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Finite element modeling and analysis of effect of preexisting cervical degenerative disease on the spinal cord during flexion and extension

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Abstract

Recent studies have emphasized the importance of dynamic activity in the development of myelopathy. However, current knowledge of how degenerative factors affect the spinal cord during motion is still limited. This study aimed to investigate the effect of various types of preexisting herniated cervical disc and the ligamentum flavum ossification on the spinal cord during cervical flexion and extension. A detailed dynamic fluid-structure interaction finite element model of the cervical spine with the spinal cord was developed and validated. The changes of von Mises stress and maximum principal strain within the spinal cord in the period of normal, hyperflexion, and hyperextension were investigated, considering various types and grades of disc herniation and ossification of the ligamentum flavum. The flexion and extension of the cervical spine with spinal canal encroachment induced high stress and strain inside the spinal cord, and this effect was also amplified by increased canal encroachments and cervical hypermobility. The spinal cord might evade lateral encroachment, leading to a reduction in the maximum stress and principal strain within the spinal cord in local-type herniation. Although the impact was limited in the case of diffuse type, the maximum stress tended to appear in the white matter near the encroachment site while compression from both ventral and dorsal was essential to make maximum stress appear in the grey matter. The existence of canal encroachment can reduce the safe range for spinal cord activities, and hypermobility activities may induce spinal cord injury. Besides, the ligamentum flavum plays an important role in the development of central canal syndrome.

Significance. This model will enable researchers to have a better understanding of the influence of cervical degenerative diseases on the spinal cord during extension and flexion.

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Funding

This work was supported by the National Key R&D Program of China (No. 2020YFC2008703 and No. 2022YFF1202600).

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  1. Meng-lei Xu and Yi-ting Yang contributed equally to this paper.

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  1. Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, 200092, China

    Meng-lei Xu, Yi-ting Yang, Hui-zi Zeng, Yu-ting Cao, Liang-dong Zheng, Chen Jin, Shi-jie Zhu & Rui Zhu

  2. Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of the Ministry of Education, Tongji Hospital, School of Medicine, Tongji University, 389 Xincun Road, Shanghai, 200065, China

    Meng-lei Xu, Chen Jin & Rui Zhu

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Xu, Ml., Yang, Yt., Zeng, Hz. et al. Finite element modeling and analysis of effect of preexisting cervical degenerative disease on the spinal cord during flexion and extension. Med Biol Eng Comput 62, 1089–1104 (2024). https://doi.org/10.1007/s11517-023-02993-x

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  • DOI: https://doi.org/10.1007/s11517-023-02993-x

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