Three-dimensional kinematic analysis of the cervical spine after anterior cervical decompression and fusion at an adjacent level: A preliminary report

Sadayoshi Watanabe, Nozomu Inoue, Tomonori Yamaguchi, Yoshitaka Hirano, Alejandro A.Espinoza Orías, Shintaro Nishida, Yuichi Hirose, Junichi Mizuno

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Purpose Development of adjacent segment degeneration following anterior cervical decompression and fusion (ACDF) is still controversial, as adjacent-level kinematics is poorly understood. This study reports preliminary data from a high-accuracy 3D analysis technique developed for in vivo cervical kinematics. Methods From nine cervical spondylosis patients, four underwent single-level ACDF, and five underwent two-level ACDF using cylindrical titanium cage implant(s). Pre- and post-surgical CT scans were taken in flexion, neutral and extended positions, allowing us to compute segmental ranges of motion for rotation and translation, and 3D disc-height distributions. Differences in segmental motions and disc-height between fused and adjacent levels were analyzed with a Wilcoxon signed-rank test.Results are presented as mean ± SEM. Results The flexion/extension angular-ROM at the fusion level decreased after surgery (7.46 ± 1.17° vs. 3.14 ± 0.56°, p\0.003). The flexion/extension angular-ROM at one caudal adjacent level to the fusion level (3.97 ± 1.29°) tended to be greater post-operatively (6.11 ± 1.44°, p = 0.074). Translation in the anterior-posterior direction during flexion/ extension at the fusion level decreased after surgery (1.22 ± 0.20 mm vs. 0.32 ± 0.11 mm, p\0.01). No differences were found in adjacent-level disc heights between both study time-points. Conclusions This study showed increased segmental motion in flexion/extension angular-ROM at one level adjacent to ACDF. However, increases in the rotational angular-ROM were not statistically significant when cranial/ caudal adjacent levels were analyzed separately. This preliminary study highlighted the capabilities of a 3Dkinematic analysis method to detect subtle changes in kinematics and disc height at the adjacent levels to ACDF. Thus, reliable evidence related to ACDF's influence on adjacent-level cervical kinematics can be collected.

Original languageEnglish
Pages (from-to)946-955
Number of pages10
JournalEuropean Spine Journal
Volume21
Issue number5
DOIs
Publication statusPublished - 01-05-2012

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Decompression
Biomechanical Phenomena
Spine
Spondylosis
Nonparametric Statistics
Articular Range of Motion
Titanium

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Watanabe, Sadayoshi ; Inoue, Nozomu ; Yamaguchi, Tomonori ; Hirano, Yoshitaka ; Orías, Alejandro A.Espinoza ; Nishida, Shintaro ; Hirose, Yuichi ; Mizuno, Junichi. / Three-dimensional kinematic analysis of the cervical spine after anterior cervical decompression and fusion at an adjacent level : A preliminary report. In: European Spine Journal. 2012 ; Vol. 21, No. 5. pp. 946-955.
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abstract = "Purpose Development of adjacent segment degeneration following anterior cervical decompression and fusion (ACDF) is still controversial, as adjacent-level kinematics is poorly understood. This study reports preliminary data from a high-accuracy 3D analysis technique developed for in vivo cervical kinematics. Methods From nine cervical spondylosis patients, four underwent single-level ACDF, and five underwent two-level ACDF using cylindrical titanium cage implant(s). Pre- and post-surgical CT scans were taken in flexion, neutral and extended positions, allowing us to compute segmental ranges of motion for rotation and translation, and 3D disc-height distributions. Differences in segmental motions and disc-height between fused and adjacent levels were analyzed with a Wilcoxon signed-rank test.Results are presented as mean ± SEM. Results The flexion/extension angular-ROM at the fusion level decreased after surgery (7.46 ± 1.17° vs. 3.14 ± 0.56°, p\0.003). The flexion/extension angular-ROM at one caudal adjacent level to the fusion level (3.97 ± 1.29°) tended to be greater post-operatively (6.11 ± 1.44°, p = 0.074). Translation in the anterior-posterior direction during flexion/ extension at the fusion level decreased after surgery (1.22 ± 0.20 mm vs. 0.32 ± 0.11 mm, p\0.01). No differences were found in adjacent-level disc heights between both study time-points. Conclusions This study showed increased segmental motion in flexion/extension angular-ROM at one level adjacent to ACDF. However, increases in the rotational angular-ROM were not statistically significant when cranial/ caudal adjacent levels were analyzed separately. This preliminary study highlighted the capabilities of a 3Dkinematic analysis method to detect subtle changes in kinematics and disc height at the adjacent levels to ACDF. Thus, reliable evidence related to ACDF's influence on adjacent-level cervical kinematics can be collected.",
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Three-dimensional kinematic analysis of the cervical spine after anterior cervical decompression and fusion at an adjacent level : A preliminary report. / Watanabe, Sadayoshi; Inoue, Nozomu; Yamaguchi, Tomonori; Hirano, Yoshitaka; Orías, Alejandro A.Espinoza; Nishida, Shintaro; Hirose, Yuichi; Mizuno, Junichi.

