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Title: Biomechanical effects of cervical arthroplasty with U-shaped disc implant on segmental range of motion and loading of surrounding soft tissue
Authors: Mo, ZJ
Zhao, YB
Wang, LZ
Sun, Y
Zhang, M 
Fan, YB
Keywords: Cervical disc arthroplasty
U-shaped implant
Finite element method
Range of motion
Intradiscal pressure
Ligament strain
Issue Date: 2014
Publisher: Springer
Source: European spine journal, 2014, v. 23, no. 3, p. 613-621 How to cite?
Journal: European spine journal 
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.
ISSN: 0940-6719
EISSN: 1432-0932
DOI: 10.1007/s00586-013-3070-4
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