TY - JOUR
T1 - Biomechanical Effects on Cervical Spinal Cord and Nerve Root Following Laminoplasty for Ossification of the Posterior Longitudinal Ligament in the Cervical Spine
T2 - A Comparison Between Open-Door and Double-Door Laminoplasty Using Finite Element Analysis
AU - Khuyagbaatar, Batbayar
AU - Kim, Kyungsoo
AU - Purevsuren, Tserenchimed
AU - Lee, Sang Hun
AU - Kim, Yoon Hyuk
N1 - Funding Information:
• National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIP) (NRF-2017R1E1A1A03070418).
Publisher Copyright:
© 2018 by ASME.
Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2018/7/1
Y1 - 2018/7/1
N2 - Many clinical case series have reported the predisposing factors for C5 palsy and have presented comparisons of the two types of laminoplasty. However, there have been no biomechanical studies focusing on cervical spinal cord and nerve root following laminoplasty. The purpose of this study is to investigate biomechanical changes in the spinal cord and nerve roots following the two most common types of laminoplasty, open-door and double-door laminoplasty, for cervical ossification of the posterior longitudinal ligament (OPLL). A finite element (FE) model of the cervical spine and spinal cord with nerve root complex structures was developed. Stress changes in the spinal cord and nerve roots, posterior shift of the spinal cord, and displacement of the cervical nerve roots were analyzed with two types of cervical laminoplasty models for variations in the degree of canal occupying ratio and shape of the OPLL. The shape and degree of spinal cord compression caused by the OPLL had more influence on the changes in stress, posterior shift of the spinal cord, and displacement of the nerve root than the type of laminoplasty. The lateral-type OPLL resulted in imbalanced stress on the nerve roots and the highest nerve root displacement. Type of laminoplasty and shape and degree of spinal cord compression caused by OPLL were found to influence the changes in stress and posterior displacement of the cervical spinal cord and nerve roots. Lateral-type OPLL might contribute to the development of C5 palsy due to the imbalanced stress and tension on the nerve roots after laminoplasty.
AB - Many clinical case series have reported the predisposing factors for C5 palsy and have presented comparisons of the two types of laminoplasty. However, there have been no biomechanical studies focusing on cervical spinal cord and nerve root following laminoplasty. The purpose of this study is to investigate biomechanical changes in the spinal cord and nerve roots following the two most common types of laminoplasty, open-door and double-door laminoplasty, for cervical ossification of the posterior longitudinal ligament (OPLL). A finite element (FE) model of the cervical spine and spinal cord with nerve root complex structures was developed. Stress changes in the spinal cord and nerve roots, posterior shift of the spinal cord, and displacement of the cervical nerve roots were analyzed with two types of cervical laminoplasty models for variations in the degree of canal occupying ratio and shape of the OPLL. The shape and degree of spinal cord compression caused by the OPLL had more influence on the changes in stress, posterior shift of the spinal cord, and displacement of the nerve root than the type of laminoplasty. The lateral-type OPLL resulted in imbalanced stress on the nerve roots and the highest nerve root displacement. Type of laminoplasty and shape and degree of spinal cord compression caused by OPLL were found to influence the changes in stress and posterior displacement of the cervical spinal cord and nerve roots. Lateral-type OPLL might contribute to the development of C5 palsy due to the imbalanced stress and tension on the nerve roots after laminoplasty.
KW - C5 palsy
KW - biomechanics
KW - finite element analysis
KW - laminoplasty
KW - ossification of the posterior longitudinal ligament
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U2 - 10.1115/1.4039826
DO - 10.1115/1.4039826
M3 - Article
C2 - 29677281
AN - SCOPUS:85046633703
SN - 0148-0731
VL - 140
JO - Journal of Biomechanical Engineering
JF - Journal of Biomechanical Engineering
IS - 7
M1 - 071006
ER -