Adjacent Segment Mechanics in Cervical Arthrodesis Patients

颈椎融合术患者的邻近节段力学

基本信息

项目摘要

 DESCRIPTION (provided by applicant): Anterior cervical discectomy and fusion (ACDF) is the most common surgical procedure to treat degenerative cervical spine disease in the United States. Unfortunately, ACDF does not prevent degeneration of motion segments adjacent to the initial surgery (i.e. adjacent segment disease), and approximately 25% of the patients require reoperation within 10 years of the initial surgery. This study aims to identify factors that may increase the risk for adjacent segment degeneration. This research may help decrease healthcare spending by reducing reoperations and improve patient safety and quality of life. Abstract: The etiology of adjacent segment pathology following cervical fusion remains highly controversial. Adjacent segment disease is believed to result from one or more of the following distinct causes: 1) the natural history of the adjacent disc; 2) disruption of the adjacent segment anatomy due to the initial surgery; and 3) biomechanical stress on the adjacent level following the fusion. The long-term goal of our research is to reduce or prevent symptomatic adjacent segment degeneration in the spine. The overall hypothesis of this study is that adjacent segment kinematics (i.e. translations, rotations, helical axis of motion) and arthrokinematics (i.e disc deformation and facet joint surface interactions) after ACDF are determined primarily by patient-specific anatomy and iatrogenic factors, and not by increased biomechanical stress due to the fusion. A prospective longitudinal study is proposed to determine to what extent patient-specific factors (Specific Aim 1), iatrogenic factors (Specific Aim 2), and altered biomechanics (Specific Aim 3) affect dynamic cervical spine function following fusion. Participants will be C56 (n=22) and C67 (n=22) single-level fusion patients, C456 (n=22) and C567 (n=22) two-level fusion patients, and asymptomatic controls similar in age to the fusion patients (n=22). Patients will be tested prior to surgery, one year post-surgery, and three years post-surgery. At each test, participants will complete clinical questionnaires to assess pain and function, and they will perform full range of motion flexion\extension and axial rotation of the head and cervical spine while biplane radiographs are recorded at 30 images per second. A highly accurate and validated volumetric model- based tracking process and custom data analysis software will be utilized to determine intervertebral kinematics (i.e. translations, rotations, helical axis of motin) and arthrokinematics (i.e. disc deformation and facet joint surface interactions) at each test session. This prospective study will identify the factors that have the greatest effect on adjacent segment mechanics after cervical fusion. If the hypotheses are confirmed, this will provide support for increased attention to patient-specific factors and surgical technique. Alternatively, f the results indicate that adjacent segment mechanics are influenced primarily by increased stress after arthrodesis, this will provide support for increased attention to the design of motion sparing devices.


项目成果

期刊论文数量(5)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
Surgery-related Factors Do Not Affect Short-term Adjacent Segment Kinematics After Anterior Cervical Arthrodesis.
  • DOI:
    10.1097/brs.0000000000004080
  • 发表时间:
    2021-12-01
  • 期刊:
  • 影响因子:
    3
  • 作者:
    Chen SR;LeVasseur CM;Pitcairn S;Kanter AS;Okonkwo DO;Shaw JD;Donaldson WF;Lee JY;Anderst WJ
  • 通讯作者:
    Anderst WJ
The effects of pathology and one-level versus two-level arthrodesis on cervical spine intervertebral helical axis of motion.
  • DOI:
    10.1016/j.jbiomech.2022.110960
  • 发表时间:
    2022-01
  • 期刊:
  • 影响因子:
    2.4
  • 作者:
    Clarissa M. LeVasseur;Samuel W. Pitcairn;Jeremy D. Shaw;W. Donaldson;J. Lee;W. Anderst
  • 通讯作者:
    Clarissa M. LeVasseur;Samuel W. Pitcairn;Jeremy D. Shaw;W. Donaldson;J. Lee;W. Anderst
In Vivo Evidence of Early Instability and Late Stabilization in Motion Segments Immediately Superior to Anterior Cervical Arthrodesis.
  • DOI:
    10.1097/brs.0000000000004388
  • 发表时间:
    2022-09-01
  • 期刊:
  • 影响因子:
    3
  • 作者:
  • 通讯作者:
Dynamic functional nucleus is a potential biomarker for structural degeneration in cervical spine discs.
动态功能核是颈椎间盘结构退化的潜在生物标志物。
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William J. Anderst其他文献

