In Vitro Biomechanics of Human Cadaveric Cervical Spines With Mature Fusion

Sawa, Anna G.U.; Pereira, Bernardo de Andrada; Rodriguez-Martinez, Nestor G.; Reyes, Phillip M.; Kelly, Brian P.; Crawford, Neil R.

doi:10.14444/8114

Cited by 4 publications

(5 citation statements)

References 14 publications

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“…Our study demonstrated increased amplitude in adjacent segments after ACDF and decreased amplitude in the caudal segment and no change in the cranial segment in CTDA group. Similar results were obtained during experimental studies [ 9 , 10 ]. The increased amplitude of adjacent segments may later serve as a factor of adjacent level syndrome development.…”

Section: Discussionsupporting

confidence: 91%

“…The importance of studying cervical segments mobility lies in its possible influence on development of adjacent level syndrome. Degenerative changes progression is directly related both to segmental motion and cervical spine motion Before surgery 6.9 [-12.2; 2 overall volume [9] and to the effect of these movements on intradiscal pressure [10] which causes morphological changes of the intervertebral disc [11,12]. This study showed increased range of motion at the operated segment in CTDA group, which is not surprising since mobility preservation after ACDF is caused either by incorrectly performed surgery or by pseudoarthrosis development [13].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Sagittal Balance Parameters after Anterior Cervical Discectomy with Spondylodesis and Arthroplasty Using Endocarbon Endoprosthesis: Results of Randomized Study

Eliseev¹,

Bokov²,

Mlyavykh³

2022

Sovrem Tehnol Med

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The aim of the study was to examine the effect of cervical segment mobility on spinal sagittal balance parameters after cervical total disc arthroplasty (CTDA) and anterior cervical discectomy and fusion (ACDF) using the first domestic intervertebral disc endoprosthesis.Materials and Methods. The randomized prospective study included 98 patients (48 with CTDA, 50 with ACDF). Implants used: intervertebral disc endoprosthesis or intervertebral fusion cage (Endocarbon; NPP "MedInzh", Russia).Total cervical mobility and range of motion in the target and adjacent vertebral motion segments were studied by functional radiography before surgery, at an early postoperative period (within 3 days), and 3, 6, and 12 months after the intervention.Values of cervical lordosis (CL, °), cervical sagittal vertical alignment (cSVA, mm), and first thoracic vertebra slope (T1 slope, °) were determined by using spinal radiography. Surgimap V2.2 software (Nemaris, USA) was used for measurements.Results. When comparing changes of overall cervical mobility at different time intervals, statistically significant differences were obtained in ACDF group (p=0.001). When comparing this parameter between ACDF and CTDA, a statistically significant difference was found only at the early postoperative period (p=0.004).In CTDA group, the range of motion increased at the operated segment (p=0.001) and decreased at the caudal segment (p=0.002). In ACDF group, no motion was observed at the operated segment (p=0.001) and the range of motion increased at adjacent segments (p=0.001). A statistically significant difference between ACDF and CTDA was obtained only at the operated (p=0.001) and caudal segments (p≤0.002).Correlation analysis showed no dependence between range of motion influence and regional/global balance values (p>0.5). The intergroup comparison of cervical lordosis (CL) values revealed a statistically significant difference after 6 (p=0.001) and 12 (p=0.001) months. The best results were obtained at ACDF group towards lordosis increase (p=0.001). The relationship between cervical lordosis and arthroplasty of segments C5-C6, C6-C7 (p=0.003; ρ=0.41) was determined using correlation analysis. The correlation between CL and ACDF (p=0.001; ρ=0.72) was also established.cSVA comparison between groups showed no difference at preoperative period (p=0.215), 6 (p=0.20) and 12 (p=0.425) months after surgery. cSVAs at both groups were equally close to normal values.T1 slope changes before and 12 months after surgery were statistically significant at ACDF (p=0.008) and CTDA (p=0.001) groups. T1 slope values comparison between ACDF and CTDA shows statistically significant difference after 12 months (p=0.003). T1 slopes were equally close to normal values 1 year after surgical treatment.Conclusion. Over a 12-month observation period, the segmental range of motion was found to have no effect on changes of regional and global balance of the cervical spine. No influence was confirmed of range of motion on adjacent level syndrome development -the syndrome was ...

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Sagittal Balance Parameters after Anterior Cervical Discectomy with Spondylodesis and Arthroplasty Using Endocarbon Endoprosthesis: Results of Randomized Study

Eliseev¹,

Bokov²,

Mlyavykh³

2022

Sovrem Tehnol Med

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“…В течение нескольких лет после ACDF частой причиной повторных операций является синдром смежного уровня. Поиски причины его развития привели к лучшему пониманию биомеханики шейного отдела позвоночника [14]. В качестве одной из причин ASD стали рассматривать спондилодез ранее оперированного смежного сегмента.…”

Section: Discussionunclassified

Degenerative changes in the intervertebral joints of the cervical spine after anterior interbody fusion and intervertebral disc arthroplasty

Eliseev,

Bokov,

Mlyavykh

2023

Hir. pozvonoč.

