In vitro biomechanics of cervical disc arthroplasty with the ProDisc-C total disc implant

2004 ◽  
Vol 17 (3) ◽  
pp. 44-54 ◽  
Author(s):  
Denis J. DiAngelo ◽  
Kevin T. Foley ◽  
Brian R. Morrow ◽  
John S. Schwab ◽  
Jung Song ◽  
...  
Keyword(s):  
Axial Rotation ◽  
Biomechanical Study ◽  
Cervical Disc ◽  
Cervical Disc Arthroplasty ◽  
Disc Arthroplasty ◽  
Single Level ◽  
Flexion Extension ◽  
Adjacent Segments ◽  
Treated Site

An in vitro biomechanical study was conducted to compare the effects of disc arthroplasty and anterior cervical fusion on cervical spine biomechanics in a multilevel human cadaveric model. Three spine conditions were studied: harvested, single-level cervical disc arthroplasty, and single-level fusion. A programmable testing apparatus was used that replicated physiological flexion/extension, lateral bending, and axial rotation. Measurements included vertebral motion, applied load, and bending moments. Relative rotations at the superior, treated, and inferior motion segment units (MSUs) were normalized with respect to the overall rotation of those three MSUs and compared using a one-way analysis of variance with Student–Newman–Keuls test (p < 0.05). Simulated fusion decreased motion across the treated site relative to the harvested and disc arthroplasty conditions. The reduced motion at the treated site was compensated at the adjacent segments by an increase in motion. For all modes of testing, use of an artificial disc prosthesis did not alter the motion patterns at either the instrumented level or adjacent segments compared with the harvested condition, except in extension.

scholarly journals Effect of Facet Tropism on Postoperative Cervical Range of Motion After Single-Level Cervical Disc Arthroplasty

2021 ◽  
pp. 219256822098614
Author(s):  
Ziyang Liu ◽  
Xin Rong ◽  
Hao Liu ◽  
Chen Ding ◽  
Ying Hong ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Cervical Disc ◽  
Cervical Disc Arthroplasty ◽  
Facet Joints ◽  
Disc Arthroplasty ◽  
Single Level ◽  
Cervical Range Of Motion ◽  
Significant Difference ◽  
Flexion Extension ◽  
Facet Tropism

Study Design: Retrospective analysis. Objectives: Cervical disc arthroplasty (CDA) was designed to replace the degenerated disc with the prosthesis to preserve cervical motion. The commonly used artificial discs are designed symmetric, whereas the facet joints were reported to be asymmetric in many people. This study aimed to evaluate the effect of facet tropism on the cervical range of motion (ROM) after single-level CDA using Prestige LP. Methods: A total of 90 patients who underwent single-level CDA using Prestige LP from 2012 to 2017 were retrospectively reviewed. Radiographs were taken at each time point to measure the C2-C7 ROM and the ROM at the surgical segment. The pre-operation CT scans were utilized to reconstruct and calculate the angular direction of facet joints with respect to transverse, coronal, and sagittal reference planes. Facet tropism above 7° was defined as facet joint asymmetry. Results: No significant difference was found in flexion-extension C2-C7 ROM or ROM at the surgical segment between patients with symmetric and asymmetric fact joints regarding the sagittal plane. Patients with coronal asymmetric facet joints had lower flexion-extension ROM at the surgical level. Patients with transverse asymmetric facet joints had both lower flexion-extension C2-C7 ROM and ROM at the surgical level. After CDA surgery, patients obtained good clinical outcomes including increased Japanese Orthopedic Association (JOA) and decreased Neck Disability Index (NDI) as well as Visual Analogue Scale (VAS). Conclusion: The coronal and transverse tropism seemed to be correlated with decreased flexion-extension ROM after CDA using Prestige LP.

