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Spine J. 2012 Oct;12(10):949-59. doi: 10.1016/j.spinee.2012.08.013. Epub 2012 Sep 10.

Facet joint contact pressure is not significantly affected by ProDisc cervical disc arthroplasty in sagittal bending: a single-level cadaveric study.

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1
Department of Neurosurgery, 3 Silverstein Hospital of the University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104, USA.

Abstract

BACKGROUND CONTEXT:

Total disc arthroplasty is a motion-preserving spinal procedure that has been investigated for its impact on spinal motions and adjacent-level degeneration. However, the effects of disc arthroplasty on facet joint biomechanics remain undefined despite the critical role of these posterior elements on guiding and limiting spinal motion.

PURPOSE:

The goal was to measure the pressure in the facet joint in cadaveric human cervical spines subjected to sagittal bending before and after implantation of the ProDisc-C (Synthes Spine Company, L.P, West Chester, PA, USA).

STUDY DESIGN:

A biomechanical study was performed using cadaveric human cervical spines during sagittal bending in the intact and implanted conditions.

METHODS:

Seven C2-T1 osteoligamentous cadaveric cervical spines were instrumented with a transducer to measure the C5-C6 facet pressure profiles during physiological sagittal bending, before and after implantation of a ProDisc-C at that level. Rotations of the index segment and global cervical spine were also quantified.

RESULTS:

The mean C5-C6 range of motion significantly increased (p=.009) from 9.6°±5.1° in the intact condition to 16.2°±3.6° after implantation. However, despite such changes in rotation, there was no significant difference in the facet contact pressure during extension between the intact (64±30 kPa) and implanted (44±55 kPa) conditions. Similarly, there was no difference in facet pressure developed during flexion.

CONCLUSIONS:

Although implantation of a ProDisc-C arthroplasty device at the C5-C6 level increases angular rotations, it does not significantly alter the local facet pressure at the index level in flexion or extension. Using a technique that preserves the capsular ligament, this study provides the first direct measurement of cervical facet pressure in a disc arthroplasty condition.

PMID:
22975463
DOI:
10.1016/j.spinee.2012.08.013
[Indexed for MEDLINE]
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