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The Role of Posterior Longitudinal Ligament in Cervical Disc Replacement: An Ovine Cadaveric Biomechanical Analysis.

Yu CC, Hao DJ, Ma YL, Huang DG, Li HK, Feng H, Hou Q - Med. Sci. Monit. (2016)

Bottom Line: RESULTS The C3/C4 ROM in group 3 (CDR with PLL removed) increased significantly in flexion-extension and axial rotation compared with group 1 (intact spine).All the ROM observed in group 2 (CDR with PLL preserved) did not significantly differ from the ROM observed in group 1.Moreover, the ROM in CDR with PLL preservation did not significantly differ from the ROM observed in intact spines.

View Article: PubMed Central - PubMed

Affiliation: Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China (mainland).

ABSTRACT
BACKGROUND Cervical disc replacement (CDR) has been widely used to restore and maintain mobility and function of the treated and adjacent motion segments. Posterior longitudinal ligament (PLL) resection has been shown to be efficient in anterior cervical decompression and fusion. However, less is known about the biomechanical effect of PLL removal versus preservation in cervical disc arthroplasty. MATERIAL AND METHODS Three motion segments of 24 ovine cervical spines (C2-C5) were evaluated in a robotic spine system with axial compressive loads of 50 N. These cervical spines were divided in three groups according to the following conditions: (1) intact spine, (2) C3/C4 CDR with the Prestige LP prosthesis and PLL preservation, and (3) C3/C4 CDR with the Prestige LP prosthesis and PLL removal. The ranges of motion (ROMs) were recorded and analyzed in each group. RESULTS The C3/C4 ROM in group 3 (CDR with PLL removed) increased significantly in flexion-extension and axial rotation compared with group 1 (intact spine). Moreover, in flexion-extension, the mean total ROM was significantly larger in group 3 than in group 1. All the ROM observed in group 2 (CDR with PLL preserved) did not significantly differ from the ROM observed in group 1. CONCLUSIONS Compared with intact spines, CDR with PLL removal partly increased ROM. Moreover, the ROM in CDR with PLL preservation did not significantly differ from the ROM observed in intact spines. The PLL appears to contribute to the balance and stability of the cervical spine and should thus be preserved in cervical disc replacement provided that the posterior longitudinal ligament is not degenerative and the compression can be removed without PLL takedown.

No MeSH data available.


Related in: MedlinePlus

Mean ROM (±SD) for each of the three groups in flexion-extension (A), lateral bending (B), and axial rotation (C). An asterisk (*) indicates a significant difference between the corresponding groups (as indicated by the horizontal bar) at p<0.05.
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f6-medscimonit-22-1843: Mean ROM (±SD) for each of the three groups in flexion-extension (A), lateral bending (B), and axial rotation (C). An asterisk (*) indicates a significant difference between the corresponding groups (as indicated by the horizontal bar) at p<0.05.

Mentions: The mean ROMs of C2/C3, C3/C4, and C4/C5 segments in the three motion directions and for each of the three groups are listed in Table 1. Compared with group 1 (intact spine), the C3/C4 ROM in group 3 (CDR with PLL removed) significantly increased (p<0.05) in FE and AR (FE: 10.45°±1.51° for group 3 vs. 8.87°±1.28° for group 1; AR: 8.34°±1.37° for group 3 vs. 6.65°±1.67° for group 1). In addition, the ROM in group 2 (CDR with PLL preserved) was not significantly different from that in group 1 (intact spine) regardless of the motion direction and the vertebral segment (p>0.05) (Figure 6).


The Role of Posterior Longitudinal Ligament in Cervical Disc Replacement: An Ovine Cadaveric Biomechanical Analysis.

Yu CC, Hao DJ, Ma YL, Huang DG, Li HK, Feng H, Hou Q - Med. Sci. Monit. (2016)

Mean ROM (±SD) for each of the three groups in flexion-extension (A), lateral bending (B), and axial rotation (C). An asterisk (*) indicates a significant difference between the corresponding groups (as indicated by the horizontal bar) at p<0.05.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4920594&req=5

f6-medscimonit-22-1843: Mean ROM (±SD) for each of the three groups in flexion-extension (A), lateral bending (B), and axial rotation (C). An asterisk (*) indicates a significant difference between the corresponding groups (as indicated by the horizontal bar) at p<0.05.
Mentions: The mean ROMs of C2/C3, C3/C4, and C4/C5 segments in the three motion directions and for each of the three groups are listed in Table 1. Compared with group 1 (intact spine), the C3/C4 ROM in group 3 (CDR with PLL removed) significantly increased (p<0.05) in FE and AR (FE: 10.45°±1.51° for group 3 vs. 8.87°±1.28° for group 1; AR: 8.34°±1.37° for group 3 vs. 6.65°±1.67° for group 1). In addition, the ROM in group 2 (CDR with PLL preserved) was not significantly different from that in group 1 (intact spine) regardless of the motion direction and the vertebral segment (p>0.05) (Figure 6).

Bottom Line: RESULTS The C3/C4 ROM in group 3 (CDR with PLL removed) increased significantly in flexion-extension and axial rotation compared with group 1 (intact spine).All the ROM observed in group 2 (CDR with PLL preserved) did not significantly differ from the ROM observed in group 1.Moreover, the ROM in CDR with PLL preservation did not significantly differ from the ROM observed in intact spines.

View Article: PubMed Central - PubMed

Affiliation: Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China (mainland).

ABSTRACT
BACKGROUND Cervical disc replacement (CDR) has been widely used to restore and maintain mobility and function of the treated and adjacent motion segments. Posterior longitudinal ligament (PLL) resection has been shown to be efficient in anterior cervical decompression and fusion. However, less is known about the biomechanical effect of PLL removal versus preservation in cervical disc arthroplasty. MATERIAL AND METHODS Three motion segments of 24 ovine cervical spines (C2-C5) were evaluated in a robotic spine system with axial compressive loads of 50 N. These cervical spines were divided in three groups according to the following conditions: (1) intact spine, (2) C3/C4 CDR with the Prestige LP prosthesis and PLL preservation, and (3) C3/C4 CDR with the Prestige LP prosthesis and PLL removal. The ranges of motion (ROMs) were recorded and analyzed in each group. RESULTS The C3/C4 ROM in group 3 (CDR with PLL removed) increased significantly in flexion-extension and axial rotation compared with group 1 (intact spine). Moreover, in flexion-extension, the mean total ROM was significantly larger in group 3 than in group 1. All the ROM observed in group 2 (CDR with PLL preserved) did not significantly differ from the ROM observed in group 1. CONCLUSIONS Compared with intact spines, CDR with PLL removal partly increased ROM. Moreover, the ROM in CDR with PLL preservation did not significantly differ from the ROM observed in intact spines. The PLL appears to contribute to the balance and stability of the cervical spine and should thus be preserved in cervical disc replacement provided that the posterior longitudinal ligament is not degenerative and the compression can be removed without PLL takedown.

No MeSH data available.


Related in: MedlinePlus