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Biomechanical effects of cervical arthroplasty with U-shaped disc implant on segmental range of motion and loading of surrounding soft tissue

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Abstract

Purpose

Various design concepts have been adopted in cervical disc prostheses, including sliding articulation and standalone configuration. This study aimed to evaluate the biomechanical effects of the standalone U-shaped configuration on the cervical spine.

Methods

Based on an intact finite element model of C3–C7, a standalone U-shaped implant (DCI) was installed at C5–C6 and compared with a sliding articulation design (Prodisc-C) and an anterior fusion system. The range of motion (ROM), adjacent intradiscal pressure (IDP) and capsular ligament strain were calculated under different spinal motions.

Results

Compared to the intact configuration, the ROM at C5–C6 was reduced by 90 % after fusion, but increased by 70 % in the Prodisc-C model, while the maximum percentage change in the DCI model was 30 % decrease. At the adjacent segments, up to 32 % increase in ROM happened after fusion, while up to 34 % decrease occurred in Prodisc-C model and 17 % decrease in DCI model. The IDP increased by 11.6 % after fusion, but decreased by 5.6 and 6.3 % in the DCI and Prodisc-C model, respectively. The capsular ligament strain increased by 147 % in Prodisc-C and by 13 % in the DCI model. The DCI implant exhibited a high stress distribution.

Conclusions

Spinal fusion resulted in compensatory increase of ROM at the adjacent sites, thereby elevating the IDP. Prodisc-C resulted in hyper-mobility at the operative site that led to an increase of ligament force and strain. The U-shaped implant could maintain the spinal kinematics and impose minimum influence on the adjacent soft tissues, despite the standalone configuration encountering the disadvantages of high stress distribution.

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Acknowledgments

This project was supported by the National Natural Science Foundation of China (Nos. 10925208, 11120101001, 11202017, 11272273 and 81271666), the 111 Project (No. B13003), National Science & Technology Pillar Program (Nos. 2012BAI18B05, 2012BAI18B07) and The Hong Kong Polytechnic university Research Grant (No. G-UA40).

Conflict of interest

None.

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Authors and Affiliations

  1. Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Key Laboratory for Optimal Design and Evaluation Technology of Implantable & Interventional Medical Devices, International Joint Research Center of Aerospace Biotechnology and Medical Engineering of Ministry of Science and Technology, School of Biological Science and Medical Engineering, Beihang University, XueYuan Road No.37, HaiDian District, Beijing, 100191, People’s Republic of China

    Zhong Jun Mo, Li Zhen Wang & Yu Bo Fan

  2. Department of Orthopedic Surgery, Peking University Third Hospital, North Garden Road NO.49, HaiDian District, Beijing, 100191, People’s Republic of China

    Yan Bin Zhao & Yu Sun

  3. Interdisciplinary Division of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, Hong Kong

    Zhong Jun Mo & Ming Zhang

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  1. Zhong Jun Mo
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  2. Yan Bin Zhao
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  4. Yu Sun
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Corresponding authors

Correspondence to Yu Sun or Yu Bo Fan.

Additional information

Zhong Jun Mo and Yan Bin Zhao contributed equally to this work.

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Mo, Z.J., Zhao, Y.B., Wang, L.Z. et al. Biomechanical effects of cervical arthroplasty with U-shaped disc implant on segmental range of motion and loading of surrounding soft tissue. Eur Spine J 23, 613–621 (2014). https://doi.org/10.1007/s00586-013-3070-4

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  • DOI: https://doi.org/10.1007/s00586-013-3070-4

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