Internal stress distribution in cervical intervertebral discs - The influence of an artificial cervical joint and simulated anterior interbody fusion

被引:76
作者
Wigfield, CC [1 ]
Skrzypiec, D
Jackowski, T
Adams, MA
机构
[1] Frenchay Hosp, Dept Neurosurg, Bristol BS16 1LE, Avon, England
[2] Univ Bristol, Dept Anat, Bristol, Avon, England
[3] Royal Orthopaed Hosp, Dept Spinal Surg, Birmingham B31 2AP, W Midlands, England
来源
JOURNAL OF SPINAL DISORDERS & TECHNIQUES | 2003年 / 16卷 / 05期
关键词
artificial cervical disc; stress distribution; interbody fusion;
D O I
10.1097/00024720-200310000-00002
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
There is concern that cervical interbody fusion can result in accelerated degenerative changes occurring at adjacent spinal levels. The cervical spine clearly evolved to be mobile. It would seem to be desirable for spinal surgeons to have an alternative to fusion, and spinal arthroplasty is an appealing concept. The Bristol Disc is a mechanical device comprising two articulating components that result in motion with 6 df. It has been shown to have favorable kinematics when compared with intact and fused cadaveric spines. The current study attempts to record changes in the distribution of stresses within cervical intervertebral discs adjacent to the artificial disc or a simulated fusion. The technique used to measure intradiscal stress distributions is based on earlier work by McNally and Adams on lumbar intervertebral discs. The study generated stress profiles through cervical intervertebral discs statically loaded in four different postures in addition to recording changes in intradiscal pressure within both the nucleus and the annulus during flexion. Similar stress profiles were recorded from intact specimens and those with the artificial joint inserted. The artificial joint resulted in reduced stresses in the annulus compared with spines with a simulated fusion. The study demonstrates how different testing conditions can result in researchers being confronted with paradoxical data, and the simulation of muscle forces is recommended.
引用
收藏
页码:441 / 449
页数:9
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