School of Mechanical Engineering, Dalian University of Technology, Dalian, China.
Proc Inst Mech Eng H. 2024 Jan;238(1):78-89. doi: 10.1177/09544119231215721. Epub 2023 Dec 16.
In recent years, artificial cervical discs have been used in intervertebral disc replacement surgery and hybrid surgery (HS). The advantages and disadvantages of different artificial cervical discs in artificial cervical disc replacement surgery have been compared. However, few scholars have studied the biomechanical effects of various artificial disc prostheses on the human cervical spine in HS which include the Anterior Cervical Discectomy and Fusion (ACDF) and Cervical Disc Arthroplasty (CDA). This study compared the biomechanical behavior of Mobi-C and Prestige LP in the operative and adjacent segments during two-level hybrid surgery. A three-dimensional finite element model of C2-C7 was first established and validated. Subsequently, clinical surgery was then simulated to establish a surgical model of anterior cervical fusion at the C4-C5 level. Mobi-C and Prestige-LP artificial disc prostheses were implanted at the C5-C6 level to create two hybrid models. All finite element models were fixed on the lower endplate of the C7 vertebra and subjected to a load of 73.6 N and different directions of 1 Nm torque on the odontoid process of the C2 vertebra to simulate human flexion, extension, lateral bending, and axial rotation. This paper compares the ROM, intervertebral pressure, and facet joint force after hybrid surgery with the intact model. The results show that compared with Prestige LP, Mobi-C can improve ROM of the replacement segment and compensate for the intervertebral pressure of the adjacent segment more effectively, but the facet joint pressure of the replacement segment may be higher.
近年来,人工颈椎间盘已应用于颈椎间盘置换术和杂交手术(HS)中。比较了不同人工颈椎间盘在颈椎间盘置换术中的优缺点。然而,很少有学者研究各种人工椎间盘假体在包括前路颈椎间盘切除融合术(ACDF)和颈椎间盘置换术(CDA)在内的 HS 中对人体颈椎的生物力学影响。本研究比较了 Mobi-C 和 Prestige LP 在双节段杂交手术中手术节段和相邻节段的生物力学行为。首先建立并验证了 C2-C7 的三维有限元模型。随后,模拟临床手术,在 C4-C5 水平建立前路颈椎融合的手术模型。在 C5-C6 水平植入 Mobi-C 和 Prestige-LP 人工椎间盘假体,构建两种杂交模型。所有有限元模型均固定在 C7 椎体的下终板上,在 C2 椎体的齿突上施加 73.6N 的载荷和 1Nm 的不同方向扭矩,以模拟人体的屈伸、侧屈和轴向旋转。本文比较了杂交手术后与完整模型的 ROM、椎间盘压力和小关节力。结果表明,与 Prestige LP 相比,Mobi-C 可以改善置换节段的 ROM,并更有效地补偿相邻节段的椎间盘压力,但置换节段的小关节压力可能更高。
Proc Inst Mech Eng H. 2024-1
Proc Inst Mech Eng H. 2023-1