Outcomes of single-level cervical disc arthroplasty versus anterior cervical discectomy and fusion

2014 ◽  
Vol 21 (11) ◽  
pp. 1905-1908 ◽  
Author(s):  
Robert W. Tracey ◽  
Daniel G. Kang ◽  
John P. Cody ◽  
Scott C. Wagner ◽  
Michael K. Rosner ◽  
...  
Keyword(s):  
Anterior Cervical Discectomy ◽  
Cervical Disc ◽  
Cervical Disc Arthroplasty ◽  
Disc Arthroplasty ◽  
Cervical Discectomy ◽  
Single Level

New anterior controllable antedisplacement and fusion surgery for cervical ossification of the posterior longitudinal ligament: a biomechanical study

2022 ◽  
pp. 1-9
Keyword(s):  
Fatigue Loading ◽  
Axial Rotation ◽  
Posterior Longitudinal Ligament ◽  
Cyclic Fatigue ◽  
Biomechanical Study ◽  
Biomechanical Stability ◽  
Loading Test ◽  
Crossover Effect ◽  
Flexion Extension

OBJECTIVE The traditional anterior approach for multilevel severe cervical ossification of the posterior longitudinal ligament (OPLL) is demanding and risky. Recently, a novel surgical procedure—anterior controllable antedisplacement and fusion (ACAF)—was introduced by the authors to deal with these problems and achieve better clinical outcomes. However, to the authors’ knowledge, the immediate and long-term biomechanical stability obtained after this procedure has never been evaluated. Therefore, the authors compared the postoperative biomechanical stability of ACAF with those of more traditional approaches: anterior cervical discectomy and fusion (ACDF) and anterior cervical corpectomy and fusion (ACCF). METHODS To determine and assess pre- and postsurgical range of motion (ROM) (2 Nm torque) in flexion-extension, lateral bending, and axial rotation in the cervical spine, the authors collected cervical areas (C1–T1) from 18 cadaveric spines. The cyclic fatigue loading test was set up with a 3-Nm cycled load (2 Hz, 3000 cycles). All samples used in this study were randomly divided into three groups according to surgical procedures: ACDF, ACAF, and ACCF. The spines were tested under the following conditions: 1) intact state flexibility test; 2) postoperative model (ACDF, ACAF, ACCF) flexibility test; 3) cyclic loading (n = 3000); and 4) fatigue model flexibility test. RESULTS After operations were performed on the cadaveric spines, the segmental and total postoperative ROM values in all directions showed significant reductions for all groups. Then, the ROMs tended to increase during the fatigue test. No significant crossover effect was detected between evaluation time and operation method. Therefore, segmental and total ROM change trends were parallel among the three groups. However, the postoperative and fatigue ROMs in the ACCF group tended to be larger in all directions. No significant differences between these ROMs were detected in the ACDF and ACAF groups. CONCLUSIONS This in vitro biomechanical study demonstrated that the biomechanical stability levels for ACAF and ACDF were similar and were both significantly greater than that of ACCF. The clinical superiority of ACAF combined with our current results showed that this procedure is likely to be an acceptable alternative method for multilevel cervical OPLL treatment.

Immediate Stiffness of the C5–C6 Segment after Discectomy with the Cloward Technique: An in Vitro Biomechanical Study on a Human Cadaveric Model

Neurosurgery ◽  
2001 ◽  
Vol 49 (6) ◽  
pp. 1399-1408 ◽  
Author(s):  
Andrzej Maciejczak ◽  
Michał Ciach ◽  
Maciej Radek ◽  
Andrzej Radek ◽  
Jan Awrejcewicz
Keyword(s):  
Interbody Fusion ◽  
Spinal Instrumentation ◽  
Axial Rotation ◽  
Postoperative Management ◽  
Biomechanical Study ◽  
Lateral Bending ◽  
Cervical Discectomy ◽  
Cloward Procedure ◽  
Flexion Extension

