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Unique biomechanical signatures of Bryan, Prodisc C, and Prestige LP cervical disc replacements: a finite element modelling study

  • Hoon ChoiEmail author
  • Yuvaraj Purushothaman
  • Jamie Baisden
  • Narayan Yoganandan
Original article

Abstract

Purpose

The purpose of the study is to examine the biomechanical alterations in the index and adjacent levels of the human cervical spine after cervical arthroplasty with Bryan, Prodisc C, or Prestige LP.

Methods

A previously validated C2–T1 osteoligamentous finite element model was used to perform virtual C5–6 arthroplasty using three different FDA-approved artificial cervical discs. Motion-controlled moment loading protocol was used. Moment was varied until Bryan, Prodisc C, and Prestige LP models displayed the same total range of motion across C3–C7 as the intact spine model at 2 Nm of pure moment loading. Range of motion (ROM) and facet force (FF) were recorded at the index level. ROM, FF, and intradiscal pressure (IDP) were recorded at the adjacent levels.

Results

Prodisc C and Prestige LP led to supraphysiologic ROM and FF at the index level while decreasing ROM and FF at the adjacent levels. In contrast, Bryan reduced ROM and FF at the index level. Bryan increased ROM and FF at the adjacent levels in flexion, but decreased ROM and FF in the adjacent levels in extension. Prodisc C decreased IDP at the adjacent levels. Bryan reduced IDP in extension only. Prestige LP increased adjacent-level IDP.

Conclusions

The distinct designs and material compositions of the three artificial discs result in varying biomechanical alterations at the index and adjacent levels in the cervical spine after implantation. The findings confirm the design and material influence on the spine biomechanics, as well as the advantages and contraindications of cervical arthroplasty in general.

Graphic abstract

These slides can be retrieved under Electronic Supplementary Material.

Keywords

Cervical artificial disc Cervical arthroplasty Cervical total disc replacement Finite element modelling Biomedical engineering 

Abbreviations

ACDF

Anterior cervical discectomy and fusion

ROM

Range of motion

IDP

Intradiscal pressure

FF

Facet force

FEM

Finite element modeling

Notes

Acknowledgements

This material is the result of work supported by the U.S. Department of Defense, Medical Research and Materiel Command, Grant W81XWH-16-1-0010, with the resources and use of facilities at the Zablocki VA Medical Center, Milwaukee, Wisconsin, and the Center for NeuroTrauma Research (CNTR) from the Department of Neurosurgery. The last author is a part-time employee of the VA Medical Center, Milwaukee, Wisconsin. Any views expressed in this article are those of the authors and not necessarily representative of the funding organizations.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

586_2019_6113_MOESM1_ESM.pptx (1.9 mb)
Supplementary file1 (PPTX 1941 kb)

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Copyright information

© This is a U.S. government work and its text is not subject to copyright protection in the United States; however, its text may be subject to foreign copyright protection 2019

Authors and Affiliations

  1. 1.Department of NeurosurgeryMedical College of WisconsinMilwaukeeUSA
  2. 2.School of Mechanical and Building ScienceVIT University, Chennai CampusChennaiIndia

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