title: Effect of posterior decompression extent on biomechanical parameters of the spinal cord in cervical ossification of the posterior longitudinal ligament.
abstract: Ossification of the posterior longitudinal ligament is a common cause of the cervical myelopathy due to compression of the spinal cord. Patients with ossification of the posterior longitudinal ligament usually require the decompression surgery, and there is a need to better understand the optimal surgical extent with which sufficient decompression without excessive posterior shifting can be achieved. However, few quantitative studies have clarified this optimal extent for decompression of cervical ossification of the posterior longitudinal ligament. We used finite element modeling of the cervical spine and spinal cord to investigate the effect of posterior decompression extent for continuous-type cervical ossification of the posterior longitudinal ligament on changes in stress, strain, and posterior shifting that occur with three different surgical methods (laminectomy, laminoplasty, and hemilaminectomy). As posterior decompression extended, stress and strain in the spinal cord decreased and posterior shifting of the cord increased. The location of the decompression extent also influenced shifting. Laminectomy and laminoplasty were very similar in terms of decompression results, and both were superior to hemilaminectomy in all parameters tested. Decompression to the extents of C3-C6 and C3-C7 of laminectomy and laminoplasty could be considered sufficient with respect to decompression itself. Our findings provide fundamental information regarding the treatment of cervical ossification of the posterior longitudinal ligament and can be applied to patient-specific surgical planning.
authors.affiliation: Department of Mechanical Engineering, Kyung Hee University, Yongin, Korea.
authors.forename: Batbayar
authors.initials: B
authors.lastname: Khuyagbaatar
authors.affiliation: Department of Applied Mathematics, Kyung Hee University, Yongin, Korea.
authors.forename: Kyungsoo
authors.initials: K
authors.lastname: Kim
authors.affiliation: Department of Mechanical Engineering, Kyung Hee University, Yongin, Korea.
authors.forename: Won Man
authors.initials: WM
authors.lastname: Park
authors.affiliation: Department of Mechanical Engineering, Kyung Hee University, Yongin, Korea yoonhkim@khu.ac.kr.
authors.forename: Yoon Hyuk
authors.initials: YH
authors.lastname: Kim
mesh_terms: D001696:Biomechanical Phenomena; D002574:Cervical Vertebrae / Q000503:physiopathology / Q000601:surgery; D019299:Decompression, Surgical / Q000379:methods; D020342:Finite Element Analysis; D006801:Humans; D007796:Laminectomy; D065406:Laminoplasty; D017846:Longitudinal Ligaments / Q000503:physiopathology / Q000601:surgery; D008953:Models, Anatomic; D017887:Ossification of Posterior Longitudinal Ligament / Q000503:physiopathology* / Q000601:surgery*; D013116:Spinal Cord / Q000503:physiopathology / Q000601:surgery; D013117:Spinal Cord Compression / Q000503:physiopathology / Q000601:surgery
keywords: Spine biomechanics; clinical outcome prediction; finite element modeling/analysis; modeling/simulation; orthopedic procedures