Surgical Parameters During Reverse Shoulder Arthroplasty Predict Post-Surgical Kinematics During the Hand-to-Head Motion
  • DOI:
    10.1007/s10439-024-03621-x
  • 发表时间:
    2024-09-19
  • 期刊:
  • 影响因子:
    5.400
  • 作者:
    Ajinkya A. Rai;Clarissa M. LeVasseur;Gillian E. Kane;Maria A. Munsch;Christopher J. Como;Alexandra S. Gabrielli;Jonathan D. Hughes;William J. Anderst;Albert Lin
  • 通讯作者:
    Albert Lin

William J. Anderst的其他文献

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{{ truncateString('William J. Anderst', 18)}}的其他基金

Characterizing dynamic thumb metacarpal subsidence during functional tasks after trapeziectomy
梯形切除术后功能任务期间动态拇指掌骨下沉的特征
  • 批准号:
    10510638
  • 财政年份:
    2022
  • 资助金额:
    $ 38.46万
  • 项目类别:
Characterizing dynamic thumb metacarpal subsidence during functional tasks after trapeziectomy
梯形切除术后功能任务期间动态拇指掌骨下沉的特征
  • 批准号:
    10676865
  • 财政年份:
    2022
  • 资助金额:
    $ 38.46万
  • 项目类别:
The Dynamic Glenoid Track: An Updated Model of Glenohumeral Cartilage Contact During In Vivo Movement
动态关节盂轨迹:体内运动期间盂肱软骨接触的更新模型
  • 批准号:
    10375039
  • 财政年份:
    2021
  • 资助金额:
    $ 38.46万
  • 项目类别:
Effects of prosthesis design and placement on shoulder kinematics and strength after reverse shoulder arthroplasty
假体设计和放置对反向肩关节置换术后肩部运动学和力量的影响
  • 批准号:
    9808192
  • 财政年份:
    2019
  • 资助金额:
    $ 38.46万
  • 项目类别:
Effects of prosthesis design and placement on shoulder kinematics and strength after reverse shoulder arthroplasty
假体设计和放置对反向肩关节置换术后肩部运动学和力量的影响
  • 批准号:
    9981607
  • 财政年份:
    2019
  • 资助金额:
    $ 38.46万
  • 项目类别:
Adjacent Segment Mechanics in Cervical Arthrodesis Patients
颈椎融合术患者的邻近节段力学
  • 批准号:
    9077274
  • 财政年份:
    2016
  • 资助金额:
    $ 38.46万
  • 项目类别:
Three dimensional in vivo movement of cervical vertebrae during functional loadin
功能负荷过程中颈椎的三维体内运动
  • 批准号:
    8033682
  • 财政年份:
    2009
  • 资助金额:
    $ 38.46万
  • 项目类别:
Three dimensional in vivo movement of cervical vertebrae during functional loadin
功能负荷过程中颈椎的三维体内运动
  • 批准号:
    7657927
  • 财政年份:
    2009
  • 资助金额:
    $ 38.46万
  • 项目类别:
Three dimensional in vivo movement of cervical vertebrae during functional loadin
功能负荷过程中颈椎的三维体内运动
  • 批准号:
    7809534
  • 财政年份:
    2009
  • 资助金额:
    $ 38.46万
  • 项目类别:

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激素治疗、绝经年龄、既往产次和 APOE 基因型会影响老年人的认知。
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