Biomechanical Study of Cervical Disc Arthroplasty Devices Using Finite Element Modeling. J Eng Sci Med Diagn Ther 2021 May 01;4(2):021004
Date
05/01/2021Pubmed ID
35832636Pubmed Central ID
PMC8597568DOI
10.1115/1.4049907Abstract
Many artificial discs for have been introduced to overcome the disadvantages of conventional anterior discectomy and fusion. The purpose of this study was to evaluate the performance of different U.S. Food and Drug Administration (FDA)-approved cervical disc arthroplasty (CDA) on the range of motion (ROM), intradiscal pressure, and facet force variables under physiological loading. A validated three-dimensional finite element model of the human intact cervical spine (C2-T1) was used. The intact spine was modified to simulate CDAs at C5-C6. Hybrid loading with a follower load of 75 N and moments under flexion, extension, and lateral bending of 2 N·m each were applied to intact and CDA spines. From this work, it was found that at the index level, all CDAs except the Bryan disc increased ROM, and at the adjacent levels, motion decreased in all modes. The largest increase occurred under the lateral bending mode. The Bryan disc had compensatory motion increases at the adjacent levels. Intradiscal pressure reduced at the adjacent levels with Mobi-C and Secure-C. Facet force increased at the index level in all CDAs, with the highest force with the Mobi-C. The force generally decreased at the adjacent levels, except for the Bryan disc and Prestige LP in lateral bending. This study demonstrates the influence of different CDA designs on the anterior and posterior loading patterns at the index and adjacent levels with head supported mass type loadings. The study validates key clinical observations: CDA procedure is contraindicated in cases of facet arthroplasty and may be protective against adjacent segment degeneration.
Author List
Yoganandan N, Purushothaman Y, Choi H, Baisden J, Rajasekaran D, Banerjee A, Jebaseelan D, Kurpad SAuthors
Anjishnu Banerjee PhD Associate Professor in the Data Science Institute department at Medical College of WisconsinNarayan Yoganandan PhD Professor in the Neurosurgery department at Medical College of Wisconsin