• J Spinal Cord Med · Jul 2012

    Biomechanical analysis of cervical spondylotic myelopathy: the influence of dynamic factors and morphometry of the spinal cord.

    • Norihiro Nishida, Yoshihiko Kato, Yasuaki Imajo, Syunichi Kawano, and Toshihiko Taguchi.
    • Yamaguchi University Graduate School of Medicine, Yamaguchi University, Japan. n005uk@yamaguchi-u.ac.jp
    • J Spinal Cord Med. 2012 Jul 1; 35 (4): 256-61.

    ObjectivePatients with cervical spondylotic myelopathy (CSM) have the same clinical symptoms that vary according to the degree of spinal cord compression and the cross-sectional cord shape. We used a three-dimensional finite element method (3D-FEM) to analyze the stress distributions of the spinal cord with neck extension under three cross-sectional cord shapes.MethodsExperimental condition for the 3D-FEM spinal cord, ligamentum flavum, and anterior compression shape (central, lateral, and diffuse types) was established. To simulate neck extension, the spinal cord was extended by 20° and the ligamentum flavum was shifted distally according to movement of the cephalad lamina.ResultsThe stress distribution in the spinal cord increased due to invagination of the ligamentum flavum into the neck extension. The range of stress distribution observed for the diffuse type was wider than for the central and lateral types. In addition, the stress distribution in the spinal cord was increased by the pincer movement of the ligamentum flavum and by the anterior compression of the spinal cord. The range of stress distribution observed for the diffuse type under antero-posterior compression was also wider than for the central and lateral types.ConclusionThis simulation model showed that the clinical symptoms of CSM due to compression of the diffuse type may be stronger than for the central and lateral types. Therefore, careful follow-up is recommended for anterior compression of the spinal cord of diffuse type.

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