Biomechanical Changes in Kyphotic Cervical Spine After Anterior Cervical Discectomy and Fusion with Different Degrees of Correction
Cervical kyphosis is a debilitating disease, and its surgical treatment involves correction to restore sagittal alignment. Few studies have explored the appropriate degree of correction, and the biomechanical impact of correction on the cervical spine is still unclear. This study aimed to compare th...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2025-02-01
|
| Series: | Bioengineering |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2306-5354/12/3/213 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850090004171194368 |
|---|---|
| author | Hongyu Chen Xu Ma Shengfa Pan Li Zhang Yanbin Zhao Xin Chen Yu Sun Feifei Zhou |
| author_facet | Hongyu Chen Xu Ma Shengfa Pan Li Zhang Yanbin Zhao Xin Chen Yu Sun Feifei Zhou |
| author_sort | Hongyu Chen |
| collection | DOAJ |
| description | Cervical kyphosis is a debilitating disease, and its surgical treatment involves correction to restore sagittal alignment. Few studies have explored the appropriate degree of correction, and the biomechanical impact of correction on the cervical spine is still unclear. This study aimed to compare the biomechanical changes in the cervical spine after different degrees of correction by two-level anterior cervical discectomy and fusion (ACDF). Three-dimensional finite element (FE) models of the intact cervical spine (C2–C7) with normal physiological lordosis and kyphosis were constructed. Based on the kyphotic model, three two-level ACDF in C4–6 surgical models were developed: (1) non-correction: only the intervertebral heights were restored; (2) partial correction: the cervical curvature was adjusted to straighten; (3) complete correction: the cervical curvature was adjusted to physiological lordosis. A pure moment of 1.0 Nm combined with a follower load of 73.6 N was applied to the C2 vertebra to simulate flexion, extension, lateral bending, and axial rotation. The stress of vertical bodies and facet joints, intradiscal pressure (IDP), and the overall ROMs of all models were computed. The peak von Mises stress on the upper (C4) and lower (C6) instrumented vertebral bodies in the kyphotic model was greater than that of the physiological lordosis model, with the exception of C6 under lateral bending. The maximum stress was observed in C4 during lateral bending after complete correction, which increased by 145% compared to preoperative von Mises stress. For the middle (C5) instrumented vertebral body, the peak von Mises stress increased after surgery. The maximum stress was observed in partial correction during flexion. Compared to physiological lordosis, the peak von Mises stress on the facet joints in kyphotic segments was lower; however, it was higher in the adjacent segments, except C4/5 in extension. The stress on the facet joints in kyphotic segments decreased, with the most significant decrease observed in partial correction. The IDPs in adjacent segments, except for C6/7 in flexion, showed no significant difference before and after surgery. Additionally, correction seemed to have little impact on IDPs in adjacent segments. In conclusion, for the treatment of cervical kyphosis with two-level ACDF, complete correction resulted in the highest peak von Mises stress on the upper instrumented vertebral body. Partial correction mitigated von Mises stress within the facet joints in kyphotic segments, albeit at the expense of high von Mises stress on the middle instrumented vertebral body. |
| format | Article |
| id | doaj-art-820245d4350b4c68af93328ee367feaf |
| institution | DOAJ |
| issn | 2306-5354 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Bioengineering |
| spelling | doaj-art-820245d4350b4c68af93328ee367feaf2025-08-20T02:42:38ZengMDPI AGBioengineering2306-53542025-02-0112321310.3390/bioengineering12030213Biomechanical Changes in Kyphotic Cervical Spine After Anterior Cervical Discectomy and Fusion with Different Degrees of CorrectionHongyu Chen0Xu Ma1Shengfa Pan2Li Zhang3Yanbin Zhao4Xin Chen5Yu Sun6Feifei Zhou7Department of Orthopaedics, Peking University Third Hospital, Beijing 100191, ChinaKey Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing 100191, ChinaDepartment of Orthopaedics, Peking University Third Hospital, Beijing 100191, ChinaDepartment of Orthopaedics, Peking University Third Hospital, Beijing 100191, ChinaDepartment of Orthopaedics, Peking University Third Hospital, Beijing 100191, ChinaDepartment of Orthopaedics, Peking University Third Hospital, Beijing 100191, ChinaDepartment of Orthopaedics, Peking University Third Hospital, Beijing 100191, ChinaDepartment of Orthopaedics, Peking University Third Hospital, Beijing 100191, ChinaCervical kyphosis is a debilitating disease, and its surgical treatment involves correction to restore sagittal alignment. Few studies have explored the appropriate