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Zhang Z, Cao K, Zhong Y, Yang J, Chen S, Li G, Wang S, Wan Z. An in Vivo, Three-Dimensional (3D), Functional Centers of Rotation of the Healthy Cervical Spine. World Neurosurg 2024; 184:e203-e210. [PMID: 38266986 DOI: 10.1016/j.wneu.2024.01.086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 01/14/2024] [Accepted: 01/16/2024] [Indexed: 01/26/2024]
Abstract
OBJECTIVE This study examined cervical center of rotation (COR) positions in 7 postures using validated cone beam computed tomography (CBCT) combined with 3D-3D registration in healthy volunteers. METHODS CBCT scans were performed on 20 healthy volunteers in 7 functional positions, constructing a three-dimensional (3D) model. Images were registered to the neutral position using 3D-3D registration, allowing analysis of kinematic differences and rotational axes. COR measurements were obtained for each segment (C2/3 to C6/7) in each posture. RESULTS The CORs of C2/3 to C6/7 were predominantly posterior (-5.3 ± 3.8 ∼ -0.6 ± 1.2 mm) and superior (16.5 ± 6.0 ∼ 23.6 ± 3.2 mm) to the intervertebral disc's geometric center (GC) in flexion and extension. However, the C4/5 segment's COR was anterior to the GC (2.0 ± 9.8 mm) during flexion and close to it in the right-left direction. During left-right twisting, the CORs of C2/3-C6/7 were posterior (-21.8 ± 10.5 ∼-0.9 ± 0.8 mm) and superior (3.1 ± 7.5 ∼23.2 ± 3.6 mm) to the GCs in anterior-posterior and superior-inferior directions, without consistent right-left directionality. During left-right bending, each segment's COR was predominantly posterior (-25.2 ± 13.1 ∼-6.5 ± 9.9 mm) and superior (0.3 ± 12.5 ∼12.1 ± 5.1 mm) to the GC in anterior-posterior and superior-inferior directions, except for the C2/3 segment, located inferiorly (-5.9 ± 4.1 mm) in left bending. The right-left COR position varied across segments. CONCLUSIONS Our findings reveal segment-specific and posture-dependent COR variations. Notably, the CORs of C3/4, C4/5, and C5/6 consistently align near the intervertebral disc's GC at different postures, supporting their suitability for total disc replacement surgery within the C3/4 to C5/6 segments.
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Affiliation(s)
- Zizhen Zhang
- The Orthopedic Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
| | - Kai Cao
- The Orthopedic Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
| | - Yanlong Zhong
- The Orthopedic Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
| | - Jie Yang
- The Orthopedic Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
| | - Shaofeng Chen
- The Orthopedic Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
| | - Guoan Li
- Department of Orthopaedic Surgery, Orthopaedic Bioengineering Research Center, Newton-Wellesley Hospital, Harvard Medical School, Newton, Massachusetts, USA
| | - Shaobai Wang
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Zongmiao Wan
- The Orthopedic Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
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Fleck S, Lang A, Lehmberg J, Landscheidt JF, Gerlach R, Rathert J, Ulrich C, Schär RT, Hartmann S, Mueller JU, Thome C. Prospective Multicenter Trial of Cervical Arthroplasty with the ROTAIO® Cervical Disc Prosthesis. Global Spine J 2024; 14:429-437. [PMID: 35929409 PMCID: PMC10802525 DOI: 10.1177/21925682221109563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
STUDY DESIGN Clinical observational study. OBJECTIVE The ROTAIO® cervical disc prosthesis is a novel unconstrained implant with a variable center of rotation aiming at physiological motion. The objective of this multicenter prospective trial was to evaluate clinical outcome and complications within 2 years. MATERIAL AND METHODS 120 patients (72 females and 48 males with median age of 43.0 years [23-60 yrs] underwent ACDA (ROTAIO®, SIGNUS Medical, Alzenau, Germany) and were prospectively followed for 24 months. Preoperative complaints were mainly associated with radiculopathy (n = 104) or myelopathy (n=16). There were 108 monosegmental and 12 bisegmental procedures including 6 hybrid constructs. Clinical outcome was evaluated at 3, 12 and 24 months in 100%, 96% and 77% of the cohort by VAS, NDI, WL-26, Patient`s Satisfaction Index (PSI), SF-36, Nurick Score, mJOA, Composite Success Rate, complications, patient`s overall satisfaction and analgesics use. RESULTS Highly significant clinical improvements were observed according to NDI and VAS (P < .0001 (arm); P < .001 (neck); P = .002 (head)) at all time points. Analgetic use could be reduced in 87.1 to 95.2%. Doctor`s visits have been reduced in 93.8% after 24 months. Patient`s overall satisfaction was high with 78.4 to 83.5% of patients. The composite success rate was 77.5% after 12 months and 76.9% after 24 months. There were no major complications in this series. Slight subsidence of the prosthesis was observed in 2 patients and 3 patients demonstrated fusion after 24 months. 2 patients developed symptomatic foraminal stenosis, so that implant removal and fusion was performed resulting in a revision rate of 1.7% in 2 years. CONCLUSION The ROTAIO® cervical disc prosthesis is a safe and efficient treatment option for symptomatic degenerative disc disease demonstrating highly significant clinical improvement and high patient`s overall satisfaction with very low revision rates at 2 years.
