Biomechanical performance of the novel assembled uncovertebral joint fusion cage in single-level anterior cervical discectomy and fusion: A finite element analysis.
Biomechanical performance of the novel assembled uncovertebral joint fusion cage in single-level anterior cervical discectomy and fusion: A finite element analysis.
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DOI：
10.3389/fbioe.2023.931202
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发表时间：
2023
影响因子：
5.7
通讯作者：
中科院分区：
文献类型：
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作者：
颈椎前路椎间盘切除术和融合术（ACDF）被广泛接受为治疗颈椎神经根病和脊髓病的金标准手术方法。然而，对于使用Zero-P融合器进行ACDF手术后早期的低融合率存在担忧。我们创造性地设计了一种组合式不耦合关节融合装置，提高了融合率，解决了植入困难。本研究旨在评估单节段ACDF中装配的无椎体关节融合器的生物力学性能，并与Zero-P装置进行比较。方法：建立健康颈椎（C2−C7）三维有限元模型并进行验证。在单节段手术模型中，在模型的C5-C6节段植入组装好的无椎体关节融合器或零侧位装置。在C2处施加1.0 Nm的纯力矩和75 N的从动件载荷，以确定屈曲、伸展、侧向弯曲和轴向旋转。测量节段活动范围（ROM）、关节面接触力（FCF）、最大椎间盘内压力（IDP）和螺钉-骨应力，并与零轮廓装置进行比较。结果：两种模型融合节段的ROMs均接近于零，但未融合节段的运动不均匀增加。装配无椎关节融合器组相邻节段FCF小于Zero-P组。装配无椎关节融合器组相邻节段的IDP和螺钉-骨应力略高于Zero-P组。对笼的应力主要集中在翅膀两侧，装配的无椎关节融合笼组应力达到13.4 ~ 20.4 Mpa。结论：组装后的无椎关节融合器具有很强的固定性，类似于Zero-P装置。与Zero-P组相比，组装后的无椎关节融合器在FCF、IDP和螺钉-骨应力方面获得了相似的结果值。此外，装配的非椎体关节融合器有效地实现了早期骨形成和融合，这可能是由于两侧翼的应力分布适当。
Introduction: Anterior cervical discectomy and fusion (ACDF) is widely accepted as the gold standard surgical procedure for treating cervical radiculopathy and myelopathy. However, there is concern about the low fusion rate in the early period after ACDF surgery using the Zero-P fusion cage. We creatively designed an assembled uncoupled joint fusion device to improve the fusion rate and solve the implantation difficulties. This study aimed to assess the biomechanical performance of the assembled uncovertebral joint fusion cage in single-level ACDF and compare it with the Zero-P device. Methods: A three-dimensional finite element (FE) of a healthy cervical spine (C2−C7) was constructed and validated. In the one-level surgery model, either an assembled uncovertebral joint fusion cage or a zero-profile device was implanted at the C5–C6 segment of the model. A pure moment of 1.0 Nm combined with a follower load of 75 N was imposed at C2 to determine flexion, extension, lateral bending, and axial rotation. The segmental range of motion (ROM), facet contact force (FCF), maximum intradiscal pressure (IDP), and screw−bone stress were determined and compared with those of the zero-profile device. Results: The results showed that the ROMs of the fused levels in both models were nearly zero, while the motions of the unfused segments were unevenly increased. The FCF at adjacent segments in the assembled uncovertebral joint fusion cage group was less than that that of the Zero-P group. The IDP at the adjacent segments and screw–bone stress were slightly higher in the assembled uncovertebral joint fusion cage group than in those of the Zero-P group. Stress on the cage was mainly concentrated on both sides of the wings, reaching 13.4–20.4 Mpa in the assembled uncovertebral joint fusion cage group. Conclusion: The assembled uncovertebral joint fusion cage provided strong immobilization, similar to the Zero-P device. When compared with the Zero-P group, the assembled uncovertebral joint fusion cage achieved similar resultant values regarding FCF, IDP, and screw–bone stress. Moreover, the assembled uncovertebral joint fusion cage effectively achieved early bone formation and fusion, probably due to proper stress distributions in the wings of both sides.
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DOI：
10.1080/10255842.2010.493517
发表时间：
2011-01-01
影响因子：
1.6
作者：
Ayturk, Ugur M.;Puttlitz, Christian M.
通讯作者：
Puttlitz, Christian M.
部分非肠切除术与前宫颈椎间盘切除术和融合一起治疗一级宫颈辐射病：临床功效和矢状比对分析。
影响因子：
2.3
作者：
Abudouaini H;Wu T;Liu H;Wang B;Chen H;Huang C;Hong Y;Meng Y
通讯作者：
Meng Y
影响因子：
--
作者：
Chen, Shih-Hao;Hsiao, Chih-Kun;Wang, Chih-Wei;Chen, Hsiang-Ho;Zhong, Zheng-Cheng
通讯作者：
Zhong, Zheng-Cheng
影响因子：
4.1
作者：
Hacker, RJ
通讯作者：
Hacker, RJ
影响因子：
2.8
作者：
Galbusera, Fabio;Bellini, Chiara M.;Fornari, Maurizio
通讯作者：
Fornari, Maurizio