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The Role of Posterior Longitudinal Ligament in Cervical Disc Replacement: An Ovine Cadaveric Biomechanical Analysis

BACKGROUND: Cervical disc replacement (CDR) has been widely used to restore and maintain mobility and function of the treated and adjacent motion segments. Posterior longitudinal ligament (PLL) resection has been shown to be efficient in anterior cervical decompression and fusion. However, less is k...

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Autores principales: Yu, Cheng-Cheng, Hao, Ding-Jun, Ma, Yu-Li, Huang, Da-Geng, Li, Hou-Kun, Feng, Hang, Hou, Qian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Scientific Literature, Inc. 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4920594/
https://www.ncbi.nlm.nih.gov/pubmed/27243444
http://dx.doi.org/10.12659/MSM.899138
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author Yu, Cheng-Cheng
Hao, Ding-Jun
Ma, Yu-Li
Huang, Da-Geng
Li, Hou-Kun
Feng, Hang
Hou, Qian
author_facet Yu, Cheng-Cheng
Hao, Ding-Jun
Ma, Yu-Li
Huang, Da-Geng
Li, Hou-Kun
Feng, Hang
Hou, Qian
author_sort Yu, Cheng-Cheng
collection PubMed
description BACKGROUND: Cervical disc replacement (CDR) has been widely used to restore and maintain mobility and function of the treated and adjacent motion segments. Posterior longitudinal ligament (PLL) resection has been shown to be efficient in anterior cervical decompression and fusion. However, less is known about the biomechanical effect of PLL removal versus preservation in cervical disc arthroplasty. MATERIAL/METHODS: Three motion segments of 24 ovine cervical spines (C2–C5) were evaluated in a robotic spine system with axial compressive loads of 50 N. These cervical spines were divided in three groups according to the following conditions: (1) intact spine, (2) C3/C4 CDR with the Prestige LP prosthesis and PLL preservation, and (3) C3/C4 CDR with the Prestige LP prosthesis and PLL removal. The ranges of motion (ROMs) were recorded and analyzed in each group. RESULTS: The C3/C4 ROM in group 3 (CDR with PLL removed) increased significantly in flexion-extension and axial rotation compared with group 1 (intact spine). Moreover, in flexion-extension, the mean total ROM was significantly larger in group 3 than in group 1. All the ROM observed in group 2 (CDR with PLL preserved) did not significantly differ from the ROM observed in group 1. CONCLUSIONS: Compared with intact spines, CDR with PLL removal partly increased ROM. Moreover, the ROM in CDR with PLL preservation did not significantly differ from the ROM observed in intact spines. The PLL appears to contribute to the balance and stability of the cervical spine and should thus be preserved in cervical disc replacement provided that the posterior longitudinal ligament is not degenerative and the compression can be removed without PLL takedown.
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spelling pubmed-49205942016-07-15 The Role of Posterior Longitudinal Ligament in Cervical Disc Replacement: An Ovine Cadaveric Biomechanical Analysis Yu, Cheng-Cheng Hao, Ding-Jun Ma, Yu-Li Huang, Da-Geng Li, Hou-Kun Feng, Hang Hou, Qian Med Sci Monit Animal Study BACKGROUND: Cervical disc replacement (CDR) has been widely used to restore and maintain mobility and function of the treated and adjacent motion segments. Posterior longitudinal ligament (PLL) resection has been shown to be efficient in anterior cervical decompression and fusion. However, less is known about the biomechanical effect of PLL removal versus preservation in cervical disc arthroplasty. MATERIAL/METHODS: Three motion segments of 24 ovine cervical spines (C2–C5) were evaluated in a robotic spine system with axial compressive loads of 50 N. These cervical spines were divided in three groups according to the following conditions: (1) intact spine, (2) C3/C4 CDR with the Prestige LP prosthesis and PLL preservation, and (3) C3/C4 CDR with the Prestige LP prosthesis and PLL removal. The ranges of motion (ROMs) were recorded and analyzed in each group. RESULTS: The C3/C4 ROM in group 3 (CDR with PLL removed) increased significantly in flexion-extension and axial rotation compared with group 1 (intact spine). Moreover, in flexion-extension, the mean total ROM was significantly larger in group 3 than in group 1. All the ROM observed in group 2 (CDR with PLL preserved) did not significantly differ from the ROM observed in group 1. CONCLUSIONS: Compared with intact spines, CDR with PLL removal partly increased ROM. Moreover, the ROM in CDR with PLL preservation did not significantly differ from the ROM observed in intact spines. The PLL appears to contribute to the balance and stability of the cervical spine and should thus be preserved in cervical disc replacement provided that the posterior longitudinal ligament is not degenerative and the compression can be removed without PLL takedown. International Scientific Literature, Inc. 2016-05-31 /pmc/articles/PMC4920594/ /pubmed/27243444 http://dx.doi.org/10.12659/MSM.899138 Text en © Med Sci Monit, 2016 This work is licensed under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)
spellingShingle Animal Study
Yu, Cheng-Cheng
Hao, Ding-Jun
Ma, Yu-Li
Huang, Da-Geng
Li, Hou-Kun
Feng, Hang
Hou, Qian
The Role of Posterior Longitudinal Ligament in Cervical Disc Replacement: An Ovine Cadaveric Biomechanical Analysis
title The Role of Posterior Longitudinal Ligament in Cervical Disc Replacement: An Ovine Cadaveric Biomechanical Analysis
title_full The Role of Posterior Longitudinal Ligament in Cervical Disc Replacement: An Ovine Cadaveric Biomechanical Analysis
title_fullStr The Role of Posterior Longitudinal Ligament in Cervical Disc Replacement: An Ovine Cadaveric Biomechanical Analysis
title_full_unstemmed The Role of Posterior Longitudinal Ligament in Cervical Disc Replacement: An Ovine Cadaveric Biomechanical Analysis
title_short The Role of Posterior Longitudinal Ligament in Cervical Disc Replacement: An Ovine Cadaveric Biomechanical Analysis
title_sort role of posterior longitudinal ligament in cervical disc replacement: an ovine cadaveric biomechanical analysis
topic Animal Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4920594/
https://www.ncbi.nlm.nih.gov/pubmed/27243444
http://dx.doi.org/10.12659/MSM.899138
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