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Objective. To study the effect of arthroplasty and anterior interbody fusion in the cervical spine on degenerative changes in the adjacent intervertebral joints.Material and Methods. A retrospective cohort study included 46 patients (22 with cervical total disc arthroplasy – CTDA, and 24 with anterior cervical discectomy and fusion – ACDF) with symptoms of cervical spondylogenic compression myelopathy and/or radiculopathy. The degree of degeneration of facet joints adjacent to the operated segments was evaluated 12 months after surgical treatment. Degenerative changes in the cervical spine were assessed using CT according to the Okamoto classification. Vidar Dicom Viewer 3.2 software was used to view images and evaluate intervertebral joints. Statistical processing was performed using IBM SPSS Statistics 23. Data were presented as median and 25th and 75th percentiles – Me [Q1; Q3].Results. The mean age of patients in both groups was 47 [39; 52] years (Mann – Whitney U-test, p = 0.047). In the ACDF group it was 48 [42; 55] years and in the CTDA group – 42 [36; 52] years. Comparison of degenerative changes in the ACDF group before and after treatment (Wilcoxon analysis) showed a statistically significant difference in the cranial (p = 0.023), and caudal (p = 0.001) joints, with the progression of degeneration degree. In the CTDA group, no difference between pre- and post-treatment degeneration degree (Wilcoxon analysis) was found in either cranial joints (p = 0.157) or caudal joints (p = 0.161).Conclusion. Surgeries to stabilize spinal segments in degenerative diseases undeniably affect the development of the adjacent level syndrome. However, the use of endoprosthetic technology makes it possible to aggravate the degree of degenerative changes in the intervertebral joints of adjacent segments to a lesser extent.

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“…[4][5][6] To better understand its role in healthy, injured, and pathologic states, the posterior thoracolumbar ligamentous complex has been well studied in cadaveric specimens to assess mechanical properties. [5][6][7][8][9][10][11][12][13][14][15] However, it is well accepted that cadaveric tests often do not fully replicate in vivo function of tissues, [16][17][18] and for this structure, very little is known about its dynamic, physiologic biomechanics.…”

Section: Introductionmentioning

confidence: 99%

Ultrasound Shear Wave Elastography Quantitatively Assesses Tension Changes of Supraspinous/Interspinous Ligament Complex Under Varied Loads

Yancey,

Rbil,

Chatterjee

et al. 2023

Int J Spine Surg

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Background: Although interspinous and supraspinous ligaments of the lumbar spine are thought to contribute to spinal stability, little is known about their dynamic biomechanics. We demonstrate that shear wave elastography (SWE) offers a novel technique to noninvasively and quantitatively evaluate posterior spinous ligament complex functional loading and stiffness in different physiologic positions.Methods: We performed SWE and measured the length of the interspinous/supraspinous ligament complex in cadaveric torsos (N = 5), isolated ligaments (N = 10), and healthy volunteers (N = 9) to obtain length and shear wave velocity measurements. For cadavers and volunteers, SWE was utilized in 2 lumbar positions: lumbar spine flexion and extension. In addition, SWE was performed on isolated ligaments undergoing uniaxial tension to correlate shear wave velocities with experienced load.Results: Average shear wave velocity in cadaveric supraspinous/interspinous ligament complexes increased for lumbar levels (23%-43%) and most thoracic levels (0%-50%). This corresponded to an average increase in interspinous distance from extension to flexion for the lumbar spine (19%-63%) and thoracic spine (3%-8%). Volunteer spines also demonstrated an average increase in shear wave velocity from extension to flexion for both the lumbar spine (195% at L2-L3 to 200% at L4-L5) and thoracic spine (31% at T10-T11). There was an average increase in interspinous distance from extension to flexion for the lumbar spine (93% at L2-L3 to 127% at L4-L5) and thoracic spine (11% at T10-T11). In isolated ligaments, there was a positive correlation between applied tensile load and average shear wave velocity.Conclusion: This study creates a foundation to apply SWE as a noninvasive tool for assessing the mechanical stiffness of posterior ligamentous structures and has potential applications in augmenting or evaluating these ligaments in patients with spine pathology.Clinical Relevance: The interspinous and supraspinous ligaments are critical soft tissue supports of the posterior lumbar spine. Disruption of these structures is thought to have a negative impact on spinal stability in trauma and spine deformities.Level of Evidence: 4.

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In Vitro Biomechanics of Human Cadaveric Cervical Spines With Mature Fusion

Cited by 4 publications

References 14 publications

Sagittal Balance Parameters after Anterior Cervical Discectomy with Spondylodesis and Arthroplasty Using Endocarbon Endoprosthesis: Results of Randomized Study

Sagittal Balance Parameters after Anterior Cervical Discectomy with Spondylodesis and Arthroplasty Using Endocarbon Endoprosthesis: Results of Randomized Study

Degenerative changes in the intervertebral joints of the cervical spine after anterior interbody fusion and intervertebral disc arthroplasty

Ultrasound Shear Wave Elastography Quantitatively Assesses Tension Changes of Supraspinous/Interspinous Ligament Complex Under Varied Loads

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