Influence of cervical spine sagittal alignment on range of motion after corpectomy: a finite element study

Background Sagittal alignment of the cervical spine might influence the development of radiological adjacent segment pathology (RASP) after central corpectomy (CC). Range of motion (ROM) of the adjacent segments is closely linked to the development of RASP. Methods To investigate the ROM of the adja...

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Bibliographic Details
Published in:Acta neurochirurgica 2021-01, Vol.163 (1), p.251-257
Main Authors: John, Jobin D., Kumar, Gurunathan Saravana, Yoganandan, Narayan, Rajshekhar, Vedantam
Format: Article
Language:English
Subjects:
Adult
Cervical Vertebrae - diagnostic imaging
Cervical Vertebrae - surgery
Female
Finite Element Analysis
Humans
Interventional Radiology
Kyphosis
Kyphosis - diagnostic imaging
Lordosis - diagnostic imaging
Male
Mathematical models
Medicine
Medicine & Public Health
Minimally Invasive Surgery
Neurology
Neuroradiology
Neurosurgery
Original Article - Spine - Other
Postoperative Complications - diagnostic imaging
Radiography - methods
Range of motion
Range of Motion, Articular
Spine (cervical)
Spine - Other
Surgical Orthopedics
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Summary:Background Sagittal alignment of the cervical spine might influence the development of radiological adjacent segment pathology (RASP) after central corpectomy (CC). Range of motion (ROM) of the adjacent segments is closely linked to the development of RASP. Methods To investigate the ROM of the adjacent segments after CC, we developed a C2-T1 finite element (FE) model. The model with a lordotic sagittal alignment served as the baseline model. Models with straight and kyphotic alignment were generated using mesh morphing methods. Single-level corpectomy at C5 was done on these models. Segmental ROMs of intact and corpectomized spines were compared for physiologic flexion-extension loads. Results The flexion ROM decreased by an average of 13% with the change in sagittal alignment from lordosis to kyphosis; however, a consistent decrease was not observed in extension. After CC, the ROM increased by an average of 95% and 31% in the superior and inferior adjacent segments. With kyphotic change in the sagittal alignment, the postoperative increase in flexion ROM exhibited a decreasing trend, while this was not seen in extension. Conclusions Kyphotic changes of the intact spine resulted in segmental stiffening, and after corpectomy, it resulted in inconsistent variations of segmental extension ROMs.
ISSN:0001-6268
0942-0940
DOI:10.1007/s00701-020-04619-9