Recent Advances of Biomechanical Studies on Cervical Fusion and Nonfusion Surgery_Journal of Biomedical Engineering

Authors：

LIAOZhenhua ^1,2 ,  LIUWeiqiang ^1,2

1. Department of Mechanical Engineering, Tsinghua University, Beijing 100084, China;
2. Research Institute of Tsinghua University in Shenzhen, Shenzhen 518057, China;

Corresponding author：

LIUWeiqiang, Email: weiqliu@hotmail.com

Keywords：

biomechanics; cervical spine; fusion; nonfusion; hybrid surgery

DOI：

10.7507/1001-5515.20160031

Video：

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This article reviews the progress of biomechanical studies on anterior cervical fusion and nonfusion surgery in recent years. The similarities and differences between animal and human cervical spines as well as the major three biomechanical test methods are introduced. Major progresses of biomechanical evaluation in anterior cervical fusion and nonfusion devices, hybrid surgery, coupled motion and biomechanical parameters, such as the instant center of rotation, are classified and summarized. Future development of loading method, multilevel hybrid surgery and coupling character are also discussed.

Citation： LIAOZhenhua, LIUWeiqiang. Recent Advances of Biomechanical Studies on Cervical Fusion and Nonfusion Surgery. Journal of Biomedical Engineering, 2016, 33(1): 171-176. doi: 10.7507/1001-5515.20160031 Copy

