Rahman Waseemur Ur, Jiang Wei, Zhao Fulin, Li Zhijun, Wang Guohua, Yang Guanghui
School of Mechanical Engineering, Dalian University of Technology, Dalian, China.
Department of Orthopedics, Dalian No. 2 People's Hospital, Dalian, China.
Proc Inst Mech Eng H. 2023 Jan;237(1):91-103. doi: 10.1177/09544119221135627. Epub 2022 Nov 17.
Recently, many different types of artificial discs have been introduced to persevere the biomechanical behavior of the cervical spine. This study compares the biomechanical behavior of single- and double-level cervical disc arthroplasty, that is "Prestige LP and Mobi-C" on the index and adjacent segment. A three-dimension finite element model of C2-C7 was developed and validated. In single-level prostheses, the Prestige LP or Mobi-C was implanted in the segment C5-C6, while the double-level arthroplasty was integrated at both segments C4-C5 and C5-C6 in the FE model. The intact FE and prosthesis-modified models were constrained from the inferior endplate of the vertebra C7 and applied a compressive load of 73.6 N with a moment load of 1 Nm on the odontoid process of the vertebra C2 to produce flexion/extension, lateral bending, and axial rotation. The prosthesis-modified model's range of motion and intradiscal pressure were determined and compared to the intact model. Also examined the impact of the prostheses on the stress at the bone-implant interface. The range of motion of the implanted segments in both single- and double-levels arthroplasty was increased while that of the adjacent segment of implanted segments decreased. The intradiscal pressure in both levels of arthroplasty was greater than in the intact model. In conclusion, Mobi-C's cervical prostheses could better preserve the normal range of motion and maintain intradiscal pressure than the Prestige LP.
最近,许多不同类型的人工椎间盘被引入以维持颈椎的生物力学行为。本研究比较了单节段和双节段颈椎间盘置换术(即“Prestige LP和Mobi-C”)在手术节段及相邻节段的生物力学行为。建立并验证了C2-C7的三维有限元模型。在单节段假体中,将Prestige LP或Mobi-C植入C5-C6节段,而在有限元模型中,双节段置换术则整合在C4-C5和C5-C6两个节段。完整的有限元模型和假体改良模型在C7椎体下终板处进行约束,并在C2椎体齿突上施加73.6 N的压缩载荷和1 Nm的弯矩载荷,以产生屈伸、侧弯和轴向旋转。确定假体改良模型的活动范围和椎间盘内压力,并与完整模型进行比较。还研究了假体对骨-植入物界面应力的影响。单节段和双节段置换术中植入节段的活动范围均增加,而植入节段相邻节段的活动范围减小。两个节段置换术的椎间盘内压力均高于完整模型。总之,与Prestige LP相比,Mobi-C颈椎假体能够更好地保留正常活动范围并维持椎间盘内压力。
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