Kinematics of cervical spine discectomy with and without bone grafting: Quantitative evaluation of late fusion in a sheep model

E. Jian Lee, Yu Chang Hung, Ming Yang Lee, Jing Jou Yan, Yei Tae Lee, Jia Hao Chang, Guan Liang Chang, Kao Chi Chung

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

OBJECTIVE: This study was conducted to evaluate the kinematic response of late fusion results for cervical spine discectomies with and without bone grafting. MATERIALS AND METHODS: Fifteen Barbados Black Belly sheep underwent sham operations (Group A, n = 5), C2-C3 discectomies only (Group B, n = 5), and C2-C3 discectomies with autologous iliac bone grafting (Group C, n = 5). Ten months after surgery, the animals were killed. Fresh ligamentous spines (C1-C5) were subjected to the relevantly applied loads through a loading frame attached to the C1. Each vertebra (from C2 to C4) was attached with a set of three infrared light-emitting diodes to record the spatial location relating to each load application using a Selspot II system (Selcom Selective Electronics, Inc., Valdese, NC). The load-deformation data of the C2-C3 and C3-C4 motion segments were recorded and analyzed for the three groups. RESULTS: At the C2-C3 motion segment, the results indicated that Group B displayed larger motion ranges of rotation and lateral bending loads than did the other two groups. Significantly larger motion ranges of rotation loads were found in Group B than in Group C (P < 0.05, for both comparisons). In contrast, Group C had the smallest motion ranges of flexion, lateral bending, and rotation loads. At the C3-C4 motion segment, both groups that had undergone discectomies had a significantly larger motion range of flexion load corn pared with Group A (P < 0.05, for both comparisons). A significant increase in the motion range of right axial rotation was found in Group B (P < 0.05), but not in Group C, compared with Group A. Group B exhibited larger motion ranges responding to all six tested loads than did Group C. CONCLUSION: The results indicate that anterior fusion after C2-C3 cervical discectomies, regardless of the presence or absence of bone grafting, decreases the motion range of flexion load at the C2-C3 motion segment, and contrary data were seen at the C3-C4 motion segment. For axial rotation loads, discectomies without bone grafting resulted in increased motion ranges of both C2-C3 and C3-C4 motion segments whereas discectomies with bone grafting did not. The data may have clinical relevance regarding the role of bone grafting in cases of cervical spine disease.

Original languageEnglish
Pages (from-to)139-147
Number of pages9
JournalNeurosurgery
Volume44
Issue number1
DOIs
Publication statusPublished - 1999 Jan

Keywords

  • Bone grafting
  • Cervical discectomy
  • Kinematics

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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