1.	RYU W H, KOWALCZYK I, DUGGAL N. Long-term kinematic analysis of cervical spine after single level implantation of Bryan cervical disc prosthesis[J] . Spine J, 2013, 13(6): 628-634.
2.	BEUTLER W J, CLAVENNA A L, GUDIPALLY M, et al. A biomechanical evaluation of a spacer with integrated plate for treating adjacent level disease in the subaxial cervical spine[J] . Spine J, 2012, 12(7): 585-589.
3.	ROBSON BROWN K, TARSUSLUGIL S, WIJAYATHUNGA V N, et al. Comparative finite element analysis: a single computational modelling method can estimate the mechanical properties of porcine and human vertebrae[J] . J R Soc Interface, 2014, 11(95): 20140186.
4.	DEVRIES N A, GANDHI A A, FREDERICKS D C, et al. Biomechanical analysis of the intact and destabilized sheep cervical spine[J] . Spine (Phila Pa 1976), 2012, 37(16): E957-E963.
5.	盛孙仁, 徐华梓,王向阳,等.猪､小牛与人颈椎的生物力学比较[J] .医用生物力学,2010,25(5):380-384.
6.	PANJABI M M. Hybrid multidirectional test method to evaluate spinal adjacent level effects[J] . Clin Biomech (Bristol, Avon), 2007, 22(3): 257-265.
7.	PU T, LIU WQ, LIAO ZH, et al. Biomechanical comparison of one and Two Level cervical arthroplasty versus fusion[J] . Advanced materials research, 2014, 850: 1202-1206.
8.	SAARI A, DENNISON C R, ZHU Qingan, et al. Compressive follower load influences cervical spine kinematics and kinetics during simulated head first impact in an in vitro model[J] . J Biomech Eng, 2013, 135(11): 111003.
9.	MAJID K, CHINTHAKUNTA S, MUZUMDAR A, et al. A comparative biomechanical study of a novel integrated plate spacer for stabilization of cervical spine: an in vitro human cadaveric model[J] . Clin Biomech (Bristol, Avon), 2012, 27(6): 532-536.
10.	STEIN M I, NAYAK A N, GASKINS R B, et al. Biomechanics of an integrated interbody device versus ACDF anterior locking plate in a single level cervical spine fusion construct[J] . Spine J, 2014, 14(1): 128-136.
11.	PAIK H, KANG D G, LEHMAN R A, et al. Do stand alone interbody spacers with integrated screws provide adequate segmental stability for multilevel cervical arthrodesis?[J] . Spine J, 2014, 14(8): 1740-1747.
12.	CLAVENNA A L, BEUTLER W J, GUDIPALLY M, et al. The biomechanical stability of a novel spacer with integrated plate in contiguous two level and three level ACDF models: an in vitro cadaveric study[J] . Spine J, 2012, 12(2): 157-163.
13.	WOJEWNIK B, GHANAYEM A J, TSITSOPOULOS P P, et al. Biomechanical evaluation of a low profile, anchored cervical interbody spacer device in the setting of progressive flexion distraction injury of the cervical spine[J] . Eur Spine J, 2013, 22(1): 135-141.
14.	BALARAM A K, GHANAYEM A J, O?LEARY P T, et al. Biomechanical evaluation of a low profile, anchored cervical interbody spacer device at the index level or adjacent to plated fusion[J] . Spine (Phila Pa 1976), 2014, 39(13): E763-E769.
15.	HOFSTETTER C C, KESAVABHOTLA K, BOOCKVAR J A. Zero profile Anchored Spacer Reduces Rate of Dysphagia Compared to ACDF With Anterior Plating[J] . J Spinal Disord Tech, [Epub ahead of print], 2013.
16.	MIAO Jinhao, SHEN Ye, KUANG Yong, et al. Early follow up outcomes of a new zero profile implant used in anterior cervical discectomy and fusion[J] . J Spinal Disord Tech, 2013, 26(5): E193-E197.
17.	VANEK P, BRADAC O, DELACY P, et al. Anterior interbody fusion of the cervical spine with Zero P spacer: prospective comparative study clinical and radiological results at a minimum 2 years after surgery[J] . Spine (Phila Pa 1976), 2013, 38(13): E792-E797.
18.	FAIZAN A, GOEL V K, BIYANI A, et al. Adjacent level effects of bi level disc replacement, bi level fusion and disc replacement plus fusion in cervical spine a finite element based study[J] . Clin Biomech (Bristol, Avon), 2012, 27(3): 226 233.
19.	COLLE K O, BUTLER J B, REYES P M, et al. Biomechanical evaluation of a metal on metal cervical intervertebral disc prosthesis[J] . Spine J, 2013, 13(11): 1640 1649.
