Effects of Unilateral Graded Facetectomy of Facet Joints under Endoscope on Stability of Cervical Spine
10.16156/j.1004-7220.2024.03.004
- VernacularTitle:内镜下单侧小关节分级切除对颈椎节段稳定性影响
- Author:
Guangnan YANG
1
,
2
;
Jiang LIU
;
Qiang JIANG
;
Hanshuo ZHANG
;
Tusheng LI
;
Jingbo MA
;
Yu DING
Author Information
1. 华南理工大学医学院,广州 510006
2. 中国人民解放军总医院第六医学中心中医学部骨伤科,北京 100048
- Keywords:
cervical endoscopic surgery;
cervical spinal stenosis;
facet joints;
graded facetectomy
- From:
Journal of Medical Biomechanics
2024;39(3):400-406
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effect of facet joint resection at different ranges under endoscopy on the stability of the cervical spine and provide a biomechanical theoretical basis for clinical surgery.Methods A normal finite element model of the cervical spine C5-6 was established based on CT data,and unilateral facetectomy models with different ranges(0,25％,50％,75％,and 100％)of laminectomy were obtained(Models 1-5)by simulating cervical endoscopic surgery.The ranges of motion(ROMs)of C5-6 and the von Mises stresses of the discs for the models in each group were compared and analyzed.Results Except for flexion,Models 1 and 2 showed insignificant changes in ROMs and disc von Mises stresses in each direction compared with those of the normal model.Model 3 showed a noticeable increase in ROMs and disc von Mises stresses in each direction compared with those of the normal model:ROMs under flexion,extension,left lateral bending,right lateral bending,left rotation,and right rotation increased by 27％,4％,3％,13％,5％,and 16％,respectively,and von Mises stresses increased by 32％,4％,2％,5％,9％,and 5％,respectively.Models 4 and 5 exhibited a significant increase in the ROMs and disc von Mises stresses in each direction compared to the normal model.For Model 4,ROMs were increased by 27％,14％,6％,24％,7％,167％,and von Mises stresses were increased by 33％,13％,3％,32％,10％,130％.For Model 5,ROMs were increased by 27％,17％,6％,25％,7％,167％,and von Mises stresses were increased by 33％,29％,8％,33％,12％,138％.Conclusions As the range of unilateral facetectomy increased,cervical ROM and disc von Mises stress extremum gradually increased.The cervical spine shows a significant ROM increase and stress changes when facet joint resection on one side exceeds 1/2.More than 1/2 of the facet joint should be preserved during surgery to avoid medical instability.