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Affiliation(s)
- Steffen Fleck
- Department of Neurosurgery, University Medicine Greifswald, Greifswald, Germany
| | - Anna Lang
- Department of Neurosurgery, Medical University Innsbruck, Innsbruck, Austria
| | - Jens Lehmberg
- Department of Neurosurgery, Klinikum Bogenhausen, Munich, Germany
| | | | - Ruediger Gerlach
- Department of Neurosurgery, University Medicine Erfurt, Erfurt, Germany
| | - Julian Rathert
- Department of Neurosurgery, University Medicine Erfurt, Erfurt, Germany
| | | | - Ralph T. Schär
- Department of Neurosurgery, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Sebastian Hartmann
- Department of Neurosurgery, Medical University Innsbruck, Innsbruck, Austria
| | - Jan-Uwe Mueller
- Department of Neurosurgery, University Medicine Greifswald, Greifswald, Germany
| | - Claudius Thome
- Department of Neurosurgery, Medical University Innsbruck, Innsbruck, Austria
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Hutchins J, Lagerstrand K, Stävlid E, Svensson PA, Rennerfelt K, Hebelka H, Brisby H. MRI evaluation of foraminal changes in the cervical spine with assistance of a novel compression device. Sci Rep 2023; 13:11508. [PMID: 37460649 DOI: 10.1038/s41598-023-38401-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 07/07/2023] [Indexed: 07/20/2023] Open
Abstract
Standard supine Magnetic Resonance Imaging (MRI) does not acquire images in a position where most patients with intermittent arm radiculopathy have symptoms. The aim of this study was to test the feasibility of a new compression device and to evaluate image quality and foraminal properties during a Spurling test under MRI acquisition. Ten asymptomatic individuals were included in the study (6 men and 4 women; age range 27 to 55 years). First, the subjects were positioned in the cervical compression device in a 3 T MRI scanner, and a volume T2 weighted (T2w) sequence was acquired in a relaxed supine position (3 min). Thereafter, the position and compressive forces on the patient's neck (provocation position) were changed by maneuvering the device from the control room, with the aim to simulate a Spurling test, causing a mild foraminal compression, followed by a repeated image acquisition (3 min). A radiologist measured the blinded investigations evaluating cervical lordosis (C3-C7), foraminal area on oblique sagittal images and foraminal cross-distance in the axial plane. A total of three levels (C4-C7) were measured on the right side on each individual. Measurements were compared between the compressed and relaxed state. Reliability tests for inter- and intraclass correlation were performed. The device was feasible to use and well tolerated by all investigated individuals. Images of adequate quality was obtained in all patients. A significant increase (mean 9.4, p = 0.013) in the cervical lordosis and a decreased foraminal cross-distance (mean 32%, p < 0.001) was found, during the simulated Spurling test. The area change on oblique sagittal images did not reach a statistically significant change. The reliability tests on the quantitative measures demonstrated excellent intraobserver reliability and moderate to good interobserver reliability. Applying an individualized provocation test on the cervical spine, which simulates a Spurling test, during MRI acquisition was feasible with the novel device and provided images of satisfactory quality. MRI images acquired with and without compression showed changes in cervical lordosis and foraminal cross distance indicating the possibility of detecting changes of the foraminal properties. As a next step, the method is to be tested on symptomatic patients.
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Affiliation(s)
- J Hutchins
- Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
- Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden.
| | - K Lagerstrand
- Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Medical Physics and Biomedical Engineering Physics, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - E Stävlid
- Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - P-A Svensson
- Department of Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - K Rennerfelt
- Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - H Hebelka
- Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - H Brisby
- Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden
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Page Á, Inglés M, Venegas W, Mollà-Casanova S, Serra-Añó P. Effect of non-specific neck pain on the path of the instantaneous axis of rotation of the neck during its flexion-extension movement. Musculoskelet Sci Pract 2023; 64:102737. [PMID: 36871441 DOI: 10.1016/j.msksp.2023.102737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 02/21/2023] [Accepted: 02/24/2023] [Indexed: 03/07/2023]
Abstract
Non-specific neck pain is a common musculoskeletal disorder with a high prevalence and involves impaired joint movement pattern. Therefore, this study aimed to compare the trajectory of the instantaneous axis of rotation(IAR) in flexion-extension movements of the neck between people with and without nonspecific neck pain, using functional data analysis techniques. Furthermore, possible relationships between neck kinematics and perceived pain and disability were explored. Seventy-three volunteers participated in this cross-sectional study. They were allocated in a non-specific pain group (PG, n = 28) and a control group (CG, n = 45). A cyclic flexion-extension movement was assessed by a video photogrammetry system and numerical and functional variables were computed to analyze IAR trajectory during movement. Moreover, to explore possible relationships of these variables with pain and neck disability, a visual analogue scale (VAS) and the neck disability index (NDI) were used. The instantaneous axis of rotation trajectory during the flexion-extension cyclic movement described a path like Greek letter rho both in the CG and the PG, but this trajectory was shorter and displaced upward in the PG, compared to the CG. A reduction of the displacement range and a rise in the vertical position of the IAR were related to VAS and NDI scores. Non-specific neck pain is associated with a higher location of the instantaneous axis of rotation and a decrease in length of the path traveled during the flexion-extension movement. This study contributes to a better description of neck movement in people with non-specific neck pain, which would help to plan an individualized treatment.
