Finite Element Analysis of Cervical Arthroplasty Combined With Fusion Against 2-Level Fusion

Zhao, Yannan; Li, Qi; Mo, Zhongjun; Sun, Yu; Fan, Yubo

doi:10.1097/bsd.0b013e318246b163

Cited by 23 publications

(7 citation statements)

References 15 publications

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“…In addition to ACDF and total ADR, the use of both methods has been reported. Outcomes after hybrid surgery are still under investigation, especially with regard to the effect on cervical kinematics at adjacent disc levels [ 24 ]. There is some suggestion that ADR located close to 2-level fusion may be a more challenging biomechanical environment compared to ADR alone [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison of Hybrid Constructs with 2-Level Artificial Disc Replacement and 2-Level Anterior Cervical Discectomy and Fusion for Surgical Reconstruction of the Cervical Spine: A Kinematic Study in Whole Cadavers

2015

Med Sci Monit

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BackgroundMulti-level cervical degeneration of the spine is a common clinical pathology that is often repaired by anterior cervical discectomy and fusion (ACDF).The aim of this study was to investigate the kinematics of the cervical spine after hybrid surgery compared with 2-level ACDF.Material/MethodsFive freshly frozen, unembalmed whole human cadavers were used including 3 males and 2 females with a mean age of 51±8 years. After evaluating the intact spine for range of motion (ROM), sagittal alignment and instantaneous center of rotation (ICR), each cadaver underwent 4 consecutive surgeries: 2-level artificial disc replacement (ADR) from C4 to C6 (ADR surgery); 2-level ACDF from C4 to C6 (ACDF surgery); hybrid C4–5 ACDF and C5–6 ADR (ACDF+ADR surgery); and hybrid C4–5 ADR and C5–6 ACDF (ADR+ACDF surgery). The ROM and ICR of adjacent intact segments (C3–4; C6–7), and whole sagittal alignment were revaluated.ResultsTwo-level ACDF resulted in increased ROM at C3–4 and C6–7 compared with intact spine. ROM was significantly different to intact spine using ACDF surgery at C3–C4 and C6–C7 and ROM was increased with ACDF+ADR surgery at C6–C7 (all P<0.05). No improvement in sagittal alignment was observed with any approach. The localization of the ICR shifted upwards and anteriorly at C3–C4 after reconstruction. ICR changes at C3–C4 were greatest for ADR+ACDF surgery and were significantly different to ACDF surgery (P<0.05), but not between ADR surgery and ACDF+ADR surgery. At C6–C7, the ICR was more posterior and superior than in the intact condition. The greatest change in ICR was observed in ACDF surgery at the C6–C7 level, significantly different from the other groups (P<0.05).ConclusionsFor 2-level reconstruction, hybrid surgery and ADR did not alter ROM and minimally changed ICR at the adjacent-level. The type of surgery had a significant impact on the ICR location. This suggests that hybrid surgery may be a viable option for 2-level cervical surgery.

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Section: Discussionmentioning

confidence: 99%

Comparison of Hybrid Constructs with 2-Level Artificial Disc Replacement and 2-Level Anterior Cervical Discectomy and Fusion for Surgical Reconstruction of the Cervical Spine: A Kinematic Study in Whole Cadavers

2015

Med Sci Monit

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“…The scientific advent of finite element analysis has enabled the performance of dynamic studies and their applications in the automotive [26] and in the aircraft industries [27] , for military [28] and medical purposes [29] , for the investigation of the biomechanism in areas such as orthodontics [30] , [31] , implantology [32] , [33] , and blunt injuries [34] , and as a new tool to aid in the forensic sciences [35] . Research studies that utilize finite element analysis on ballistics issues to reproduce gunshot effects in the human skull remain sparse.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Gunshot Entrance Morphologies Caused by .40-Caliber Smith & Wesson, .380-Caliber, and 9-mm Luger Bullets: A Finite Element Analysis Study

et al. 2014

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Firearms can cause fatal wounds, which can be identified by traces on or around the body. However, there are cases where neither the bullet nor gun is found at the crime scene. Ballistic research involving finite element models can reproduce computational biomechanical conditions, without compromising bioethics, as they involve no direct tests on animals or humans. This study aims to compare the morphologies of gunshot entrance holes caused by.40-caliber Smith & Wesson (S&W), .380-caliber, and 9×19-mm Luger bullets. A fully metal-jacketed.40 S&W projectile, a fully metal-jacketed.380 projectile, and a fully metal-jacketed 9×19-mm Luger projectile were computationally fired at the glabellar region of the finite element model from a distance of 10 cm, at perpendicular incidence. The results show different morphologies in the entrance holes produced by the three bullets, using the same skull at the same shot distance. The results and traits of the entrance holes are discussed. Finite element models allow feasible computational ballistic research, which may be useful to forensic experts when comparing and analyzing data related to gunshot wounds in the forehead.

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“…29 In terms of adjacent level ROM, heterogeneity exists in the biomechanical literature with most suggesting that HS decreases adjacent level ROM compared with 2-level fusion constructs. [30][31][32][33] Furthermore, the meta-analysis by Jia and colleagues observed that the intradiscal pressure was lower in the adjacent levels for HS than for 2-level fusions. Zhao et al 30 found that the intradiscal pressure increased by > 40% at adjacent levels in fusion models, whereas this was <10% in HS models.…”

Section: Two-level Constructs Biomechanical Studiesmentioning

confidence: 99%

Current Evidence for Hybrid Constructs

Lee,

Lehman

2023

Clinical Spine Surgery: A Spine Publication

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It is not surprising that the utilization of hybrid constructs, combining cervical disc arthroplasty with anterior cervical disc arthroplasty, has steadily increased over the last decade. Known limitations exist with multi-level anterior cervical disc arthroplasty and cervical disc arthroplasty procedures. Hybrid surgery offers the possibility to address patient-specific pathology in a more tailored manner by restoring functional mobility and promoting fusion where appropriate. This review discusses the current evidence, both biomechanical and clinical, of hybrid surgery for 2-level and 3-level cervical disease.

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Finite Element Analysis of Cervical Arthroplasty Combined With Fusion Against 2-Level Fusion

Abstract: (1) The ROM of C56 (ProDisc-C arthroplasty) in HS was increased. (2) The HS model has a better ROM of C3-C7 than the TLF model. (3) The HS model offered less increase of adjacent segmental IDP and ROM than the TLF model.

Cited by 23 publications

References 15 publications

Comparison of Hybrid Constructs with 2-Level Artificial Disc Replacement and 2-Level Anterior Cervical Discectomy and Fusion for Surgical Reconstruction of the Cervical Spine: A Kinematic Study in Whole Cadavers

Comparison of Hybrid Constructs with 2-Level Artificial Disc Replacement and 2-Level Anterior Cervical Discectomy and Fusion for Surgical Reconstruction of the Cervical Spine: A Kinematic Study in Whole Cadavers

Comparison of Gunshot Entrance Morphologies Caused by .40-Caliber Smith & Wesson, .380-Caliber, and 9-mm Luger Bullets: A Finite Element Analysis Study

Current Evidence for Hybrid Constructs

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