ArticleJournal of orthopaedic surgery and research2024
Biomechanical study of the stability of posterior cervical expansive open-door laminoplasty combined with bilateral C4/5 foraminotomy and short-segment lateral mass screw fixation: a finite element analysis.
Article in Journal of orthopaedic surgery and research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed.
- Finite element biomechanical evaluation of a novel double-door screw-plate system for posterior cervical laminoplasty.BMC musculoskeletal disorders · 2026Article
- Endoscopic posterior cervical canal decompression versus laminoplasty for two-level cervical spondylotic myelopathy: clinical outcomes and finite element analysis.Journal of orthopaedic surgery and research · 2026Article
- A novel posterior endoscopic cervical approach for treating cervical spondylotic radiculopathy: a finite-element analysis(C2-T1).Frontiers in bioengineering and biotechnology · 2025Article
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11 authors.
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Abstract
backgroundPosterior cervical expansive open-door laminoplasty (EODL) may cause postoperative C5 palsy, and it can be avoided by EODL with bilateral C4/5 foraminotomy. However, prophylactic C4/5 foraminotomy can compromise cervical spine stability. To prevent postoperative C5 palsy and boost cervical stability, We propose a new operation method: EODL combined with bilateral C4/5 foraminotomy and short-segment lateral mass screw fixation. However, there are no studies on the biomechanical properties of this surgery. PURPOSE: Evaluating the biomechanical characteristics of EODL combined with bilateral C4/5 foraminotomy and short-segment lateral mass screw fixation and other three classic surgery.
methodsAn original model (A) and four surgical models (B-E) of the C2-T1 vertebrae of a female patient were constructed. (B) EODL; (C) EODL combined with bilateral C4/5 foraminotomy; (D) C3-6 expansive open-door laminoplasty combined with bilateral C4/5 foraminotomy and short-segment lateral mass screw fixation; (E) C3-6 expansive open-door laminoplasty combined with bilateral C4/5 foraminotomy and C3-6 lateral mass screw system. To compare the biomechanical properties of cervical posterior internal fixation; (E) C3-6 expansive open-door laminoplasty combined with bilateral C4/5 foraminotomy and C3-6 lateral mass screw system. To compare the biomechanical properties of cervical posterior internal fixation methods, six physiological motion states were simulated for the five models using a 100N load force and 1.5Nm torque. The biomechanical advantages of the four internal fixation systems were evaluated by comparing the ranges of motion (ROMs) and maximum stresses.
resultsThe overall ROM of Model C outperformed the other four models, reaching a maximum ROM in the extension state of 10.59°±0.04°. Model C showed a significantly higher ROMs of C4/5 segment than other four models. Model D showed a significantly lower ROM of C4/5 segment than both Model B and Model C. Model E showed a significantly lower ROM of C4/5 segment than Model D. The stress in the four surgical models were mainly concentrated on the internal fixation systems.
conclusionEODL combined with bilateral C4/5 foraminotomy and short-segment lateral mass screw fixation can maintain the stability of the spine and has minimal effects on the patient's cervical spine ROMs in the extension and flexion state. As a result, it may be a promising treatment option for cervical spondylotic myelopathy (CSM) to prevention of postoperative C5 palsy.
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