Total disc arthroplasties alter the characteristics of the instantaneous helical axis of the cervical functional spinal units C3/C4 and C5/C6 during flexion and extension in in vitro conditions
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Total disc arthroplasties alter the characteristics of the instantaneous helical axis of the cervical functional spinal units C3/C4 and C5/C6 during flexion and extension in in vitro conditions. / Roch, Paul Jonathan; Wagner, Markus; Weiland, Jan; Spiering, Stefan; Lehmann, Wolfgang; Saul, Dominik; Weiser, Lukas; Viezens, Lennart; Wachowski, Martin Michael.
in: J BIOMECH, Jahrgang 100, Nr. 13, 109608, 13.02.2020.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Total disc arthroplasties alter the characteristics of the instantaneous helical axis of the cervical functional spinal units C3/C4 and C5/C6 during flexion and extension in in vitro conditions
AU - Roch, Paul Jonathan
AU - Wagner, Markus
AU - Weiland, Jan
AU - Spiering, Stefan
AU - Lehmann, Wolfgang
AU - Saul, Dominik
AU - Weiser, Lukas
AU - Viezens, Lennart
AU - Wachowski, Martin Michael
N1 - Copyright © 2020 Elsevier Ltd. All rights reserved.
PY - 2020/2/13
Y1 - 2020/2/13
N2 - Total disc arthroplasty (TDA) increases the risk of adjacent segment disease (ASD). Kinematic analyses are necessary to compare the intact condition (IC) with alterations after TDA to develop better prostheses. A well-established 6D measuring apparatus (resolution < 2.4 μm; 400 positions/cycle) was used. Kinematics of the flexion and extension of 8 human cervical spine segments (cFSU) C3/C4 and C5/C6 (67.9 ± 13.2 y) were analyzed in the IC and after TDA (Bryan® Cervical Disc [B-TDA], Prestige LP® Cervical Disc [P-TDA]). The migration of the instantaneous helical axis (IHA) and the stiffness of the segments were calculated. Analyses demonstrated a stretched U-curved IHA migration in the sagittal plane. The IHA positions were significantly more cranial in cFSU C5/C6 than in C3/C4 in IC and after either TDA (IC: p < 0.001; B-TDA: p = 0.001; P-TDA: p = 0.045). In cFSU C3/C4 IHA positions shifted anteriocranially after either TDA (p < 0.001). In cFSU C5/C6, the IHA positions were significantly more anterocranial after B-TDA than in IC and after P-TDA (anterior: p < 0.001; cranial: p = 0.005). After B-TDA, the IHA migration path length was significantly longer in cFSU C3/C4 than in C5/C6 (p = 0.007) and longer than in IC in both cFSU (C3/C4: p = 0.047; C5/C6: p < 0.001). Stiffness was increased after both TDA. Various kinematic alterations were observed after both TDA. Increased translation and IHA position shifting after both TDA might indicate abnormal strain and a derogated benefit of TDA. These results imply the most abnormal strain after B-TDA. The lower cFSU might be more susceptible to alterations after TDA than the upper cFSU.
AB - Total disc arthroplasty (TDA) increases the risk of adjacent segment disease (ASD). Kinematic analyses are necessary to compare the intact condition (IC) with alterations after TDA to develop better prostheses. A well-established 6D measuring apparatus (resolution < 2.4 μm; 400 positions/cycle) was used. Kinematics of the flexion and extension of 8 human cervical spine segments (cFSU) C3/C4 and C5/C6 (67.9 ± 13.2 y) were analyzed in the IC and after TDA (Bryan® Cervical Disc [B-TDA], Prestige LP® Cervical Disc [P-TDA]). The migration of the instantaneous helical axis (IHA) and the stiffness of the segments were calculated. Analyses demonstrated a stretched U-curved IHA migration in the sagittal plane. The IHA positions were significantly more cranial in cFSU C5/C6 than in C3/C4 in IC and after either TDA (IC: p < 0.001; B-TDA: p = 0.001; P-TDA: p = 0.045). In cFSU C3/C4 IHA positions shifted anteriocranially after either TDA (p < 0.001). In cFSU C5/C6, the IHA positions were significantly more anterocranial after B-TDA than in IC and after P-TDA (anterior: p < 0.001; cranial: p = 0.005). After B-TDA, the IHA migration path length was significantly longer in cFSU C3/C4 than in C5/C6 (p = 0.007) and longer than in IC in both cFSU (C3/C4: p = 0.047; C5/C6: p < 0.001). Stiffness was increased after both TDA. Various kinematic alterations were observed after both TDA. Increased translation and IHA position shifting after both TDA might indicate abnormal strain and a derogated benefit of TDA. These results imply the most abnormal strain after B-TDA. The lower cFSU might be more susceptible to alterations after TDA than the upper cFSU.
KW - Biomechanical Phenomena
KW - Cervical Vertebrae/physiology
KW - Female
KW - Humans
KW - Male
KW - Mechanical Phenomena
KW - Prostheses and Implants
KW - Total Disc Replacement
U2 - 10.1016/j.jbiomech.2020.109608
DO - 10.1016/j.jbiomech.2020.109608
M3 - SCORING: Journal article
C2 - 31926589
VL - 100
JO - J BIOMECH
JF - J BIOMECH
SN - 0021-9290
IS - 13
M1 - 109608
ER -