Journal article
A comprehensive finite element model of surgical treatment for cervical myelopathy
Clinical biomechanics (Bristol), Vol.74, pp.79-86
04/2020
DOI: 10.1016/j.clinbiomech.2020.02.009
PMID: 32145673
Abstract
Cervical myelopathy is a common and debilitating chronic spinal cord dysfunction. Treatment includes anterior and/or posterior surgical intervention to decompress the spinal cord and stabilize the spine, but no consensus has been made as to the preferable surgical intervention. The objective of this study was to develop an finite element model of the healthy and myelopathic C2-T1 cervical spine and common anterior and posterior decompression techniques to determine how spinal cord stress and strain is altered in healthy and diseased states.
A finite element model of the C2-T1 cervical spine, spinal cord, pia, dura, cerebral spinal fluid, and neural ligaments was developed and validated against in vivo human displacement data. To model cervical myelopathy, disc herniation and osteophytes were created at the C4-C6 levels. Three common surgical interventions were then incorporated at these levels.
The finite element model accurately predicted healthy and myelopathic spinal cord displacement compared to motions observed in vivo. Spinal cord strain increased during extension in the cervical myelopathy finite element model. All surgical techniques affected spinal cord stress and strain. Specifically, adjacent levels had increased stress and strain, especially in the anterior cervical discectomy and fusion case.
This model is the first biomechanically validated, finite element model of the healthy and myelopathic C2-T1 cervical spine and spinal cord which predicts spinal cord displacement, stress, and strain during physiologic motion. Our findings show surgical intervention can cause increased strain in the adjacent levels of the spinal cord which is particularly worse following anterior cervical discectomy and fusion.
Details
- Title: Subtitle
- A comprehensive finite element model of surgical treatment for cervical myelopathy
- Creators
- Kirsten E Stoner - Biomedical Engineering, The University of Iowa, USA. Electronic address: kirsten.stoner@gmail.comKingsley O Abode-Iyamah - Department of Neurosurgery, Mayo Clinic, Jacksonville, FL, USADouglas C Fredericks - Department of Orthopedics and Rehabilitation, The University of Iowa Hospitals and Clinics, USAStephanus Viljoen - Department of Neurosurgery, The Ohio State University Wexner Medical Center, USAMatthew A Howard - Department of Neurosurgery, The University of Iowa Hospitals and Clinics, USANicole M Grosland - Biomedical Engineering, The University of Iowa, USA; Department of Orthopedics and Rehabilitation, The University of Iowa Hospitals and Clinics, USA. Electronic address: nicole-grosland@uiowa.edu
- Resource Type
- Journal article
- Publication Details
- Clinical biomechanics (Bristol), Vol.74, pp.79-86
- DOI
- 10.1016/j.clinbiomech.2020.02.009
- PMID
- 32145673
- NLM abbreviation
- Clin Biomech (Bristol)
- ISSN
- 0268-0033
- eISSN
- 1879-1271
- Publisher
- England
- Grant note
- DOI: 10.13039/100005217, name: National Center for Injury Prevention and Control/CDC, award: 1U49CE002108-03; DOI: 10.13039/100008893, name: University of Iowa
- Language
- English
- Date published
- 04/2020
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Neurology; Iowa Neuroscience Institute; Orthopedics and Rehabilitation; Craniofacial Anomalies Research Center; Injury Prevention Research Center; Neurosurgery; Otolaryngology
- Record Identifier
- 9984070156402771
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