Finite Element Analysis of Biomechanics of Cervical Spine after Dynamic Cervical Implant Surgery_Journal of Biomedical Engineering

Authors：

1. School of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, Shanghai 200093, China;
2. School of Energy and Motivation, University of Shanghai for Science and Technology, Shanghai Key Laboratory of Multiphase Flow and Heat Transfer in Power Engineering, Shanghai 200093, China;
3. Shanghai First People's Hospital, Shanghai 200080, China;

Corresponding author：

Keywords：

dynamic cervical implant; bone fusion; lower cervical spine; finite element analysis; mechanical properties

DOI：

10.7507/1001-5515.20160107

Video：

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This study aims to investigate the range of motion (ROM) and the stress variation in the intervertebral disc and the vertebral body on adjacent segments and the influence of force transmission mode after the dynamic cervical implant (DCI) surgery. Two types of surgery, DCI implantation and interbody fusion were used to establish the finite element model of the cervical C_{5, 6} segment degeneration treatment. The ROM and the adjacent discs and vertebral body stresses of two procedures under flexion, extension, lateral bending and axial rotation working conditions were analyzed. The results showed that ROM of the surgical segment in DCI model was well preserved and could restore to the normal ROM distributions (reduction of the amplitude was less than 25%), and the kinetic characteristics of adjacent segments was less affected. In fusion surgery model, however, ROM of the surgical segment was reduced by 86%-91%, while ROM, disc stress and vertebral stress of adjacent segments were increased significantly, and stress of the C₅ vertebral body was increased up to 171.21%. Therefore DCI surgery has relatively small influence on cervical ROM and stress. The study provides a theoretical basis for DCI and fusion surgery in clinic.

Citation： WANGChenxi, ZHAOGaiping, BAILeilei, CHENNanxin, SONGYanmei, CHENEryun, ZHAOQinghua. Finite Element Analysis of Biomechanics of Cervical Spine after Dynamic Cervical Implant Surgery. Journal of Biomedical Engineering, 2016, 33(4): 645-651. doi: 10.7507/1001-5515.20160107 Copy

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2.	PHILLIPS F M, ALLEN T R, REGAN J J, et al. Cervical disc replacement in patients with and without previous adjacent level fusion surgery:a prospective study[J]. Spine, 2009, 34(6):556-565.
3.	MATSUNAGA S, KABAYAMA S, YAMAMOTO T, et al. Strain on intervertebral discs after anterior cervical decompression and fusion[J]. Spine, 1999, 24(7):670-675.
4.	MUMMANENI P V, HAID R W. The future in the care of the cervical spine:interbody fusion and arthroplasty[J]. J Neurosurg Spine, 2004, 1(2):155-159.
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6.	莫中军, 都承斐, 樊瑜波.Hybrid手术对颈椎力传导方式的影响[J].医用生物力学, 2015, 30(2):111-117, 130.
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9.	ZHU Ruofu, YANG Huilin, WANG Zhidong, et al. Comparisons of three anterior cervical surgeries in treating cervical spondylotic myelopathy[J]. BMC Musculoskelet Disord, 2014, 15(1):233.
10.	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.
11.	俞科斌, 李郝林, 陈吉勇.圆盘剪刀轴有限元分析及优化设计[J].上海理工大学学报, 2014, 36(1):39-43.
12.	苏文献, 季鹏.大型直立设备现场安装辅助设计及有限元验证[J].上海理工大学学报, 2011, 33(5):508-510.
13.	PANJABI M M, WHITE A A 3rd, JOHNSON R M. Cervical spine mechanics as a function of transection of components[J]. J Biomech, 1975, 8(5):327-336.
14.	TEO E C, NG H W. Evaluation of the role of ligaments, facets and disk nucleus in lower cervical spine under compression and sagittal moments using finite element method[J]. Med Eng Phys, 2001, 23(3):155-164.
15.	YOGANANDAN N, KUMARESAN S, VOO L, et al. Finite element model of the human lower cervical spine:parametric analysis of the C4-C6 unit[J]. J Biomed Eng, 1997, 119(1):87-92.
16.	HA S K. Finite element modeling of multi-level cervical spinal segments (C3-C6) and biomechanical analysis of an elastomer-type prosthetic disc[J]. Med Eng Phys, 2006, 28(6):534-541.
17.	PANZER M B, CRONIN D S. C4-C5 segment finite element model development, validation, and load-sharing investigation[J]. J Biomech, 2009, 42(4):480-490.
18.	DUAN Y, WANG H H, JIN A M, et al. Finite element analysis of posterior cervical fixation[J]. Orthop Traumatol Surg Res, 2015, 101(1):23-29.
19.	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.
20.	ZHANG Q H, TEO E C, NG H W, et al. Finite element analysis of moment-rotation relationships for human cervical spine[J]. J Biomech, 2006, 39(1):189-193.
21.	刘红欣, 王以进.腰椎椎间植骨融合的三维有限元分析[J].医用生物力学, 2001, 16(3):169-173.

