open access

https://hdl.handle.net/2115/14766

Multidirectional flexibility analysis of cervical artificial disc reconstruction: in vitro human cadaveric spine model.

英語

biomechanical study

2005-02

American Association of Neurological Surgeons

Journal of Neurosurgery : Spine

2(2)

188-194

OBJECT: This in vitro experimental study was conducted to investigate the initial biomechanical effect of artificial intervertebral disc replacement in the cervical spine. The multidirectional flexibility of replaced and adjacent spinal segments were analyzed using a cadaveric cervical spine model. METHODS: The following three cervical reconstructions were sequentially performed at the C5-6 level after anterior discectomy in seven human cadaveric occipitocervical spines: anterior artificial disc replacement with a bioactive three-dimensional (3D) fabric disc (FD); anterior iliac bone graft; and anterior plate fixation with iliac bone graft. Six unconstrained pure moments were applied with a 6-df spine simulator, and 3D segmental motions at the operative and adjacent segments were measured with an optoelectronic motion measurement system. The 3D FD group demonstrated statistically equivalent ranges of motion (ROMs) when compared with intact values in axial rotation and lateral bending. The 45% increase in flexion-extension ROM was demonstrated in 3D FD group; however, neutral zone analysis did not reach statistical significance between the intact spine and 3D FD. The anterior iliac bone graft and iliac bone graft reconstructions demonstrated statistically lower ROMs when compared with 3D FD in all loading modes (p < 0.05). The adjacent-level ROMs of the 3D FD group demonstrated nearly physiological characteristics at upper and lower adjacent levels. Excellent stability at the interface was maintained during the whole testing without any device displacement and dislodgment. CONCLUSIONS: The stand-alone cervical 3D FD demonstrated nearly physiological biomechanical characteristics at both operative and adjacent spinal segments in vitro, indicating an excellent clinical potential for cervical artificial disc replacement.

学術雑誌論文

Accepted Manuscript

The final version of the paper was published in Journal of Neurosurgery:Spine, vol. 2-2. For reuse of any of the materials, including editorial copy, figures, or tables please contact the Journal of Neurosurgery at jneuro@virginia.edu

1547-5654