Influence of cervical spine sagittal alignment on range of motion after corpectomy: a finite element study. Acta Neurochir (Wien) 2021 Jan;163(1):251-257
Date
10/24/2020Pubmed ID
33095354DOI
10.1007/s00701-020-04619-9Scopus ID
2-s2.0-85093931069 (requires institutional sign-in at Scopus site) 6 CitationsAbstract
BACKGROUND: Sagittal alignment of the cervical spine might influence the development of radiological adjacent segment pathology (RASP) after central corpectomy (CC). Range of motion (ROM) of the adjacent segments is closely linked to the development of RASP.
METHODS: To investigate the ROM of the adjacent segments after CC, we developed a C2-T1 finite element (FE) model. The model with a lordotic sagittal alignment served as the baseline model. Models with straight and kyphotic alignment were generated using mesh morphing methods. Single-level corpectomy at C5 was done on these models. Segmental ROMs of intact and corpectomized spines were compared for physiologic flexion-extension loads.
RESULTS: The flexion ROM decreased by an average of 13% with the change in sagittal alignment from lordosis to kyphosis; however, a consistent decrease was not observed in extension. After CC, the ROM increased by an average of 95% and 31% in the superior and inferior adjacent segments. With kyphotic change in the sagittal alignment, the postoperative increase in flexion ROM exhibited a decreasing trend, while this was not seen in extension.
CONCLUSIONS: Kyphotic changes of the intact spine resulted in segmental stiffening, and after corpectomy, it resulted in inconsistent variations of segmental extension ROMs.
Author List
John JD, Kumar GS, Yoganandan N, Rajshekhar VAuthor
Narayan Yoganandan PhD Professor in the Neurosurgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultCervical Vertebrae
Female
Finite Element Analysis
Humans
Kyphosis
Lordosis
Male
Postoperative Complications
Radiography
Range of Motion, Articular
