Cervical disc prostheses need a variable center of rotation for flexion / extension below disc level, plus a separate COR for lateral bending above disc level to more closely replicate in-vivo motion: MRI-based biomechanical in-vivo study

• Published in: BMC musculoskeletal disorders 2022-03, Vol.23 (1), p.227-227, Article 227
• Main Authors: Muhlbauer, Manfred K, Tomasch, Ernst, Sinz, Wolfgang, Trattnig, Siegfried, Steffan, Hermann
• Format: Article
• Language: English
• Subjects: Biomechanical Phenomena; Biomechanics; Cervical arthroplasty; Cervical disc prostheses; Cervical spine biomechanics; Cervical Vertebrae - diagnostic imaging; Cervical Vertebrae - physiology; Cervical Vertebrae - surgery; Humans; In-vivo kinematic study; Intervertebral Disc - diagnostic imaging; Intervertebral Disc - physiology; Intervertebral Disc - surgery; Magnetic Resonance Imaging; Mechanical properties; Orthopedic implants; Physiological aspects; Prosthesis Design; Range of Motion, Articular - physiology; Rotation; Spine; Surgery; Surgery, Experimental; Surgical research; Vertebrae, Cervical
• ISSN: 1471-2474; 1471-2474
• DOI: 10.1186/s12891-022-05121-2

Cervical disc prostheses are used to preserve motion after discectomy, but they should also provide a near-physiological qualitative motion pattern. Nevertheless, they come in many completely different biomechanical concepts. This caused us to perform an in-vivo MR-based biomechanical study to further investigate cervical spine motion with the aim to gain new information for improving the design of future cervical arthroplasty devices. Fifteen healthy volunteers underwent MRI-investigation (in order to avoid radiation exposure) of their cervical spines from C3 to C7; for each segment centers of rotation (COR) for flexion / extension were determined from 5 different positions, and CORs for lateral bending from 3 different positions. The motion path of the COR is then described and illustrated in relation to the respective COR for maximum flexion / extension or lateral bending, respectively, and the findings are translated into implications for a better biomechanical prosthesis-design. The COR for flexion / extension does not remain constant during motion. The CORs for the respective motion intervals were always found at different positions than the COR for maximum flexion /extension showing that the COR moves both along the x- and the y-axis throughout flexion / extension. For lateral bending a completely independent COR was found above disc-level. Flexion / extension is not a simple circular motion. Disc prostheses need a variable COR for flexion / extension below disc level with the capability to move both along the x- and the y-axis during motion, plus a second completely independent COR for lateral bending above disc level to closely replicate in-vivo motion. These findings are important for improving the biomechanical design of such devices in the future.