Article

Load-carrying capacity of the human cervical spine in compression is increased under a follower load.

Department of Orthopaedic Surgery and Rehabilitation, Loyola University Medical Center, Maywood, IL 60153, USA.
Spine (Impact Factor: 2.16). 06/2000; 25(12):1548-54.
Source: PubMed

ABSTRACT An experimental approach was used to test human cadaveric cervical spine specimens.
To assess the response of the cervical spine to a compressive follower load applied along a path that approximates the tangent to the curve of the cervical spine.
The compressive load on the human cervical spine is estimated to range from 120 to 1200 N during activities of daily living. Ex vivo experiments show it buckles at approximately 10 N. Differences between the estimated in vivo loads and the ex vivo load-carrying capacity have not been satisfactorily explained.
A new experimental technique was developed for applying a compressive follower load of physiologic magnitudes up to 250 N. The experimental technique applied loads that minimized the internal shear forces and bending moments, loading the specimen in nearly pure compression.
A compressive vertical load applied in the neutral and forward-flexed postures caused large changes in cervical lordosis at small load magnitudes. The specimen collapsed in extension or flexion at a load of less than 40 N. In sharp contrast, the cervical spine supported a load of up to 250 N without damage or instability in both the sagittal and frontal planes when the load path was tangential to the spinal curve. The cervical spine was significantly less flexible under a compressive follower load compared with the hypermobility demonstrated under a compressive vertical load (P < 0.05).
The load-carrying capacity of the ligamentous cervical spine sharply increased under a compressive follower load. This experiment explains how a whole cervical spine can be lordotic and yet withstand the large compressive loads estimated in vivo without damage or instability.

0 Bookmarks
 · 
78 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To evaluate fixation properties of a new intervertebral anchored fusion device and compare these with ventral locking plate fixation. In vitro biomechanical evaluation. Cadaveric canine C4-C7 cervical spines (n = 9). Cervical spines were nondestructively loaded with pure moments in a nonconstraining testing apparatus to induce flexion/extension while angular motion was measured. Range of motion (ROM) and neutral zone (NZ) were calculated for (1) intact specimens, (2) specimens after discectomy and fixation with a purpose-built intervertebral fusion cage with integrated ventral fixation, and (3) after removal of the device and fixation with a ventral locking plate. Both fixation techniques resulted in a decrease in ROM and NZ (P < .001) compared with the intact segments. There were no significant differences between the anchored spacer and locking plate fixation. An anchored spacer appears to provide similar biomechanical stability to that of locking plate fixation.
    Veterinary Surgery 09/2013; · 1.24 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The effects of degeneration and surgery on cervical spine mechanics are commonly evaluated through in vitro testing and finite element models derived from these tests. The objectives of the current study were to estimate the load applied to the C2 vertebra during in vivo functional flexion-extension and to evaluate the effects of anterior cervical arthrodesis on spine kinetics. Spine and head kinematics from 16 subjects (six arthrodesis patients and ten asymptomatic controls) were determined during functional flexion-extension using dynamic stereo X-ray and conventional reflective markers. Subject-specific inverse dynamics models, including three flexor muscles and four extensor muscles attached to the skull, estimated the force applied to C2. Total force applied to C2 was not significantly different between arthrodesis and control groups at any 10 deg increment of head flexion-extension (all p values ≥ 0.937). Forces applied to C2 were smallest in the neutral position, increased slowly with flexion, and increased rapidly with extension. Muscle moment arms changed significantly during flexion-extension, and were dependent upon the direction of head motion. The results suggest that in vitro protocols and finite element models that apply constant loads to C2 do not accurately represent in vivo cervical spine kinetics.
    Journal of Biomechanical Engineering 06/2013; 135(6):61007-8. · 1.52 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Object Biomechanical studies have shown that anterior cervical fusion construct stiffness and arthrodesis rates vary with different reconstruction techniques; however, the behavior of the adjacent segments in the setting of different procedures is poorly understood. This study was designed to investigate the adjacent-segment biomechanics after 3 different anterior cervical decompression and fusion techniques, including 3-level discectomy and fusion, 2-level corpectomy and fusion, and a corpectomy-discectomy hybrid technique. The authors hypothesized that biomechanical changes at the segments immediately superior and inferior to the multilevel fusion would be inversely proportional to the number of fused bone grafts and that these changes would be related to the type of fusion technique. Methods A previously validated 3D finite element model of an intact C3-T1 segment was used. Three C4-7 fusion models were built from this intact model by varying the number of bone grafts used to span the decompression: a 1-graft model (2-level corpectomy), a 2-graft model (C-5 corpectomy and C6-7 discectomy), and a 3-graft model (3-level discectomy). The corpectomy and discectomy models were also previously validated and compared well with the literature findings. Range of motion, disc stresses, and posterior facet loads at the segments superior (C3-4) and inferior (C7-T1) to the fusion construct were assessed. Results Motion, disc stresses, and posterior facet loads generally increased at both of the adjacent segments in relation to the intact model. Greater biomechanical changes were noted in the superior C3-4 segment than in the inferior C7-T1 segment. Increasing the number of bone grafts from 1 to 2 and from 2 to 3 was associated with a lower magnitude of biomechanical changes at the adjacent segments. Conclusions At segments adjacent to the fusion level, biomechanical changes are not limited solely to the discs, but also propagate to the posterior facets. These changes in discs and posterior facets were found to be lower for discectomy than for corpectomy, thereby supporting the current study hypothesis of inverse relationship between the adjacent-segment variations and the number of fused bone grafts. Such changes may go on to influence the likelihood of adjacent-segment degeneration accordingly. Further studies are warranted to identify the causes and true impact of these observed changes.
    Journal of neurosurgery. Spine 11/2013; · 1.61 Impact Factor