Increased stress and strain on the spinal cord due to ossification of the posterior longitudinal ligament in the cervical spine under flexion after laminectomy

被引:13
作者
Khuyagbaatar, Batbayar [1 ]
Kim, Kyungsoo [2 ]
Park, Won Man [1 ]
Lee, SuKyoung [3 ]
Kim, Yoon Hyuk [1 ]
机构
[1] Kyung Hee Univ, Dept Mech Engn, 1732 Deogyeong Daero, Yongin 17104, Gyeonggi Do, South Korea
[2] Kyung Hee Univ, Dept Appl Math, Yongin, South Korea
[3] Yonsei Univ, Dept Comp Sci, Seoul, South Korea
基金
新加坡国家研究基金会;
关键词
Stress analysis/testing; strain analysis/testing; orthopedic procedures; spine biomechanics; finite element modeling/analysis; modeling/simulation; FINITE-ELEMENT-ANALYSIS; CROSS-SECTIONAL AREA; SPONDYLOTIC MYELOPATHY; BIOMECHANICAL PARAMETERS; SURGICAL STRATEGY; DOOR LAMINOPLASTY; DYNAMIC CHANGES; WHITE-MATTER; INJURY; COMPRESSION;
D O I
10.1177/0954411917718222
中图分类号
R318 [生物医学工程];
学科分类号
0831 ;
摘要
Myelopathy in the cervical spine due to cervical ossification of the posterior longitudinal ligament could be induced by static compression and/or dynamic factors. It has been suggested that dynamic factors need to be considered when planning and performing the decompression surgery on patients with the ossification of the posterior longitudinal ligament. A finite element model of the C2-C7 cervical spine in the neutral position was developed and used to generate flexion and extension of the cervical spine. The segmental ossification of the posterior longitudinal ligament on the C5 was assumed, and laminectomy was performed on C4-C6 according to a conventional surgical technique. For various occupying ratios of the ossified ligament between 20% and 60%, von-Mises stresses, maximum principal strains in the spinal cord, and cross-sectional area of the cord were investigated in the pre-operative and laminectomy models under flexion, neutral position, and extension. The results were consistent with previous experimental and computational studies in terms of stress, strain, and cross-sectional area. Flexion leads to higher stresses and strains in the cord than the neutral position and extension, even after decompression surgery. These higher stresses and strains might be generated by residual compression occurring at the segment with the ossification of the posterior longitudinal ligament. This study provides fundamental information under different neck positions regarding biomechanical characteristics of the spinal cord in cervical ossification of the posterior longitudinal ligament.
引用
收藏
页码:898 / 906
页数:9
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