20.	MO Zhongjun, ZHAO Yanbin, WANG Lizhen, et al. Biomechanical effects of cervical arthroplasty with U shaped disc implant on segmental range of motion and loading of surrounding soft tissue[J] . Eur Spine J, 2014, 23(3): 613 621.
21.	DING Fan, JIA Zhiwei, WU Yaohong, et al. Fusion nonfusion hybrid construct versus anterior cervical hybrid decompression and fusion: a comparative study for 3 level cervical degenerative disc diseases[J] . Spine (Phila Pa 1976), 2014, 39(23): 1934-1942.
22.	JIA Zhiwei, MO Zhongjun, DING Fan, et al. Hybrid surgery for multilevel cervical degenerative disc diseases: a systematic review of biomechanical and clinical evidence[J] . Eur Spine J, 2014, 23(8): 1619-1632.
23.	BARREY C, CAMPANA S, PERSOHN S, et al. Cervical disc prosthesis versus arthrodesis using one level, hybrid and two level constructs: an in vitro investigation[J] . Eur Spine J, 2012, 21(3): 432-442.
24.	LEE M J, DUMONSKI M, PHILLIPS F M, et al. Disc replacement adjacent to cervical fusion: a biomechanical comparison of hybrid construct versus two level fusion[J] . Spine (Phila Pa 1976), 2011, 36(23): 1932-1939.
25.	MARTIN S, GHANAYEM A J, TZERMIADIANOS M N, et al. Kinematics of cervical total disc replacement adjacent to a two level, straight versus lordotic fusion[J] . Spine (Phila Pa 1976), 2011, 36(17): 1359-1366.
26.	HEY H D, HONG C c, LONG A s, et al. Is hybrid surgery of the cervical spine a good balance between fusion and arthroplasty?Pilot results from a single surgeon series[J] . European Spine Journal, 2013, 22(1): 116-122.
27.	李杰,权正学.Hybrid手术在治疗多节段颈椎病中的临床运用[J] .重庆医科大学学报,2014,22(8):1136-1138.
28.	孙字.对颈椎前路融合与非融合手术混合应用的初步认识[J] .中国脊柱脊髓杂志,2014,24(1):8-9.
29.	PANJABI M M, CRISCO J J, VASAVADA A, et al. Mechanical properties of the human cervical spine as shown by three-dimensional load-displacement curves[J] . Spine (Phila Pa 1976), 2001, 26(24): 2692 2700.
30.	蒲婷,吕聪伟,颜滨,等.人工颈椎间盘置换术与融合术的生物力学比较[J] .医用生物力学,2014,29(2):105 112.
31.	王艳国,张琪,刘凯.有限元法在颈椎生物力学中应用研究分析[J] .中国中医骨伤科杂志,2013(7):62 64.
32.	NAGAMOTO Y, ISHII T, SAKAURA H, et al. In vivo three-dimensional kinematics of the cervical spine during head rotation in patients with cervical spondylosis[J] . Spine (Phila Pa 1976), 2011, 36(10): 778-783.
33.	DANIELS A H, PALLER D J, FELLER R J, et al. Examination of cervical spine kinematics in complex, multiplanar motions after anterior cervical discectomy and fusion and total disc replacement[J] . The International Journal of Spine Surgery, 2012, 6(1): 190-194.
34.	ANDERST W, BAILLARGEON E, DONALDSON W, et al. Motion path of the instant center of rotation in the cervical spine during in vivo dynamic flexion extension: implications for artificial disc design and evaluation of motion quality after arthrodesis[J] . Spine (Phila Pa 1976), 2013, 38(10): E594-E601.
35.	CUNNINGHAM B W, HU N, ZORN C M, et al. Biomechanical comparison of single and two level cervical arthroplasty versus arthrodesis: effect on adjacent level spinal kinematics[J] . Spine J, 2010, 10(4): 341-349.
36.	COBIAN D G, DAEHN N S, ANDERSON P A, et al. Active cervical and lumbar range of motion during performance of activities of daily living in healthy young adults[J] . Spine (Phila Pa 1976), 2013, 38(20): 1754-1763.
37.	THALER M, HARTMANN S, GSTTTNER M, et al. Footprint mismatch in total cervical disc arthroplasty[J] . Eur Spine J, 2013, 22(4): 759-765.
38.	季伟, 王向阳.脊柱离体运动加载方法研究进展[J] .医用生物力学,2012,27(4):464-469.
39.	刘伟强, 吕聪伟,蒲婷,等.颈椎前路三节段融合与置换混合术的力学特性[J] .清华大学学报:自然科学版,2014,54(5):685-689.
40.	WANG Huiren, LI Xilei, DONG Jian, et al. Skip level anterior cervical discectomy and fusion with self locking stand alone PEEK cages for the treatment of 2 noncontiguous levels of cervical spondylosis[J] . J Spinal Disord Tech, 2013, 26(7): E286-E292.