1. HELLER J G, SASSO R C, PAPADOPOULOS S M, et al. Comparison of Bryan cervical disc arthroplasty with anterior cervical decompression and fusion:clinical and radiographic results of a randomized, controlled, clinical trial[J]. Spine, 2009, 34(2):101-107.
2. PHILLIPS F M, ALLEN T R, REGAN J J, et al. Cervical disc replacement in patients with and without previous adjacent level fusion surgery:a prospective study[J]. Spine, 2009, 34(6):556-565.
3. MATSUNAGA S, KABAYAMA S, YAMAMOTO T, et al. Strain on intervertebral discs after anterior cervical decompression and fusion[J]. Spine, 1999, 24(7):670-675.
4. MUMMANENI P V, HAID R W. The future in the care of the cervical spine:interbody fusion and arthroplasty[J]. J Neurosurg Spine, 2004, 1(2):155-159.
5. ELSAWAF A, MASTRONARDI L, ROPERTO R, et al. Effect of cervical dynamics on adjacent segment degeneration after anterior cervical fusion with cages[J]. Neurosurg Rev, 2009, 32(2):215-224; discussion 224.
6. 莫中军, 都承斐, 樊瑜波.Hybrid手术对颈椎力传导方式的影响[J].医用生物力学, 2015, 30(2):111-117, 130.
7. MATGÉ G, EIF M, HERDMANN J, et al. Dynamic cervical implant (DCITM):clinical results from an international multicenter prospective study[J]. Paradigm Spine, 2009, 1:1-3.
8. 侯振扬, 徐耀增, 顾叶, 等.颈椎动态稳定器置入非融合颈椎的生物力学分析[J].中国组织工程研究与临床康复, 2011, 15(26):4821-4824.
9. ZHU Ruofu, YANG Huilin, WANG Zhidong, et al. Comparisons of three anterior cervical surgeries in treating cervical spondylotic myelopathy[J]. BMC Musculoskelet Disord, 2014, 15(1):233.
10. 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.
11. 俞科斌, 李郝林, 陈吉勇.圆盘剪刀轴有限元分析及优化设计[J].上海理工大学学报, 2014, 36(1):39-43.
12. 苏文献, 季鹏.大型直立设备现场安装辅助设计及有限元验证[J].上海理工大学学报, 2011, 33(5):508-510.
13. PANJABI M M, WHITE A A 3rd, JOHNSON R M. Cervical spine mechanics as a function of transection of components[J]. J Biomech, 1975, 8(5):327-336.
14. TEO E C, NG H W. Evaluation of the role of ligaments, facets and disk nucleus in lower cervical spine under compression and sagittal moments using finite element method[J]. Med Eng Phys, 2001, 23(3):155-164.
15. YOGANANDAN N, KUMARESAN S, VOO L, et al. Finite element model of the human lower cervical spine:parametric analysis of the C4-C6 unit[J]. J Biomed Eng, 1997, 119(1):87-92.
16. HA S K. Finite element modeling of multi-level cervical spinal segments (C3-C6) and biomechanical analysis of an elastomer-type prosthetic disc[J]. Med Eng Phys, 2006, 28(6):534-541.
17. PANZER M B, CRONIN D S. C4-C5 segment finite element model development, validation, and load-sharing investigation[J]. J Biomech, 2009, 42(4):480-490.
18. DUAN Y, WANG H H, JIN A M, et al. Finite element analysis of posterior cervical fixation[J]. Orthop Traumatol Surg Res, 2015, 101(1):23-29.
19. 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.
20. ZHANG Q H, TEO E C, NG H W, et al. Finite element analysis of moment-rotation relationships for human cervical spine[J]. J Biomech, 2006, 39(1):189-193.
21. 刘红欣, 王以进.腰椎椎间植骨融合的三维有限元分析[J].医用生物力学, 2001, 16(3):169-173.

Journal of Biomedical Engineering

Finite Element Analysis of Biomechanics of Cervical Spine after Dynamic Cervical Implant Surgery

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