A biomechanical study comparing arthroplasty with fusion using human cadaveric C2-T1 spines.
To compare the kinematics of the cervical spine following arthroplasty and fusion using single level, two-level and hybrid constructs.
Previous studies have shown that spinal levels adjacent to a fusion experience increased motion and higher stress which may lead to adjacent segment disc degeneration. Cervical arthroplasty achieves similar decompression but preserves the motion at the operated level, potentially decreasing the occurrence of adjacent segment disc degeneration.
Eleven specimens (C2-T1) were divided into two groups (BRYAN® and PRESTIGE LP®). The specimens were tested in the following order; intact, single level total disc replacement (TDR) at C5-C6, two-level TDR at C5-C6-C7, fusion at C5-C6 and TDR at C6-C7 (Hybrid construct), and lastly a two-level fusion. The intact specimens were tested up to a moment of 2.0 Nm. Following each surgical intervention, the specimens were loaded until the primary motion (C2-T1) matched the motion of the respective intact state (hybrid control).
An arthroplasty preserved motion at the implanted level and maintained normal motion at the nonoperative levels. Arthrodesis resulted in a significant decrease in motion at the fused level and an increase in motion at the un-fused levels. In the hybrid construct, the TDR adjacent to fusion preserved motion at the arthroplasty level, thereby reducing the demand on the other levels.
Cervical disc arthroplasty with both the BRYAN® and PRESTIGE LP® discs not only preserved the motion at the operated level, but also maintained the normal motion at the adjacent levels. Under simulated physiologic loading, the motion patterns of the spine with the BRYAN® or PRESTIGE LP® disc were very similar and were closer than fusion to the intact motion pattern. An adjacent segment disc replacement is biomechanically favorable to a fusion in the presence of a pre-existing fusion.
This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 21 October 2015.
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