degree of correction, and the biomechanical impact of correction on the cervical spine is still unclear. This study aimed to compare the biomechanical changes in the cervical spine after different degrees of correction by two-level anterior cervical discectomy and fusion (ACDF). Three-dimensional finite element (FE) models of the intact cervical spine (C2–C7) with normal physiological lordosis and kyphosis were constructed. Based on the kyphotic model, three two-level ACDF in C4–6 surgical models were developed: (1) non-correction: only the intervertebral heights were restored; (2) partial correction: the cervical curvature was adjusted to straighten; (3) complete correction: the cervical curvature was adjusted to physiological lordosis. A pure moment of 1.0 Nm combined with a follower load of 73.6 N was applied to the C2 vertebra to simulate flexion, extension, lateral bending, and axial rotation. The stress of vertical bodies and facet joints, intradiscal pressure (IDP), and the overall ROMs of all models were computed. The peak von Mises stress on the upper (C4) and lower (C6) instrumented vertebral bodies in the kyphotic model was greater than that of the physiological lordosis model, with the exception of C6 under lateral bending. The maximum stress was observed in C4 during lateral bending after complete correction, which increased by 145% compared to preoperative von Mises stress. For the middle (C5) instrumented vertebral body, the peak von Mises stress increased after surgery. The maximum stress was observed in partial correction during flexion. Compared to physiological lordosis, the peak von Mises stress on the facet joints in kyphotic segments was lower; however, it was higher in the adjacent segments, except C4/5 in extension. The stress on the facet joints in kyphotic segments decreased, with the most significant decrease observed in partial correction. The IDPs in adjacent segments, except for C6/7 in flexion, showed no significant difference before and after surgery. Additionally, correction seemed to have little impact on IDPs in adjacent segments. In conclusion, for the treatment of cervical kyphosis with two-level ACDF, complete correction resulted in the highest peak von Mises stress on the upper instrumented vertebral body. Partial correction mitigated von Mises stress within the facet joints in kyphotic segments, albeit at the expense of high von Mises stress on the middle instrumented vertebral body.https://www.mdpi.com/2306-5354/12/3/213cervical kyphosiscorrectionbiomechanicalfinite element |
| spellingShingle | Hongyu Chen Xu Ma Shengfa Pan Li Zhang Yanbin Zhao Xin Chen Yu Sun Feifei Zhou Biomechanical Changes in Kyphotic Cervical Spine After Anterior Cervical Discectomy and Fusion with Different Degrees of Correction Bioengineering cervical kyphosis correction biomechanical finite element |
| title | Biomechanical Changes in Kyphotic Cervical Spine After Anterior Cervical Discectomy and Fusion with Different Degrees of Correction |
| title_full | Biomechanical Changes in Kyphotic Cervical Spine After Anterior Cervical Discectomy and Fusion with Different Degrees of Correction |
| title_fullStr | Biomechanical Changes in Kyphotic Cervical Spine After Anterior Cervical Discectomy and Fusion with Different Degrees of Correction |
| title_full_unstemmed | Biomechanical Changes in Kyphotic Cervical Spine After Anterior Cervical Discectomy and Fusion with Different Degrees of Correction |
| title_short | Biomechanical Changes in Kyphotic Cervical Spine After Anterior Cervical Discectomy and Fusion with Different Degrees of Correction |
| title_sort | biomechanical changes in kyphotic cervical spine after anterior cervical discectomy and fusion with different degrees of correction |
| topic | cervical kyphosis correction biomechanical finite element |
| url | https://www.mdpi.com/2306-5354/12/3/213 |
| work_keys_str_mv | AT hongyuchen biomechanicalchangesinkyphoticcervicalspineafteranteriorcervicaldiscectomyandfusionwithdifferentdegreesofcorrection AT xuma biomechanicalchangesinkyphoticcervicalspineafteranteriorcervicaldiscectomyandfusionwithdifferentdegreesofcorrection AT shengfapan biomechanicalchangesinkyphoticcervicalspineafteranteriorcervicaldiscectomyandfusionwithdifferentdegreesofcorrection AT lizhang biomechanicalchangesinkyphoticcervicalspineafteranteriorcervicaldiscectomyandfusionwithdifferentdegreesofcorrection AT yanbinzhao biomechanicalchangesinkyphoticcervicalspineafteranteriorcervicaldiscectomyandfusionwithdifferentdegreesofcorrection AT xinchen biomechanicalchangesinkyphoticcervicalspineafteranteriorcervicaldiscectomyandfusionwithdifferentdegreesofcorrection AT yusun biomechanicalchangesinkyphoticcervicalspineafteranteriorcervicaldiscectomyandfusionwithdifferentdegreesofcorrection AT feifeizhou biomechanicalchangesinkyphoticcervicalspineafteranteriorcervicaldiscectomyandfusionwithdifferentdegreesofcorrection |