgeons, and patients in the neurosurgery clinic has been invaluable to my education. Thank you to Dr. Nicole Kallemeyn and Dr. David Wilder for being on my committee and always asking interesting and thought provoking questions. Dr. Nicole Watson also deserves a big thank you for all of her patience and help with my finite element models. You're the best office-mate I could ask for! Thanks to Lisa and Jenny at CCAD for always making things run smoothly! Thank you to all of the good friends I've made over the last four years. Relaxing and having fun together has made this time wonderful. Finally I need to thank my family, especially my mother and sister, for always supporting and loving me unconditionally. v ABSTRACT Cervical myelopathy is the most common form of spinal cord injury in North America with roughly 19,000 new cases in the US every year. It results from chronic compression of the spinal cord by osteophytes, intervertebral disc herniation, and ossified ligaments. It commonly affects adults over the age of 50 years and causes upper extremity numbness, loss of hand dexterity, gait disturbances, and decreased proprioception. Recent studies imaging studies have shown this injury is highly

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Section: Discussioncontrasting

confidence: 65%

Section: Discussionmentioning

confidence: 99%

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Surgical treatment for cervical myelopathy

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“…OPLL is highly progressed after posterior decompressive surgery both in the longitudinal direction and in the thickness, regardless of the ossification type, which suggests that local factors of the cervical spine are significantly important in the progression [26], [27]. The progression of OPLL is highly correlated with abnormal strain distribution in the intervertebral discs and frequently observed when strain in the tensile direction is distributed over the disc [28].…”

Section: Introductionmentioning

confidence: 99%

Uniaxial Cyclic Stretch Promotes Osteogenic Differentiation and Synthesis of BMP2 in the C3H10T1/2 Cells with BMP2 Gene Variant of rs2273073 (T/G)

Zhang

Ren

et al. 2014

PLoS ONE

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Ossification of the posterior longitudinal ligament of the cervical spine (OPLL) is characterized by the replacement of ligament tissues with ectopic bone formation, and this result is strongly affected by genetic and local factors. Two single nucleotide polymorphisms (SNPs) of rs2273073 (T/G) and rs235768 (A/T) of bone morphogenetic protein 2 (BMP2) gene which are associated with OPLL have been reported in our previous report. In this study, we confirmed the connection in 18 case samples analysis of BMP2 gene in OPLL patients; additionally, it was also shown from the OPLL patients with ligament tissues that enchondral ossification and expression of BMP2 were significantly higher compared with the non-OPLL patients by histological examination, immunohistochemistry and Western blotting analysis. To investigate the underlying mechanism, we studied the effect of SNPs in cell model. The C3H10T1/2 cells with different BMP2 gene variants were constructed and then subjected to uniaxial cyclic stretch (0.5 Hz, 10% stretch). In the presence of mechanical stress, the expression of BMP2 protein in C3H10T1/2 cells transfected by BMP2 (rs2273073 (T/G)) and BMP2 (rs2273073 (T/G), rs235768 (A/T)) were significantly higher than the corresponding static groups (P<0.05). In conclusion, these results suggested that BMP2 gene variant of rs2273073 (T/G) could not only increase cell susceptibility to bone transformation similar to pre-OPLL change, but also increase the sensibility to mechanical stress which might play an important role during the progression of OPLL.

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“…With that in mind, there is a new initiative to restore the explanatory power of degenerative changes, now referred to as entheseal changes, through the incorporation of biomechanical and modern medical principles and comparative research (Andrews, 2012;Jurmain and Vilotte, 2009;Kaki et al, 2011;Kim et al, 2013;Kotani et al, 2013;Lang et al, 2013;Milella et al, 2012;Novak and Šlaus, 2011;Sokiranski et al, 2011;and Knüsel, 2012). The problem with incorporating data from modern clinical trials is that physicians, physical therapists and biomechanical engineers tend to analyze primarily the reaction of the living skeleton to a specific situation or stress factor.…”

Section: Chapter III Literature Reviewmentioning

confidence: 99%

Implications of Vertebral Degenative Disease and Vertebral Ligamentous Ossification in Native Populations of the Lower Tennessee River Valley

Boncal¹

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Biomechanical effects of spinal cord compression due to ossification of posterior longitudinal ligament and ligamentum flavum: A finite element analysis

Cited by 27 publications

References 27 publications

Surgical treatment for cervical myelopathy

Surgical treatment for cervical myelopathy

Uniaxial Cyclic Stretch Promotes Osteogenic Differentiation and Synthesis of BMP2 in the C3H10T1/2 Cells with BMP2 Gene Variant of rs2273073 (T/G)

Implications of Vertebral Degenative Disease and Vertebral Ligamentous Ossification in Native Populations of the Lower Tennessee River Valley

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