Evidence map›Paper›PMID 34429142›Full record

ArticleJournal of orthopaedic surgery and research2021

The biomechanical effect of preexisting different types of disc herniation in cervical hyperextension injury.

Jian-Jie Wang, Meng-Lei Xu, Hui-Zi Zeng, Liang-Dong Zheng, Shi-Jie Zhu, Chen Jin, Zhi-Li Zeng, Li-Ming Cheng, Rui Zhu

Open access · goldAbstract read
In one paragraph

Article in Journal of orthopaedic surgery and research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.8field-weighted citation impact, top 30% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 6 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 1 country.

Jian-Jie WangKey Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Orthopaedic Department of Tongji Hospital, Tongji University School of Medicine, 389 Xincun Road, 200065, Shanghai, People's Republic of China.
Meng-Lei XuKey Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Orthopaedic Department of Tongji Hospital, Tongji University School of Medicine, 389 Xincun Road, 200065, Shanghai, People's Republic of China.
Hui-Zi ZengKey Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Orthopaedic Department of Tongji Hospital, Tongji University School of Medicine, 389 Xincun Road, 200065, Shanghai, People's Republic of China.
Liang-Dong ZhengKey Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Orthopaedic Department of Tongji Hospital, Tongji University School of Medicine, 389 Xincun Road, 200065, Shanghai, People's Republic of China.
Shi-Jie ZhuKey Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Orthopaedic Department of Tongji Hospital, Tongji University School of Medicine, 389 Xincun Road, 200065, Shanghai, People's Republic of China.
Chen JinKey Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Orthopaedic Department of Tongji Hospital, Tongji University School of Medicine, 389 Xincun Road, 200065, Shanghai, People's Republic of China.
Zhi-Li ZengKey Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Orthopaedic Department of Tongji Hospital, Tongji University School of Medicine, 389 Xincun Road, 200065, Shanghai, People's Republic of China.
Li-Ming ChengKey Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Orthopaedic Department of Tongji Hospital, Tongji University School of Medicine, 389 Xincun Road, 200065, Shanghai, People's Republic of China. limingcheng@tongji.edu.cn.
Rui ZhuKey Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Orthopaedic Department of Tongji Hospital, Tongji University School of Medicine, 389 Xincun Road, 200065, Shanghai, People's Republic of China. zhurui08@hotmail.com.
Tongji Hospital · CNTongji University · CNShanghai Clinical Research Center · CN

Funding

national key r&d program of china 2020YFC2008703 and 2018YFB1105600national natural science foundation of china 81772337pilot project of clinical collaboration between chinese and western medicine of shanghai ZY(2018-2020)-FWTX-1005shanghai health and family planning system excellent young medical talents training program 2018YQ32youth science funds of shanghai municipal commission of health and family planning 20154Y0071
6 · The paper itself

Abstract

objectivePreexisting severe cervical spinal cord compression is a significant risk factor in cervical hyperextension injury, and the neurological function may deteriorate after a slight force to the forehead. There are few biomechanical studies regarding the influence of pathological factors in hyperextension loading condition. The aim of this study is to analyze the effects of preexisting different types of cervical disc herniation and different degrees of compression on the spinal cord in cervical hyperextension.

methodA 3D finite element (FE) model of cervical spinal cord was modeled. Local type with median herniation, local type with lateral herniation, diffuse type with median herniation, and diffuse type with lateral herniation were simulated in neutral and extention positions. The compressions which were equivalent to 10%, 20%, 30%, and 40% of the sagittal diameter of the spinal cord were modeled.

resultsThe results of normal FE model were consistent with those of previous studies. The maximum von Mises stresses appeared in the pia mater for all 32 loading conditions. The maximum von Mises stresses in extension position were much higher than in neutral position. In most cases, the maximum von Mises stresses in diffuse type were higher than in local type.

conclusionCervical spinal cord with preexisting disc herniation is more likely to be compressed in hyperextension situation than in neutral position. Diffuse type with median herniation may cause more severe compression with higher von Mises stresses concentrated at the anterior horn and the peripheral white matter, resulting in acute central cord syndrome from biomechanical point of view.

Indexed as

Cervical CordIntervertebral Disc DisplacementJoint DiseasesCervical VertebraeFinite Element AnalysisHumansSpinal CordCervical hyperextension injuryDisc herniationFinite elementSpinal cord

Identifiers

PMID34429142
PMCPMC8383414
OpenAlexW3195863363

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.