1. RYU W H, KOWALCZYK I, DUGGAL N. Long-term kinematic analysis of cervical spine after single level implantation of Bryan cervical disc prosthesis[J] . Spine J, 2013, 13(6): 628-634.
2. BEUTLER W J, CLAVENNA A L, GUDIPALLY M, et al. A biomechanical evaluation of a spacer with integrated plate for treating adjacent level disease in the subaxial cervical spine[J] . Spine J, 2012, 12(7): 585-589.
3. ROBSON BROWN K, TARSUSLUGIL S, WIJAYATHUNGA V N, et al. Comparative finite element analysis: a single computational modelling method can estimate the mechanical properties of porcine and human vertebrae[J] . J R Soc Interface, 2014, 11(95): 20140186.
4. DEVRIES N A, GANDHI A A, FREDERICKS D C, et al. Biomechanical analysis of the intact and destabilized sheep cervical spine[J] . Spine (Phila Pa 1976), 2012, 37(16): E957-E963.
5. 盛孙仁, 徐华梓,王向阳,等.猪､小牛与人颈椎的生物力学比较[J] .医用生物力学,2010,25(5):380-384.
6. PANJABI M M. Hybrid multidirectional test method to evaluate spinal adjacent level effects[J] . Clin Biomech (Bristol, Avon), 2007, 22(3): 257-265.
7. PU T, LIU WQ, LIAO ZH, et al. Biomechanical comparison of one and Two Level cervical arthroplasty versus fusion[J] . Advanced materials research, 2014, 850: 1202-1206.
8. SAARI A, DENNISON C R, ZHU Qingan, et al. Compressive follower load influences cervical spine kinematics and kinetics during simulated head first impact in an in vitro model[J] . J Biomech Eng, 2013, 135(11): 111003.
9. MAJID K, CHINTHAKUNTA S, MUZUMDAR A, et al. A comparative biomechanical study of a novel integrated plate spacer for stabilization of cervical spine: an in vitro human cadaveric model[J] . Clin Biomech (Bristol, Avon), 2012, 27(6): 532-536.
10. STEIN M I, NAYAK A N, GASKINS R B, et al. Biomechanics of an integrated interbody device versus ACDF anterior locking plate in a single level cervical spine fusion construct[J] . Spine J, 2014, 14(1): 128-136.
11. PAIK H, KANG D G, LEHMAN R A, et al. Do stand alone interbody spacers with integrated screws provide adequate segmental stability for multilevel cervical arthrodesis?[J] . Spine J, 2014, 14(8): 1740-1747.
12. CLAVENNA A L, BEUTLER W J, GUDIPALLY M, et al. The biomechanical stability of a novel spacer with integrated plate in contiguous two level and three level ACDF models: an in vitro cadaveric study[J] . Spine J, 2012, 12(2): 157-163.
13. WOJEWNIK B, GHANAYEM A J, TSITSOPOULOS P P, et al. Biomechanical evaluation of a low profile, anchored cervical interbody spacer device in the setting of progressive flexion distraction injury of the cervical spine[J] . Eur Spine J, 2013, 22(1): 135-141.
14. BALARAM A K, GHANAYEM A J, O?LEARY P T, et al. Biomechanical evaluation of a low profile, anchored cervical interbody spacer device at the index level or adjacent to plated fusion[J] . Spine (Phila Pa 1976), 2014, 39(13): E763-E769.
15. HOFSTETTER C C, KESAVABHOTLA K, BOOCKVAR J A. Zero profile Anchored Spacer Reduces Rate of Dysphagia Compared to ACDF With Anterior Plating[J] . J Spinal Disord Tech, [Epub ahead of print], 2013.
16. MIAO Jinhao, SHEN Ye, KUANG Yong, et al. Early follow up outcomes of a new zero profile implant used in anterior cervical discectomy and fusion[J] . J Spinal Disord Tech, 2013, 26(5): E193-E197.
17. VANEK P, BRADAC O, DELACY P, et al. Anterior interbody fusion of the cervical spine with Zero P spacer: prospective comparative study clinical and radiological results at a minimum 2 years after surgery[J] . Spine (Phila Pa 1976), 2013, 38(13): E792-E797.
18. FAIZAN A, GOEL V K, BIYANI A, et al. Adjacent level effects of bi level disc replacement, bi level fusion and disc replacement plus fusion in cervical spine a finite element based study[J] . Clin Biomech (Bristol, Avon), 2012, 27(3): 226 233.
19. COLLE K O, BUTLER J B, REYES P M, et al. Biomechanical evaluation of a metal on metal cervical intervertebral disc prosthesis[J] . Spine J, 2013, 13(11): 1640 1649.
