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Finite element model predicts the biomechanical performance of cervical disc replacement and fusion hybrid surgery with various geometry of ball-and-socket artificial disc

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Abstract

Purpose

Few finite element studies have investigated changes in cervical biomechanics with various prosthesis design parameters using hybrid surgery (HS), and none have investigated those combined different HS strategies. The aim of our study was to investigate the effect of ball-and-socket prosthesis geometry on the biomechanical performance of the cervical spine combined with two HS constructs.

Methods

Two HS strategies were conducted: (1) ACDF at C4–C5 and anterior cervical disc replacement (ACDR) at C5–C6 (ACDF/ACDR), and (2) ACDR/ACDF. Three different prostheses were used for each HS strategy: prosthesis with the core located at the center of the inferior endplate with a radius of 5 mm (BS-5) or 6 mm (BS-6), or with a 5 mm radius core located 1 mm posterior to the center of the inferior endplate (PBS-5). Flexion and extension motions were simulated under displacement control.

Results

The flexion motions in supra- and infra-adjacent levels increased in all cases. The corresponding extension motions increased with all prostheses in ACDR/ACDF group. The stiffness in flexion and extension increased with all HS models, except for the extension stiffness with ACDF/ACDR. The facet stresses between the index and infra-adjacent level in ACDR/ACDF were significantly greater than those in the intact model . The stresses on the BS-5 UHMWPE core were greater than the yield stress.

Conclusion

The core radii and position did not significantly affect the moments, ROM, and facet stress in extension. However, the moments and ROM in flexion were easily affected by the position. The results implied that the large core radii and posterior core position in ACDR designs may reduce the risk of subsidence and wear in the long term as they showed relative low stress . The ACDF/ACDR surgery at C4–C6 level may be an optimal treatment for avoiding accelerating the degeneration of adjacent segments.

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Acknowledgements

This work was supported by the Industry Public Technology Service Platform Capital Projects of Shenzhen [Grant Number SMJKPT20140417010001] and the Science and Technology Plan Basic Research Project of Shenzhen [Grant Number JCYJ20151030160526024]. The participant was explained on the research purpose and signed the consent form.

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Authors and Affiliations

  1. State Key Laboratory of Tribology, Tsinghua University, Beijing, 100084, China

    Yang Li & Weiqiang Liu

  2. Department of Mechanical Engineering, Tsinghua University, Beijing, 100084, China

    Yang Li

  3. Spine Pain Begone Clinic, San Antonio, TX, USA

    Guy R. Fogel

  4. Biomechanics and Biotechnology Lab, Research Institute of Tsinghua University in Shenzhen, Shenzhen, 518057, People’s Republic of China

    Zhenhua Liao & Weiqiang Liu

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  1. Yang Li
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  2. Guy R. Fogel
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Correspondence to Weiqiang Liu.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Li, Y., Fogel, G.R., Liao, Z. et al. Finite element model predicts the biomechanical performance of cervical disc replacement and fusion hybrid surgery with various geometry of ball-and-socket artificial disc. Int J CARS 12, 1399–1409 (2017). https://doi.org/10.1007/s11548-017-1616-3

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  • DOI: https://doi.org/10.1007/s11548-017-1616-3

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