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Anterior Cervical Discectomy and Fusion in the Ovine Model
Published on: October 5, 2009
Biomechanical effects of progressive anterior cervical decompression
T Y Chen1, N R Crawford, V K Sonntag
1Spinal Biomechanics Research Laboratory, Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ 85013, USA.
Spine
|January 10, 2001
Summary
Anterior cervical decompression significantly increases cervical spine instability and alters motion. Preserving spinal structures during decompression is crucial to maintain stability and normal movement, especially in flexion and extension.
Area of Science:
- Biomechanics
- Spinal Surgery
- Orthopedics
Background:
- Previous studies explored discectomy consequences and uncovertebral joint removal numerically.
- No prior research assessed the biomechanical contributions of distinct anterior cervical column structures.
Purpose of the Study:
- Determine the biomechanical functions of tissues resected during anterior cervical decompression.
- Quantify the impact of various resection extents on cervical spine stability and kinematics.
Main Methods:
- A repeated-measures in vitro flexibility test was performed on seven human cadaver C4-T1 specimens.
- Torques were applied to four-level specimens after sequential resections (discectomy, uncovertebral joint removal, posterior longitudinal ligament transection).
- Angular motion at each level was measured to assess changes in range of motion and neutral zone.
Main Results:
- Progressive resections significantly increased angular range of motion and neutral zone, particularly in flexion and extension.
- Resection steps led to progressive shifts in the axis of rotation, up to 23 mm.
- Uncovertebral joint resection caused the most substantial alterations in angular coupling.
Conclusions:
- Anterior cervical decompression significantly elevates cervical motion segment instability and modifies kinematics.
- Each resected structure contributes to normal stability; preserving them during decompression without fusion is recommended.
- Grafting or fixation techniques should prioritize limiting flexion and extension due to their significant increase post-decompression.
