Biomechanical Effect of Different Graft Heights on Adjacent Segment and Graft Segment Following C4/C5 Anterior Cervical Discectomy and Fusion: A Finite Element Analysis
Biomechanical Effect of Different Graft Heights on Adjacent Segment and Graft Segment Following C4/C5 Anterior Cervical Discectomy and Fusion: A Finite Element Analysis
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C4/C5颈椎前路椎间盘切除融合术后不同移植物高度对相邻节段和移植物节段的生物力学影响：有限元分析
DOI：
10.12659/msm.916629
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发表时间：
2019-06-04
影响因子：
3.1
通讯作者：
Xue, Yuan
中科院分区：
文献类型：
--
作者：
Zhang, Yuhua;Zhou, Jiaming;Xue, Yuan
背景采用有限元分析（FEA）探讨C4/5颈椎前路椎间盘切除术融合术（ACDF）后不同植骨高度对相邻节段及植骨节段应力的影响。材料/方法通过计算机断层扫描（CT）成功建立了一个详细的、几何精确的健康成年男性颈椎三维模型。我们将C4-C5的植骨高度分别改变为术前椎间盘高度的90%、150%、175%和200%，并分别模拟不同植骨高度的术后情况。对邻段和接枝段进行应力分析。结果C3-C4在接枝高度为200%时的最大von Mises应力分别为0.99 MPa、0.85 MPa、0.91 MPa和0.89 MPa。当接枝高度为175%时，C5-C6的最大von Mises应力分别为0.77 MPa、0.83 MPa、0.91 MPa和0.81 MPa。在接枝高度为200%时，接枝段（c4 ~ c5）最大的von Mises应力分别为1.25 MPa、1.77 MPa、1.75 MPa和1.81 MPa。在4种加载条件下，在接枝高度为150%时，这3段的von Mises应力最小。结论颈椎前路椎间盘切除术融合后，植骨高度对相邻节段和植骨节段的应力有重要影响。在C4/C5 ACDF中，150%的接枝高度被认为是合适的接枝高度，相邻节段和接枝节段受到的应力最小。
Background The finite element analysis (FEA) was used to explore the effect of different graft heights on adjacent segment and graft segment stress after C4/5 anterior cervical discectomy and fusion (ACDF). Material/Methods A detailed, geometrically accurate 3-dimensional cervical spine model was successfully built from computed tomography (CT) scanning of a healthy adult male. We changed the graft height in C4–C5 to be 90%, 150%, 175%, and 200% of the preoperative disc height and simulated the postoperative scenarios with different bone graft height, respectively. A stress analysis was conducted on the adjacent segment and graft segment. Results The maximum von Mises stress on C3–C4 showed that when the graft height was 200%, the values were 0.99 MPa, 0.85 MPa, 0.91 MPa, and 0.89 MPa in different loading conditions. For C5–C6, the maximum von Mises stress was 0.77 MPa, 0.83 MPa, 0.91 MPa, and 0.81 MPa, observed when the graft height was 175%, except in extension condition. With regard to graft segment (C4–C5), the biggest von Mises stress was 1.25 MPa, 1.77 MPa, 1.75 MPa, and 1.81 MPa observed at 200% graft height. For these 3 segments, the smallest von Mises stress was found at 150% graft height under the 4 loading conditions. Conclusions The graft height makes an important difference on the stress on the adjacent segment and the graft segment after anterior cervical discectomy and fusion. A 150% graft height was considered the proper graft height in C4/C5 ACDF, with the lowest stress on the adjacent segment and the graft segment.