Intradiscal Pressure Recordings in the Cervical Spine

Intradiscal Pressure Recordings in the Cervical Spine AbstractOBJECTIVE:Experimental investigations analyzing the biomechanics of the cervical spine are less common than similar studies of other regions of the spine. There are no reports on cervical intradiscal pressure (PID) measurements in vitro. We therefore wanted to establish normal values for PID under physiological conditions by simultaneous muscle force simulation. Moreover, the impact of ventral cervical fusion should be elucidated, because in clinical studies, it is a well-known phenomenon that the adjacent segments often show increased degenerative changes. We present a pilot study.METHODS:Seven human cervical spine specimens were tested biomechanically in a specially developed spine tester. Only pure moments were used for flexion/extension, axial rotation, and lateral bending (maximal moment ± 0.5 Nm). PID was measured simultaneously in C3-C4 and C5-C6. The specimens were tested as intact specimens and after discectomy and fusion in C4-C5. Both test situations were repeated with simulation of muscle forces.RESULTS:We found characteristic load-pressure curves for each of the three motion axes. In neutral position, PID correlated well with former published data from in vivo measurements. After fusion of C4-C5, there was a marked increase of PID in both adjacent segments (e.g., <180% for axial rotation). With muscle force simulation, the increase was even higher (e.g., <400% for axial rotation).CONCLUSION:For the first time, PID could be measured in the cervical spine in an experimental setting. The results obtained using normal specimens under physiological conditions confirmed those reported in two clinical studies. After cervical fusion, a marked increase in PID could be found in both adjacent segments. Presuming that an increase in PID had a negative effect on metabolism of the intervertebral disc, our results may help to explain why progressive degeneration occurs in these segments. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Neurosurgery Oxford University Press

Intradiscal Pressure Recordings in the Cervical Spine

Intradiscal Pressure Recordings in the Cervical Spine

Josef Pospiech, M .D ., Dietmar Stolke, M .D ., Hans J. W ilke, Ph.D., Lutz E. Claes, Ph.D. Department of Neurosurgery (JP, DS), University of Essen, Essen, and Institute for Traumatological Research and Biomechanics (HJW, LEC), University of Ulm, Ulm, Germany OBJECTIVE: Experimental investigations analyzing the biom echanics of the cervical spine are less common than similar studies of other regions of the spine. There are no reports on cervical intradiscal pressure (PID) measurements in vitro. W e therefore wanted to establish normal values for PID under physiological conditions by simultaneous muscle force simulation. M oreover, the impact of ventral cervical fusion should be elucidated, because in clinical studies, it is a well-known phenomenon that the adjacent segments often show increased degenerative changes. W e present a pilot study. METHODS: Seven human cervical spine specimens were tested biom echanically in a specially developed spine > 1 tester. Only pure moments w ere used for flexion/extension, axial rotation, and lateral bending (maximal 1 1 moment ± 0.5 Nm). PID was measured simultaneously in C 3 - C 4 and C 5 - C 6 . The specimens were tested as intact specimens and after discectom y and fusion in C 4 - C 5 . Both test situations were repeated with simulation of muscle forces. RESULTS: We found ch aracteristic load-pressure curves for each of the three motion axes. In neutral position, PID correlated well with former published data from in vivo measurements. After fusion of C 4 - C 5 , there was a marked increase of PID in both adjacent segments (e.g., < 1 8 0 % for axial rotation). With muscle force simulation, the increase was even higher (e.g., < 4 0 0 % for axial rotation). CONCLUSION: For the first time, PID could be measured in the cervical spine in an experimental setting. The results obtained using normal specim ens under physiological conditions confirmed those reported in two clinical studies. After cervical fusion, a...
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Publisher
Oxford University Press
Copyright
© Published by Oxford University Press.
ISSN
0148-396X
eISSN
1524-4040
D.O.I.
10.1097/00006123-199902000-00078
Publisher site
See Article on Publisher Site

Abstract

AbstractOBJECTIVE:Experimental investigations analyzing the biomechanics of the cervical spine are less common than similar studies of other regions of the spine. There are no reports on cervical intradiscal pressure (PID) measurements in vitro. We therefore wanted to establish normal values for PID under physiological conditions by simultaneous muscle force simulation. Moreover, the impact of ventral cervical fusion should be elucidated, because in clinical studies, it is a well-known phenomenon that the adjacent segments often show increased degenerative changes. We present a pilot study.METHODS:Seven human cervical spine specimens were tested biomechanically in a specially developed spine tester. Only pure moments were used for flexion/extension, axial rotation, and lateral bending (maximal moment ± 0.5 Nm). PID was measured simultaneously in C3-C4 and C5-C6. The specimens were tested as intact specimens and after discectomy and fusion in C4-C5. Both test situations were repeated with simulation of muscle forces.RESULTS:We found characteristic load-pressure curves for each of the three motion axes. In neutral position, PID correlated well with former published data from in vivo measurements. After fusion of C4-C5, there was a marked increase of PID in both adjacent segments (e.g., <180% for axial rotation). With muscle force simulation, the increase was even higher (e.g., <400% for axial rotation).CONCLUSION:For the first time, PID could be measured in the cervical spine in an experimental setting. The results obtained using normal specimens under physiological conditions confirmed those reported in two clinical studies. After cervical fusion, a marked increase in PID could be found in both adjacent segments. Presuming that an increase in PID had a negative effect on metabolism of the intervertebral disc, our results may help to explain why progressive degeneration occurs in these segments.

Journal

NeurosurgeryOxford University Press

Published: Feb 1, 1999

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