Numerical Investigation of Spinal Cord Injury After Flexion-Distraction Injuries at the Cervical Spine.
J Biomech Eng
; 144(1)2022 01 01.
Article
em En
| MEDLINE
| ID: mdl-34369552
ABSTRACT
Flexion-distraction injuries frequently cause traumatic cervical spinal cord injury (SCI). Post-traumatic instability can cause aggravation of the secondary SCI during patient care. However, there is little information on how the pattern of disco-ligamentous injury affects the SCI severity and mechanism. This study objective was to analyze how posterior disco-ligamentous injuries affect spinal cord compression and stress and strain patterns in the spinal cord during post-traumatic flexion and extension. A cervical spine finite element model including the spinal cord was used and different combinations of partial or complete intervertebral disc (IVD) rupture and disruption of various posterior ligaments were modeled at C4-C5, C5-C6, or C6-C7. In flexion, complete IVD rupture combined with posterior ligamentous complex rupture was the most severe injury leading to the highest von Mises stress (47-66 kPa), principal strains p1 (0.32-0.41 in white matter) and p3 (-0.78 to -0.96 in white matter) in the spinal cord and the highest spinal cord compression (35-48%). The main post-trauma SCI mechanism was identified as the compression of the anterior white matter at the injured level combined with distraction of the posterior spinal cord during flexion. There was also a concentration of the maximum stresses in the gray matter during post-traumatic flexion. Finally, in extension, the injuries tested had little impact on the spinal cord. The capsular ligament was the most important structure to protect the spinal cord. Its status should be carefully examined during the patient's management.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Compressão da Medula Espinal
/
Traumatismos da Medula Espinal
/
Traumatismos da Coluna Vertebral
Limite:
Humans
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article