Cervical Stability After Sequential Capsule Resection

Zdeblick, Thomas A.; Abitbol, Jean-Jacques; Kunz, David N.; Eng, Molly; McCabe, Ronald P.; Garfin, Steven R.

doi:10.1097/00007632-199310001-00013

Cited by 135 publications

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“…Although standard clinical imaging techniques, especially nuclear magnetic resonance imaging (MRI), allow the detection of discoligamentous injuries [9,13,24,30,31], few biomechanical data exist concerning the significance of the different discoligamentous structures for the load-displacement properties of the cervical spine under physiological loads. Several studies have been carried out to evaluate the load-displacement properties of the normal lower cervical spine in vitro [6,15,17,19,25] and in vivo [2,3,12,20], as well as in different types of artificial defect situations [6,18,26,32]. Variations in the study designs with regard to testing protocol and type of artificial defect make comparison between the different studies difficult.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Variations in the study designs with regard to testing protocol and type of artificial defect make comparison between the different studies difficult. Few studies have tested artificial discoligamentous defects in the lower cervical spine under near-physiological loads [25,26,32].The objective of this study was therefore to evaluate the type and amount of instability caused by injury of different discoligamentous structures of the cervical spine in comparison to the intact cervical spine.Abstract The objective of this study was to determine which discoligamentous structures of the lower cervical spine provide significant stability with regard to different loading conditions. Accordingly, the loaddisplacement properties of the normal and injured lower cervical spine were tested in vitro.…”

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Load-displacement properties of the normal and injured lower cervical spine in vitro

Richter¹,

Wilke

Kluger³

et al. 2000

European Spine Journal

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IntroductionThe discoligamentous structures of the cervical spine are often involved in cervical spine injuries, for example in whiplash injuries. Although standard clinical imaging techniques, especially nuclear magnetic resonance imaging (MRI), allow the detection of discoligamentous injuries [9,13,24,30,31], few biomechanical data exist concerning the significance of the different discoligamentous structures for the load-displacement properties of the cervical spine under physiological loads. Several studies have been carried out to evaluate the load-displacement properties of the normal lower cervical spine in vitro [6,15,17,19,25] and in vivo [2,3,12,20], as well as in different types of artificial defect situations [6,18,26,32]. Variations in the study designs with regard to testing protocol and type of artificial defect make comparison between the different studies difficult. Few studies have tested artificial discoligamentous defects in the lower cervical spine under near-physiological loads [25,26,32].The objective of this study was therefore to evaluate the type and amount of instability caused by injury of different discoligamentous structures of the cervical spine in comparison to the intact cervical spine.Abstract The objective of this study was to determine which discoligamentous structures of the lower cervical spine provide significant stability with regard to different loading conditions. Accordingly, the loaddisplacement properties of the normal and injured lower cervical spine were tested in vitro. Four artificially created stages of increasing discoligamentous instability of the segment C5/6 were compared to the normal C5/6 segment. Six fresh human cadaver spine segments C4-C7 were tested in flexion/extension, axial rotation, and lateral bending using pure moments of ± 2.5 Nm without axial preload. Five conditions were investigated consecutively: (1) the intact functional spinal unit (FSU) C5/6; (2) the FSU C5/6 with the anterior longitudinal ligament and the intertransverse ligaments sectioned; (3) the FSU C5/6 with an additional 10-mm-deep incision of the anterior half of the anulus fibrosus and the disc; (4) the FSU C5/6 with additionally sectioned ligamenta flava as well as interspinous and supraspinous ligaments; (5) the FSU C5/6 with additional capsulotomy of the facet joints. In flexion/extension, significant differences were observed concerning range of motion (ROM) and neutral zone (NZ) for all four stages of instability compared to the intact FSU. In axial rotation, only the stage 4 instability showed a significantly increased ROM and NZ compared to the intact FSU. For lateral bending, no significant differences were observed. Based on these data, we conclude that flexion/extension is the most sensitive load-direction for the tested discoligamentous instabilities.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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confidence: 99%

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Load-displacement properties of the normal and injured lower cervical spine in vitro

Richter¹,

Wilke

Kluger³

et al. 2000

European Spine Journal

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“…Relatively few animal models have been used in analyses of cervical disc degeneration. Panjabi [20] reviewed animal models used in cervical spine biomechanical research, noting previous work in the canine [3] and goat [21,30], and Yingling et al [29] used the porcine cervical spine to model human lumbar spine.…”

Section: Introductionmentioning

confidence: 99%

Spontaneous Age-related Cervical Disc Degeneration in the Sand Rat

Gruber

Phillips

Ingram

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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Background Disc space narrowing, osteophytes, and disc degeneration are common and increase with aging. Few animal models are appropriate for the study of spontaneous age-related cervical disc degeneration. Questions/purposes We used the sand rat, a member of the gerbil family with well-recognized age-related lumbar disc degeneration, to determine whether spontaneous cervical disc degeneration differed from lumbar degeneration when evaluated by (1) radiologic and (2) histologic measures. Animals 2 to 25 months of age were used in these analyses. Methods Cervical and lumbar discs of 99 sand rats were analyzed with radiology, and cervical discs of 67 sand rats were studied with histology. Lateral digital radiographs of cervical and lumbar spines were scored for presence or absence of wedging, disc space narrowing, osteophytes, end plate calcification, and irregular disc margins at C2-C3 through C6-C7 and T12-L1 through L7-S1. Percentages for presence were calculated and statistically analyzed for younger (range, 2-11.9 months old) versus older (range, 12.0-25 months old) animals. Results Cervical discs in younger animals exhibited a greater proportion of irregular margins compared with lumbar sites (94% versus 83%; p = 0.02; 95% CI for difference, 2.7, 19.0%). In older animals, cervical discs showed a greater proportion of osteophytes than did lumbar discs (7% versus 0%; p \ 0.0001). The incidence of disc space narrowing was greater in cervical versus lumbar sites (99% versus 90%; p = 0.0008). Cervical spine sites which contained osteophytes morphologically showed irregular disc margins and revealed an extrusion of herniated disc material in the osteophytes. Conclusions Radiologic and morphologic studies confirmed age-related disc degeneration in the cervical spine of the sand rat. Clinical Relevance Clinical cervical aging studies have shown that 14% of asymptomatic subjects younger than 40 years have abnormal MRI scans with an increase to 50% by 50 years old. We studied an economic rodent model for cervical age-related spontaneous disc.

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“…Many in vitro biomechanical analyses showed the detrimental consequences of different ligamentous injuries and provided the certain assumptions about clinical stability of human spine [Yoganandan et al, 1989, Coffee et al, 1988, Shea et al, 1991, Wen et at., 1993. Resection of the facet capsule alone, without disruption of the bony facet, showed that under torsion, the rotational displacement increased by 1% after a 25% capsule resection, 19% after a 50% resection, and 25% after a 75% or 100% resection [Raynor et al, 1985, Zdeblick et al, 1993.…”

Section: Introductionmentioning

confidence: 99%

Redistribution of Load of Injured Lower Cervical Spine Under Axial Compression Using FEM

Teo

2001

Computational Mechanics–New Frontiers for the New Millennium

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Cervical Stability After Sequential Capsule Resection

Cited by 135 publications

References 0 publications

Load-displacement properties of the normal and injured lower cervical spine in vitro

Load-displacement properties of the normal and injured lower cervical spine in vitro

Spontaneous Age-related Cervical Disc Degeneration in the Sand Rat

Redistribution of Load of Injured Lower Cervical Spine Under Axial Compression Using FEM

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