Multidirectional flexibility analysis of cervical artificial disc reconstruction: in vitro human cadaveric spine model.
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概要
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OBJECT: This in vitro experimental study was conducted to investigate the initial biomechanical effect of artificial intervertebral disc replacement in the cervical spine. The multidirectional flexibility of replaced and adjacent spinal segments were analyzed using a cadaveric cervical spine model. METHODS: The following three cervical reconstructions were sequentially performed at the C5-6 level after anterior discectomy in seven human cadaveric occipitocervical spines: anterior artificial disc replacement with a bioactive three-dimensional (3D) fabric disc (FD); anterior iliac bone graft; and anterior plate fixation with iliac bone graft. Six unconstrained pure moments were applied with a 6-df spine simulator, and 3D segmental motions at the operative and adjacent segments were measured with an optoelectronic motion measurement system. The 3D FD group demonstrated statistically equivalent ranges of motion (ROMs) when compared with intact values in axial rotation and lateral bending. The 45% increase in flexion-extension ROM was demonstrated in 3D FD group; however, neutral zone analysis did not reach statistical significance between the intact spine and 3D FD. The anterior iliac bone graft and iliac bone graft reconstructions demonstrated statistically lower ROMs when compared with 3D FD in all loading modes (p < 0.05). The adjacent-level ROMs of the 3D FD group demonstrated nearly physiological characteristics at upper and lower adjacent levels. Excellent stability at the interface was maintained during the whole testing without any device displacement and dislodgment. CONCLUSIONS: The stand-alone cervical 3D FD demonstrated nearly physiological biomechanical characteristics at both operative and adjacent spinal segments in vitro, indicating an excellent clinical potential for cervical artificial disc replacement.
著者
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Minami A
Dep. Of Orthopaedic Surgery Graduate School Of Medicine Hokkaido Univ.
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Mcafee Paul
Spine And Scoliosis Center St. Joseph's Hospital
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Cunningham Bryan
Spine And Scoliosis Center St. Joseph's Hospital
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Minami Akio
北海道大学保健管理センター
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Cunningham Bryan
Orthopaedic Research Laboratory And Department Of Orthopaedic Surgery Union Memorial Hospital
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Cunningham Bryan
Orthopaedic Research Laboratory Union Memorial Hospital
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Minami Akio
Department Of Orthopaedic Surgery Hokkaido Graduate University School Of Medicine
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Ito Manabu
Orthopaedic Surgery Hokkaido Univ. Graduate School Of Medicine
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Abumi Kuniyoshi
Department Of Orthopaedic Surgery Hokkaido University Graduate School Of Medicine
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Hu Nianbin
Spine And Scoliosis Center St. Joseph's Hospital
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Arisue Makoto
Oral And Maxillofacial Surgery School Of Dentistry Health Sciences Univ. Of Hokkaido
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Shikinami Yasuo
Takiron Co. Ltd
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Arisue Makoto
Department Of Orthopaedic Surgery Hokkaido University Graduate School Of Medicine
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Arisue Makoto
Department Of Oral Maxillo-facial Surgery School Of Dentistry Health Sciences University Of Hokkaido
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Cunningham Bryan
Orthopaedic Biomechanics Laboratory
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Cunningham Bryan
St. Joseph's Hospital
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Cunningham Bryan
Orthopaedic Spinal Research Laboratory St Joseph Medical Center
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Hu Niabin
Orthopaedic Research Laboratory Union Memorial Hospital
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Mcafee Paul
Orthopaedic Spinal Research Laboratory St Joseph Medical Center
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Mcafee Paul
Department Of Orthopedic Surgery Rush University Medical Center
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Mcafee Paul
Scoliosis & Spine Center
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Kotani Yoshihisa
Dept. Of Orthop. Surg. Hokkaido University
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Arisue Makoto
Dep. Of Orthopaedic Surgery Graduate School Of Medicine Hokkaido Univ.
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Shono Yasuhiro
Department Of Orthopaedic Surgery Hokkaido University School Of Medicine
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Mcafee Paul
St. Joseph Hospital Scoliosis And Spine Center
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