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Affiliation(s)
- Álvaro Page
- Instituto Universitario de Ingeniería Mecánica y Biomecánica, Universitat Politècnica de València, Camino de Vera S/n E46022, Valencia, Spain
| | - Marta Inglés
- UBIC, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, València, Spain
| | - William Venegas
- Facultad de Ingeniería Mecánica, Escuela Politécnica Nacional, c/ Ladrón de Guevara E11-253, 17012759, Quito, Ecuador
| | - Sara Mollà-Casanova
- UBIC, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, València, Spain.
| | - Pilar Serra-Añó
- UBIC, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, València, Spain
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Zhang H, Sang D, Zhang B, Ren YN, Wang X, Feng JJ, Du CF, Liu B, Zhu R. Parameter Study on How the Cervical Disc Degeneration Affects the Segmental Instantaneous Centre of Rotation. J Med Biol Eng 2023. [DOI: 10.1007/s40846-023-00779-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
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Li C, Yu X, Xiong Y, Yang Y, Wang F, Zhao H. Mid-long-term follow-up of operated level kinematics after single-level artificial cervical disc replacement with Bryan disc. J Orthop Surg Res 2022; 17:149. [PMID: 35264233 PMCID: PMC8905739 DOI: 10.1186/s13018-022-03051-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 03/02/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Evaluation of the mid-long-term kinematics of single-level Bryan artificial cervical disc replacement (ACDR) in vivo by analyzing the center of rotation (COR) at the operated level. METHODS A retrospective analysis was conducted using data collected from 38 patients who underwent single-level Bryan ACDR from January 2010 to March 2013. Radiological parameters including range of motion (ROM), lordosis angle, translation, and COR were obtained. Clinical outcomes were assessed based on Odom Criteria, modified Japanese Orthopedic Association (mJOA), Neck Disability Index (NDI), and Visual Analogue Scale (VAS) scores. Correlations between COR and other follow-up data were discussed at the last follow-up. RESULTS Compared with preoperative values, the last follow-up data showed that 86.84% of cases achieved good-or-excellent outcomes based on Odom criteria; Significant improvements were observed across all scales assessed for clinical outcomes (P < 0.05); Lordosis angle was significantly increased in both the overall cervical spine and the operated level (P < 0.05); ROM of the overall cervical spine, operated level, and adjacent levels was preserved (P > 0.05); There was no significant change in COR at the operated level (P > 0.05). At the last follow-up and at the operated level, COR (Y) showed negative correlations with ROM and translation (P < 0.05), but no follow-up data correlated with COR (X) were found (P > 0.05). CONCLUSIONS Satisfactory clinical and radiological outcomes were achieved 7 years or more after single-level Bryan ACDR. At the operated level, preoperative COR was maintained, probably due to replicating the physiological interrelations of COR (Y), translation, and ROM.
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Affiliation(s)
- Chuanhong Li
- Department of Orthopedics, Dongzhimen Hospital, Beijing University of Chinese Medicine, No. 5 Haiyuncang Street, Dongcheng District, Beijing, 100700, China
| | - Xing Yu
- Department of Orthopedics, Dongzhimen Hospital, Beijing University of Chinese Medicine, No. 5 Haiyuncang Street, Dongcheng District, Beijing, 100700, China.
| | - Yang Xiong
- School of Materials Science and Engineering, Tsinghua University, Beijing, 100084, China
| | - Yongdong Yang
- Department of Orthopedics, Dongzhimen Hospital, Beijing University of Chinese Medicine, No. 5 Haiyuncang Street, Dongcheng District, Beijing, 100700, China
| | - Fengxian Wang
- Department of Orthopedics, Dongzhimen Hospital, Beijing University of Chinese Medicine, No. 5 Haiyuncang Street, Dongcheng District, Beijing, 100700, China
| | - He Zhao
- Department of Orthopedics, Dongzhimen Hospital, Beijing University of Chinese Medicine, No. 5 Haiyuncang Street, Dongcheng District, Beijing, 100700, China
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Cai XY, Sang D, Yuchi CX, Cui W, Zhang C, Du CF, Liu B. Using finite element analysis to determine effects of the motion loading method on facet joint forces after cervical disc degeneration. Comput Biol Med 2020; 116:103519. [DOI: 10.1016/j.compbiomed.2019.103519] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 10/23/2019] [Accepted: 10/24/2019] [Indexed: 01/19/2023]
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