20. MO Zhongjun, ZHAO Yanbin, WANG Lizhen, et al. Biomechanical effects of cervical arthroplasty with U shaped disc implant on segmental range of motion and loading of surrounding soft tissue[J] . Eur Spine J, 2014, 23(3): 613 621.
21. DING Fan, JIA Zhiwei, WU Yaohong, et al. Fusion nonfusion hybrid construct versus anterior cervical hybrid decompression and fusion: a comparative study for 3 level cervical degenerative disc diseases[J] . Spine (Phila Pa 1976), 2014, 39(23): 1934-1942.
22. JIA Zhiwei, MO Zhongjun, DING Fan, et al. Hybrid surgery for multilevel cervical degenerative disc diseases: a systematic review of biomechanical and clinical evidence[J] . Eur Spine J, 2014, 23(8): 1619-1632.
23. BARREY C, CAMPANA S, PERSOHN S, et al. Cervical disc prosthesis versus arthrodesis using one level, hybrid and two level constructs: an in vitro investigation[J] . Eur Spine J, 2012, 21(3): 432-442.
24. LEE M J, DUMONSKI M, PHILLIPS F M, et al. Disc replacement adjacent to cervical fusion: a biomechanical comparison of hybrid construct versus two level fusion[J] . Spine (Phila Pa 1976), 2011, 36(23): 1932-1939.
25. MARTIN S, GHANAYEM A J, TZERMIADIANOS M N, et al. Kinematics of cervical total disc replacement adjacent to a two level, straight versus lordotic fusion[J] . Spine (Phila Pa 1976), 2011, 36(17): 1359-1366.
26. HEY H D, HONG C c, LONG A s, et al. Is hybrid surgery of the cervical spine a good balance between fusion and arthroplasty?Pilot results from a single surgeon series[J] . European Spine Journal, 2013, 22(1): 116-122.
27. 李杰,权正学.Hybrid手术在治疗多节段颈椎病中的临床运用[J] .重庆医科大学学报,2014,22(8):1136-1138.
28. 孙字.对颈椎前路融合与非融合手术混合应用的初步认识[J] .中国脊柱脊髓杂志,2014,24(1):8-9.
29. PANJABI M M, CRISCO J J, VASAVADA A, et al. Mechanical properties of the human cervical spine as shown by three-dimensional load-displacement curves[J] . Spine (Phila Pa 1976), 2001, 26(24): 2692 2700.
30. 蒲婷,吕聪伟,颜滨,等.人工颈椎间盘置换术与融合术的生物力学比较[J] .医用生物力学,2014,29(2):105 112.
31. 王艳国,张琪,刘凯.有限元法在颈椎生物力学中应用研究分析[J] .中国中医骨伤科杂志,2013(7):62 64.
32. NAGAMOTO Y, ISHII T, SAKAURA H, et al. In vivo three-dimensional kinematics of the cervical spine during head rotation in patients with cervical spondylosis[J] . Spine (Phila Pa 1976), 2011, 36(10): 778-783.
33. DANIELS A H, PALLER D J, FELLER R J, et al. Examination of cervical spine kinematics in complex, multiplanar motions after anterior cervical discectomy and fusion and total disc replacement[J] . The International Journal of Spine Surgery, 2012, 6(1): 190-194.
34. ANDERST W, BAILLARGEON E, DONALDSON W, et al. Motion path of the instant center of rotation in the cervical spine during in vivo dynamic flexion extension: implications for artificial disc design and evaluation of motion quality after arthrodesis[J] . Spine (Phila Pa 1976), 2013, 38(10): E594-E601.
35. CUNNINGHAM B W, HU N, ZORN C M, et al. Biomechanical comparison of single and two level cervical arthroplasty versus arthrodesis: effect on adjacent level spinal kinematics[J] . Spine J, 2010, 10(4): 341-349.
36. COBIAN D G, DAEHN N S, ANDERSON P A, et al. Active cervical and lumbar range of motion during performance of activities of daily living in healthy young adults[J] . Spine (Phila Pa 1976), 2013, 38(20): 1754-1763.
37. THALER M, HARTMANN S, GSTTTNER M, et al. Footprint mismatch in total cervical disc arthroplasty[J] . Eur Spine J, 2013, 22(4): 759-765.
38. 季伟, 王向阳.脊柱离体运动加载方法研究进展[J] .医用生物力学,2012,27(4):464-469.
39. 刘伟强, 吕聪伟,蒲婷,等.颈椎前路三节段融合与置换混合术的力学特性[J] .清华大学学报:自然科学版,2014,54(5):685-689.
40. WANG Huiren, LI Xilei, DONG Jian, et al. Skip level anterior cervical discectomy and fusion with self locking stand alone PEEK cages for the treatment of 2 noncontiguous levels of cervical spondylosis[J] . J Spinal Disord Tech, 2013, 26(7): E286-E292.

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