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. 2012 Oct;12(10):949-59.
doi: 10.1016/j.spinee.2012.08.013. Epub 2012 Sep 10.

Facet Joint Contact Pressure Is Not Significantly Affected by ProDisc Cervical Disc Arthroplasty in Sagittal Bending: A Single-Level Cadaveric Study

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Facet Joint Contact Pressure Is Not Significantly Affected by ProDisc Cervical Disc Arthroplasty in Sagittal Bending: A Single-Level Cadaveric Study

Joel A Bauman et al. Spine J. .

Abstract

Background context: Total disc arthroplasty is a motion-preserving spinal procedure that has been investigated for its impact on spinal motions and adjacent-level degeneration. However, the effects of disc arthroplasty on facet joint biomechanics remain undefined despite the critical role of these posterior elements on guiding and limiting spinal motion.

Purpose: The goal was to measure the pressure in the facet joint in cadaveric human cervical spines subjected to sagittal bending before and after implantation of the ProDisc-C (Synthes Spine Company, L.P, West Chester, PA, USA).

Study design: A biomechanical study was performed using cadaveric human cervical spines during sagittal bending in the intact and implanted conditions.

Methods: Seven C2-T1 osteoligamentous cadaveric cervical spines were instrumented with a transducer to measure the C5-C6 facet pressure profiles during physiological sagittal bending, before and after implantation of a ProDisc-C at that level. Rotations of the index segment and global cervical spine were also quantified.

Results: The mean C5-C6 range of motion significantly increased (p=.009) from 9.6°±5.1° in the intact condition to 16.2°±3.6° after implantation. However, despite such changes in rotation, there was no significant difference in the facet contact pressure during extension between the intact (64±30 kPa) and implanted (44±55 kPa) conditions. Similarly, there was no difference in facet pressure developed during flexion.

Conclusions: Although implantation of a ProDisc-C arthroplasty device at the C5-C6 level increases angular rotations, it does not significantly alter the local facet pressure at the index level in flexion or extension. Using a technique that preserves the capsular ligament, this study provides the first direct measurement of cervical facet pressure in a disc arthroplasty condition.

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