In: European Spine Journal, Vol. 21, No. 5, 01.05.2012, p. 946-955.

Research output: Contribution to journalArticle

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T1 - Three-dimensional kinematic analysis of the cervical spine after anterior cervical decompression and fusion at an adjacent level

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AU - Watanabe, Sadayoshi

AU - Inoue, Nozomu

AU - Yamaguchi, Tomonori

AU - Hirano, Yoshitaka

AU - Orías, Alejandro A.Espinoza

AU - Nishida, Shintaro

AU - Hirose, Yuichi

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N2 - Purpose Development of adjacent segment degeneration following anterior cervical decompression and fusion (ACDF) is still controversial, as adjacent-level kinematics is poorly understood. This study reports preliminary data from a high-accuracy 3D analysis technique developed for in vivo cervical kinematics. Methods From nine cervical spondylosis patients, four underwent single-level ACDF, and five underwent two-level ACDF using cylindrical titanium cage implant(s). Pre- and post-surgical CT scans were taken in flexion, neutral and extended positions, allowing us to compute segmental ranges of motion for rotation and translation, and 3D disc-height distributions. Differences in segmental motions and disc-height between fused and adjacent levels were analyzed with a Wilcoxon signed-rank test.Results are presented as mean ± SEM. Results The flexion/extension angular-ROM at the fusion level decreased after surgery (7.46 ± 1.17° vs. 3.14 ± 0.56°, p\0.003). The flexion/extension angular-ROM at one caudal adjacent level to the fusion level (3.97 ± 1.29°) tended to be greater post-operatively (6.11 ± 1.44°, p = 0.074). Translation in the anterior-posterior direction during flexion/ extension at the fusion level decreased after surgery (1.22 ± 0.20 mm vs. 0.32 ± 0.11 mm, p\0.01). No differences were found in adjacent-level disc heights between both study time-points. Conclusions This study showed increased segmental motion in flexion/extension angular-ROM at one level adjacent to ACDF. However, increases in the rotational angular-ROM were not statistically significant when cranial/ caudal adjacent levels were analyzed separately. This preliminary study highlighted the capabilities of a 3Dkinematic analysis method to detect subtle changes in kinematics and disc height at the adjacent levels to ACDF. Thus, reliable evidence related to ACDF's influence on adjacent-level cervical kinematics can be collected.

AB - Purpose Development of adjacent segment degeneration following anterior cervical decompression and fusion (ACDF) is still controversial, as adjacent-level kinematics is poorly understood. This study reports preliminary data from a high-accuracy 3D analysis technique developed for in vivo cervical kinematics. Methods From nine cervical spondylosis patients, four underwent single-level ACDF, and five underwent two-level ACDF using cylindrical titanium cage implant(s). Pre- and post-surgical CT scans were taken in flexion, neutral and extended positions, allowing us to compute segmental ranges of motion for rotation and translation, and 3D disc-height distributions. Differences in segmental motions and disc-height between fused and adjacent levels were analyzed with a Wilcoxon signed-rank test.Results are presented as mean ± SEM. Results The flexion/extension angular-ROM at the fusion level decreased after surgery (7.46 ± 1.17° vs. 3.14 ± 0.56°, p\0.003). The flexion/extension angular-ROM at one caudal adjacent level to the fusion level (3.97 ± 1.29°) tended to be greater post-operatively (6.11 ± 1.44°, p = 0.074). Translation in the anterior-posterior direction during flexion/ extension at the fusion level decreased after surgery (1.22 ± 0.20 mm vs. 0.32 ± 0.11 mm, p\0.01). No differences were found in adjacent-level disc heights between both study time-points. Conclusions This study showed increased segmental motion in flexion/extension angular-ROM at one level adjacent to ACDF. However, increases in the rotational angular-ROM were not statistically significant when cranial/ caudal adjacent levels were analyzed separately. This preliminary study highlighted the capabilities of a 3Dkinematic analysis method to detect subtle changes in kinematics and disc height at the adjacent levels to ACDF. Thus, reliable evidence related to ACDF's influence on adjacent-level cervical kinematics can be collected.

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