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Biomechanical effects of uncinate process excision in cervical disc arthroplasty. Clin Biomech (Bristol, Avon) 2021 Oct;89:105451

Date

08/30/2021

Pubmed ID

34455338

DOI

10.1016/j.clinbiomech.2021.105451

Scopus ID

2-s2.0-85113584409 (requires institutional sign-in at Scopus site)   5 Citations

Abstract

BACKGROUND: Studies on the role of uncinate process have been limited to responses of the intact spine and patient's outcomes, and procedures to perform the excision. The aim of this study was to determine the role of uncinate process on the biomechanical response at the index and adjacent levels in three artificial discs used in cervical disc arthroplasty.

METHODS: A validated finite element model of cervical spine was used. Flexion, extension, and lateral moments and follower load were applied to Bryan, Mobi-C, and Prestige LP artificial discs at C5-C6 level with and without uncinate process. Ranges of motion at index level and adjacent caudal and cranial segments, intradiscal pressures at adjacent segments, and facet loads at index level and adjacent segments were obtained. Data were normalized with respect to the preservation of uncinate process.

FINDINGS: Uncinate process removal increased motions up to 27% at index and decreased up to 10% at adjacent levels, decreased disc pressures up to 14% at adjacent segments, decreased facet loads at adjacent segments up to 14%, while at index level, change in loads depended on mode and arthroplasty, with Mobi-C responding with up to 51% increase and Bryan disc up to 11% decrease, while Prestige LP increased loads by 17% in extension and decreased by 9%% in lateral bending.

INTERPRETATION: As surgical selection is based on morphology and surgeon's experience, the present computational findings provide quantitative information for an optimal choice of the device and procedure, while further studies (in vitro/clinical) would be required.

Author List

Yoganandan N, Purushothaman Y, Choi H, Jebaseelan D, Baisden J

Author

Narayan Yoganandan PhD Professor in the Neurosurgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Arthroplasty
Biomechanical Phenomena
Cervical Vertebrae
Finite Element Analysis
Humans
Intervertebral Disc
Range of Motion, Articular
Spinal Fusion