Biomechanical comparison of noncontiguous cervical disc arthroplasty and noncontiguous cervical discectomy and fusion in the treatment of noncontinuous cervical degenerative disc disease: a finite element analysis.
机构：[1]Department of Orthopaedics, Xuanwu Hospital Capital Medical University, Beijing 100053, China.首都医科大学宣武医院骨科[2] National Clinical Research Center for Geriatric Diseases, Beijing 100053, China. [3] Charité – Universitätsmedizin Berlin, Berlin 113353, Germany. [4] Department of Interdisciplinary Life Science, Purdue University, West Lafayette, IN 47907, USA. [5] Department of Orthopaedics, ChuiYang Liu Hospital affiliated to Tsinghua University, Beijing 100020, China.
Biomechanical characteristics of noncontinuous ACDF and noncontinuous CDA in the treatment of noncontinuous cervical degenerative disc disease were still unclear. The aim of this research is to compare the differences between these two kinds of treatment methods and to verify the effectiveness of Prodisc-C in noncontinuous CDA.
Eight FEMs of the cervical spine (C2-C7) were built based on CT images of 8 mild CDDD volunteers. In the arthroplasty group, we inserted Prodisc-C at C3/4 and C5/6. In the fusion group, CoRoent® Contour and NuVasive® Helix ACP were implanted at C3/4 and C5/6. Initial loads of 75 N were used to simulate the head weight and muscle forces. The application of 1.0 N m moment on the top on the C2 vertebra was used to create motion in all directions. Statistical analyses were performed using STATA version 14.0 (Stata Corp LP, College Station, Texas, USA). Statistical significance was set at P < 0.05.
The IDPs in C2/3 (P < 0.001, P = 0.005, P < 0.001, P < 0.001), C4/5 (P < 0.001), and C6/7 (P < 0.001) of the intact group were significantly less than that in the fusion group in flexion, extension, lateral bending, and axial rotation, respectively. In addition, the IDPs in C2/3 (P < 0.001, P = 0.001, P < 0.001, P < 0.001), C4/5 (P < 0.001), and C6/7 (P < 0.001) of the arthroplasty group were significantly less than that in the fusion group in flexion, extension, lateral bending, and axial rotation, respectively. Contact forces of facet joints in C2/3 (P = 0.010) in the arthroplasty group was significantly less than that in the intact group. Contact forces of facet joints in C2/3 (P < 0.001), C4/5 (P < 0.001), and C6/7 (P < 0.001) in the arthroplasty group was significantly less than that in the fusion group. Contact forces of facet joints in C2/3 (P < 0.001), C4/5 (P < 0.001), and C6/7 (P < 0.001) in the intact group were significantly less than that in the fusion group.
Noncontinuous CDA could preserve IDP and facet joint forces at the adjacent and intermediate levels to maintain the kinematics of cervical spine near preoperative values. However, noncontinuous ACDF would increase degenerative risks at adjacent and intermediate levels. In addition, the application of Prodisc-C in noncontinuous CAD may have more advantages than that of Prestige LP.
基金：
This study was funded by China Scholarship Council (no. 201908110337),
National Natural Science Foundation of China (no. 81672201, no. 81871794),
and Beijing Municipal Commission of Health and Family Planning (no.
PXM2017 026283 000002).
第一作者机构：[1]Department of Orthopaedics, Xuanwu Hospital Capital Medical University, Beijing 100053, China.[2] National Clinical Research Center for Geriatric Diseases, Beijing 100053, China. [3] Charité – Universitätsmedizin Berlin, Berlin 113353, Germany.
通讯作者：
通讯机构：[1]Department of Orthopaedics, Xuanwu Hospital Capital Medical University, Beijing 100053, China.[2] National Clinical Research Center for Geriatric Diseases, Beijing 100053, China. [3] Charité – Universitätsmedizin Berlin, Berlin 113353, Germany.
推荐引用方式(GB/T 7714)：
Sun Xiangyao,Sun Siyuan,Zhang Tongtong,et al.Biomechanical comparison of noncontiguous cervical disc arthroplasty and noncontiguous cervical discectomy and fusion in the treatment of noncontinuous cervical degenerative disc disease: a finite element analysis.[J].JOURNAL OF ORTHOPAEDIC SURGERY AND RESEARCH.2020,15(1):36.doi:10.1186/s13018-020-1549-3.
APA：
Sun Xiangyao,Sun Siyuan,Zhang Tongtong,Kong Chao,Wang Wei&Lu Shibao.(2020).Biomechanical comparison of noncontiguous cervical disc arthroplasty and noncontiguous cervical discectomy and fusion in the treatment of noncontinuous cervical degenerative disc disease: a finite element analysis..JOURNAL OF ORTHOPAEDIC SURGERY AND RESEARCH,15,(1)
MLA：
Sun Xiangyao,et al."Biomechanical comparison of noncontiguous cervical disc arthroplasty and noncontiguous cervical discectomy and fusion in the treatment of noncontinuous cervical degenerative disc disease: a finite element analysis.".JOURNAL OF ORTHOPAEDIC SURGERY AND RESEARCH 15..1(2020):36
