Citation

White NA, Moreno DP, Brown PJ, Gayzik FS, Hsu W, Powers A, Stitzel JD. Spine J. 2014; 14(9): 2195-2207.

Affiliation

Virginia Tech-Wake Forest University Center for Injury Biomechanics, Winston-Salem, NC, 27157, USA. Electronic address: jdstitzel@gmail.com.

Copyright

(Copyright © 2014, Elsevier Publishing)

DOI

10.1016/j.spinee.2014.03.001

PMID

24614252

Abstract

BACKGROUND CONTEXT: While arthrodesis is the most common surgical intervention for treatment of symptomatic cervical degenerative disc disease (CDDD), arthroplasty has become increasingly more popular over the past decade. While literature exists comparing the effects of anterior cervical discectomy and fusion (ACDF) and cervical total disc replacement (CTDR) on neck kinematics and loading, the vast majority of these studies apply only quasi-static, non-injurious loading conditions to a segment of the cervical spine. PURPOSE: The objective of this study was to investigate the effects of arthrodesis and arthroplasty on biomechanical neck response during a simulated frontal automobile collision with airbag deployment. STUDY DESIGN: This study used a full-body, 50th percentile seated male finite element (FE) model to evaluate neck response during a dynamic impact event. The cervical spine was modified to simulate either an arthrodesis or arthroplasty procedure at C5-6. METHODS: Five simulations of a belted driver, subjected to a 13.3 m/s ΔV frontal impact with airbag deployment, were run in LS-DYNA with the Global Human Body Models Consortium (GHBMC) full-body FE model. The first simulation used the original model, with no modifications to the neck, while the remaining four were modified to represent either interbody arthrodesis or arthroplasty of C5-6. Cross-sectional forces and moments at the C5 and C6 cervical level of the neck, along with interbody and facet forces between C5 and C6, were reported. This study was funded by the United States Army Medical Research and Materiel Command. It was supported through a $1,514,365.00 grant and a $5,899.00 donation in product. The authors have no potential conflicts of interest to report. RESULTS: Adjacent-level, cross-sectional neck loading was maintained in all simulations without exceeding any established injury thresholds. Interbody compression was greatest for the CTDRs, and interbody tension occurred only in the fused and non-modified spines. Some interbody separation occurred between the superior and inferior components of the CTDRs during flexion-induced tension of the cervical spine, increasing the facet loads. CONCLUSIONS: This study evaluated the effects of C5-6 cervical arthrodesis and arthroplasty on neck response during a simulated frontal automobile impact. While cervical arthrodesis and arthroplasty at C5-6 did not appear to significantly alter the adjacent-level, cross-sectional neck responses during a simulated frontal automobile impact, key differences were noted in the interbody and facet loading.

Language: en