Numerical investigation of the relative effect of disc bulging and ligamentum flavum hypertrophy on the mechanism of central cord syndrome
| Autor: | Nicolas Bailly, Lucien Diotalevi, Éric Wagnac, Marie-Hélène Beauséjour, Jean-Marc Mac-Thiong, Yvan Petit |
|---|---|
| Přispěvatelé: | Servei de Medicina Intensiva, Hospital Universitario Asociado General de Castellón, Hôpital du Sacré-Coeur de Montréal, International Laboratory on Spine Imaging and Biomechanics (iLab-Spine), Ecole de Technologie supérieur, Ecole de Technologie Supérieure, Université de Montréal (Department of Orthopaedic Surgery), Ecole Supérieure de Technologie, Ecole Technol Super, Dept Mech Engn, Montreal, PQ, Canada, Laboratoire de Biomécanique Appliquée (LBA UMR T24), Aix Marseille Université (AMU)-Université Gustave Eiffel, Department of Surgery, University of Montreal |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
musculoskeletal diseases [SDV.OT]Life Sciences [q-bio]/Other [q-bio.OT] Cord medicine.medical_treatment [SDV]Life Sciences [q-bio] Biophysics Central cord syndrome Strain (injury) cervical spine Muscle hypertrophy 03 medical and health sciences 0302 clinical medicine medicine Humans Orthopedics and Sports Medicine Spinal canal [PHYS.MECA.BIOM]Physics [physics]/Mechanics [physics]/Biomechanics [physics.med-ph] Intervertebral Disc Reduction (orthopedic surgery) ComputingMilieux_MISCELLANEOUS hyperextension business.industry spinal cord Intervertebral disc Hypertrophy 030229 sport sciences Anatomy medicine.disease Spinal cord musculoskeletal system spondylosis Ligamentum Flavum medicine.anatomical_structure medicine.symptom business 030217 neurology & neurosurgery |
| Zdroj: | Clinical Biomechanics Clinical Biomechanics, Elsevier, 2020, 74, pp.58-65. ⟨10.1016/j.clinbiomech.2020.02.008⟩ |
| ISSN: | 0268-0033 1879-1271 |
| DOI: | 10.1016/j.clinbiomech.2020.02.008⟩ |
| Popis: | International audience; Background: The pathogenesis of the central cord syndrome is still unclear. While there is a consensus on hyperextension as the main traumatic mechanism leading to this condition, there is yet to be consensus in studies regarding the pathological features of the spine (intervertebral disc bulging or ligamentum flavum hypertrophy) that could contribute to clinical manifestations. Methods: A comprehensive finite element model of the cervical spine segment and spinal cord was used to simulate high-speed hyperextension. Four stenotic cases were modelled to study the effect of ligamentum flavum hypertrophy and intervertebral disc bulging on the von Mises stress and strain. Findings: During hyperextension, the downward displacement of the ligamentum flavum and a reduction of the spinal canal diameter (up to 17%) led to a dynamic compression of the cord. Ligamentum flavum hypertrophy was associated with stress and strain (peak of 0.011 Mpa and 0.24, respectively) in the lateral corticospinal tracts, which is consistent with the histologic pattern of the central cord syndrome. Linear intervertebral disc bulging alone led to a higher stress in the anterior and posterior funiculi (peak 0.029 Mpa). Combined with hypertrophic ligamentum flavum, it further increased the stress and strain in the corticospinal tracts and in the posterior horn (peak of 0.023 Mpa and 0.35, respectively). Interpretation: The stenotic typology and geometry greatly influence stress and strain distribution resulting from hyperextension. Ligamentum flavum hypertrophy is a main feature leading to central cord syndrome. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect