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Biomechanical Evaluation of Different Surgical Approaches for the Treatment of Adjacent Segment Diseases After Primary Anterior Cervical Discectomy and Fusion: A Finite Element Analysis

Symptomatic adjacent segment disease (ASD) is a common challenge after anterior cervical discectomy and fusion (ACDF). The objective of this study was to compare the biomechanical effects of a second ACDF and laminoplasty for the treatment of ASD after primary ACDF. We developed a finite element (FE...

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Autores principales: Ke, Wencan, Chen, Chao, Wang, Bingjin, Hua, Wenbin, Lu, Saideng, Song, Yu, Luo, Rongjin, Liao, Zhiwei, Li, Gaocai, Ma, Liang, Shi, Yunsong, Wang, Kun, Li, Shuai, Wu, Xinghuo, Zhang, Yukun, Yang, Cao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8438200/
https://www.ncbi.nlm.nih.gov/pubmed/34532313
http://dx.doi.org/10.3389/fbioe.2021.718996
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author Ke, Wencan
Chen, Chao
Wang, Bingjin
Hua, Wenbin
Lu, Saideng
Song, Yu
Luo, Rongjin
Liao, Zhiwei
Li, Gaocai
Ma, Liang
Shi, Yunsong
Wang, Kun
Li, Shuai
Wu, Xinghuo
Zhang, Yukun
Yang, Cao
author_facet Ke, Wencan
Chen, Chao
Wang, Bingjin
Hua, Wenbin
Lu, Saideng
Song, Yu
Luo, Rongjin
Liao, Zhiwei
Li, Gaocai
Ma, Liang
Shi, Yunsong
Wang, Kun
Li, Shuai
Wu, Xinghuo
Zhang, Yukun
Yang, Cao
author_sort Ke, Wencan
collection PubMed
description Symptomatic adjacent segment disease (ASD) is a common challenge after anterior cervical discectomy and fusion (ACDF). The objective of this study was to compare the biomechanical effects of a second ACDF and laminoplasty for the treatment of ASD after primary ACDF. We developed a finite element (FE) model of the C2-T1 based on computed tomography images. The FE models of revision surgeries of ACDF and laminoplasty were simulated to treat one-level and two-level ASD after primary ACDF. The range of motion (ROM) and intradiscal pressure (IDP) of the adjacent segments, and stress in the cord were analyzed to investigate the biomechanical effects of the second ACDF and laminoplasty. The results indicated that revision surgery of one-level ACDF increased the ROM and IDP at the C2–C3 segment, whereas two-level ACDF significantly increased the ROM and IDP at the C2–C3 and C7-T1 segments. Furthermore, no significant changes in the ROM and IDP of the laminoplasty models were observed. The stress in the cord of the re-laminoplasty model decreased to some extent, which was higher than that of the re-ACDF model. In conclusion, both ACDF and laminoplasty can relieve the high level of stress in the spinal cord caused by ASD after primary ACDF, whereas ACDF can achieve better decompression effect. Revision surgery of the superior ACDF or the superior and inferior ACDF after the primary ACDF increased the ROM and IDP at the adjacent segments, which may be the reason for the high incidence of recurrent ASD after second ACDF.
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spelling pubmed-84382002021-09-15 Biomechanical Evaluation of Different Surgical Approaches for the Treatment of Adjacent Segment Diseases After Primary Anterior Cervical Discectomy and Fusion: A Finite Element Analysis Ke, Wencan Chen, Chao Wang, Bingjin Hua, Wenbin Lu, Saideng Song, Yu Luo, Rongjin Liao, Zhiwei Li, Gaocai Ma, Liang Shi, Yunsong Wang, Kun Li, Shuai Wu, Xinghuo Zhang, Yukun Yang, Cao Front Bioeng Biotechnol Bioengineering and Biotechnology Symptomatic adjacent segment disease (ASD) is a common challenge after anterior cervical discectomy and fusion (ACDF). The objective of this study was to compare the biomechanical effects of a second ACDF and laminoplasty for the treatment of ASD after primary ACDF. We developed a finite element (FE) model of the C2-T1 based on computed tomography images. The FE models of revision surgeries of ACDF and laminoplasty were simulated to treat one-level and two-level ASD after primary ACDF. The range of motion (ROM) and intradiscal pressure (IDP) of the adjacent segments, and stress in the cord were analyzed to investigate the biomechanical effects of the second ACDF and laminoplasty. The results indicated that revision surgery of one-level ACDF increased the ROM and IDP at the C2–C3 segment, whereas two-level ACDF significantly increased the ROM and IDP at the C2–C3 and C7-T1 segments. Furthermore, no significant changes in the ROM and IDP of the laminoplasty models were observed. The stress in the cord of the re-laminoplasty model decreased to some extent, which was higher than that of the re-ACDF model. In conclusion, both ACDF and laminoplasty can relieve the high level of stress in the spinal cord caused by ASD after primary ACDF, whereas ACDF can achieve better decompression effect. Revision surgery of the superior ACDF or the superior and inferior ACDF after the primary ACDF increased the ROM and IDP at the adjacent segments, which may be the reason for the high incidence of recurrent ASD after second ACDF. Frontiers Media S.A. 2021-08-31 /pmc/articles/PMC8438200/ /pubmed/34532313 http://dx.doi.org/10.3389/fbioe.2021.718996 Text en Copyright © 2021 Ke, Chen, Wang, Hua, Lu, Song, Luo, Liao, Li, Ma, Shi, Wang, Li, Wu, Zhang and Yang. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Bioengineering and Biotechnology
Ke, Wencan
Chen, Chao
Wang, Bingjin
Hua, Wenbin
Lu, Saideng
Song, Yu
Luo, Rongjin
Liao, Zhiwei
Li, Gaocai
Ma, Liang
Shi, Yunsong
Wang, Kun
Li, Shuai
Wu, Xinghuo
Zhang, Yukun
Yang, Cao
Biomechanical Evaluation of Different Surgical Approaches for the Treatment of Adjacent Segment Diseases After Primary Anterior Cervical Discectomy and Fusion: A Finite Element Analysis
title Biomechanical Evaluation of Different Surgical Approaches for the Treatment of Adjacent Segment Diseases After Primary Anterior Cervical Discectomy and Fusion: A Finite Element Analysis
title_full Biomechanical Evaluation of Different Surgical Approaches for the Treatment of Adjacent Segment Diseases After Primary Anterior Cervical Discectomy and Fusion: A Finite Element Analysis
title_fullStr Biomechanical Evaluation of Different Surgical Approaches for the Treatment of Adjacent Segment Diseases After Primary Anterior Cervical Discectomy and Fusion: A Finite Element Analysis
title_full_unstemmed Biomechanical Evaluation of Different Surgical Approaches for the Treatment of Adjacent Segment Diseases After Primary Anterior Cervical Discectomy and Fusion: A Finite Element Analysis
title_short Biomechanical Evaluation of Different Surgical Approaches for the Treatment of Adjacent Segment Diseases After Primary Anterior Cervical Discectomy and Fusion: A Finite Element Analysis
title_sort biomechanical evaluation of different surgical approaches for the treatment of adjacent segment diseases after primary anterior cervical discectomy and fusion: a finite element analysis
topic Bioengineering and Biotechnology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8438200/
https://www.ncbi.nlm.nih.gov/pubmed/34532313
http://dx.doi.org/10.3389/fbioe.2021.718996
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