ABSTRACT OBJECTIVE To determine whether the Cloward technique of cervical discectomy and fusion increases immediate postoperative stiffness of single cervical motion segment after application of interbody dowel bone graft. METHODS We measured and compared the stiffness of single-motion segments in cadaveric cervical spines before and immediately after interbody fusion with the Cloward technique. Changes in range of motion and stiffness of the C5–C6 segment were measured in a bending flexibility test (flexion, extension, lateral bending and axial rotation) before and after a Cloward procedure in 11 fresh-frozen human cadaveric specimens from the 4th through the 7th vertebrae. RESULTS The Cloward procedure produced a statistically significant increase in stiffness of the operated segment in flexion and lateral bending when compared with the intact spine. The less stiff the segment before the operation, the greater the increase in its postoperative flexural stiffness (statistically significant). The Cloward procedure produced nonuniform changes in rotational and extensional stiffness that increased in some specimens and decreased in others. CONCLUSION Our data demonstrate that Cloward interbody fusion increases immediate postoperative stiffness of an operated segment only in flexion and lateral bending in cadaveric specimens in an in vitro environment. Thus, Cloward fusion seems a relatively ineffective method for increasing the stiffness of a construct. This may add to discussion on the use of spinal instrumentation and postoperative management of patients after cervical discectomy, which varies from bracing in hard collars through immobilization in soft collars to no external orthosis.

scholarly journals A Biomechanical Evaluation of a Next-Generation Integrated and Modular ACDF Device Possessing Full-Plate, Half-Plate, and No-Profile Fixation Iterations

2019 ◽  
Vol 9 (8) ◽  
pp. 826-833
Author(s):  
Ripul Panchal ◽  
Anup Gandhi ◽  
Chris Ferry ◽  
Sam Farmer ◽  
Jeremy Hansmann ◽  
...  
Keyword(s):  
Plate Fixation ◽  
Testing Machine ◽  
Axial Rotation ◽  
Biomechanical Study ◽  
The Novel ◽  
Novel Device ◽  
Plate Group ◽  
Flexion Extension ◽  
Group 2

Study Design: In vitro biomechanical study. Objectives: The objective of this in vitro biomechanical range-of-motion (ROM) study was to evaluate spinal segmental stability following fixation with a novel anterior cervical discectomy and fusion (ACDF) device (“novel device”) that possesses integrated and modular no-profile, half-plate, and full-plate fixation capabilities. Methods: Human cadaveric (n = 18, C3-T1) specimens were divided into 3 groups (n = 6/group). Each group would receive one novel device iteration. Specimen terminal ends were potted. Each specimen was first tested in an intact state, followed by anterior discectomy (C5/C6) and iterative instrumentation. Testing order: (1) novel device (group 1, no-profile; group 2, half-plate; group 3, full-plate); (2) novel device (all groups) with lateral mass screws (LMS); (3) traditional ACDF plate + cage; (4) traditional ACDF plate + cage + LMS. A 2 N·m moment was applied in flexion/extension (FE), lateral bending (LB), and axial rotation (AR) via a kinematic testing machine. Segmental ROM was tracked and normalized to intact conditions. Comparative statistical analyses were performed. Results: Key findings: (1) the novel half- and full-plate constructs provided comparable reduction in FE and LB ROM to that of traditional plated ACDF ( P ≥ .05); (2) the novel full-plate construct significantly exceeded all other anterior-only constructs ( P ≤ .05) in AR ROM reduction; and (3) the novel half-plate construct significantly exceeded the no-profile construct in FE ( P < .05). Conclusions: The novel ACDF device may be a versatile alternative to traditional no-profile and independent plating techniques, as it provides comparable ROM reduction in all principle motion directions, across all device iterations.

P63. Outpatient vs inpatient single-level cervical disc arthroplasty: An all-payer database analysis of 90-day complications and costs

2021 ◽  
Vol 21 (9) ◽  
pp. S170
Author(s):  
Joseph Drain ◽  
Azeem T. Malik ◽  
Robert C. Ryu ◽  
Varun K. Singh ◽  
Elizabeth Yu ◽  
...  
Keyword(s):  
Cervical Disc ◽  
Cervical Disc Arthroplasty ◽  
Database Analysis ◽  
Disc Arthroplasty ◽  
Single Level
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