Motion response of a polycrystalline diamond adaptive axis of rotation cervical total disc arthroplasty |
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| Affiliation: | 1. Edward Hines Jr. VA Hospital, Hines, IL, USA;2. Loyola University Medical Center, Maywood, IL, USA;3. Dymicron, Inc., Orem, UT, USA;1. Department of Orthopaedics and Rehabilitation, Penn State College of Medicine, Hershey Medical Center, 500 University Drive, Mail Code H089, Hershey, PA 17033, USA;2. Department of Public Health Sciences, Penn State College of Medicine, 500 University Drive, Hershey, PA 17033, USA;1. Department of Bioengineering, University of Pennsylvania, 210 S. 33rd St., 240 Skirkanich Hall, Philadelphia, PA 19104-6321, USA;2. Academic Department of Neuropathology, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK;1. Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan;2. Department of Orthopaedic Surgery, Yawata Central Hospital, 39-1 Gotanda, Yawata-shi, Kyoto, Japan;1. Department of Biomedical Engineering, University of Shanghai for Science and Technology, 516 JunGong Road, Shanghai, China;2. Department of Orthopedic Surgery, YanBian University Hospital, China;3. Department of Biomedical Engineering, College of Biomedical Science & Engineering, Inje University, 607 O-bang, Gyongnam, Republic of Korea;4. Department of Neurosurgery, College of medicine, The Catholic University of Korea, 222 Banpo-Daero, Seoul, Republic of Korea |
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| Abstract: | BackgroundCervical fusion is associated with adjacent segment degeneration. Cervical disc arthroplasty is considered an alternative to reduce risk of adjacent segment disease. Kinematics after arthroplasty should closely replicate healthy in vivo kinematics to reduce adjacent segment stresses. The purpose of this study was to assess the kinematics of a polycrystalline diamond cervical disc prosthesis.MethodsNine cadaveric C3–T1 spines were tested intact and after one (C5–C6) and two level (C5–C7) arthroplasty (Triadyme-C, Dymicron Inc., Orem, UT, USA). Kinematics were evaluated in flexion-extension, lateral bending, and axial rotation.FindingsProsthesis placement at C5–C6 and C6–C7 was 0.5 mm anterior and 0.6 mm posterior to midline respectively. C5–C6 flexion-extension motion was 12.8° intact and 10.5° after arthroplasty. C6–C7 flexion-extension motion was 10.0 and 11.4° after arthroplasty.C5–C6 lateral bending reduced from 8.5 to 3.7° after arthroplasty and at C6–C7 from 7.5 to 5.1°. C5–C6 axial rotation decreased from 10.4 to 6.2° after arthroplasty and at C6–C7 from 7.8 to 5.3°.Segmental lordosis increased by 4.2°, and middle disc height by 1.4 mm after arthroplasty. Change in center of rotation from intact to arthroplasty averaged 0.9 mm posteriorly and 0.1 mm caudally at C5–C6, and 1.4 mm posteriorly and 0.3 mm cranially at C6–C7.InterpretationThe cervical disc arthroplasty evaluated restored flexion-extension motion to intact levels and moderately increased segmental stiffness. Disc height increased by up to 1.5 mm and segmental lordosis by 4.2°. The unique prosthesis design allowed the axis of rotation after arthroplasty to closely mimic the native location. |
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