(2016JY03) Huang Xue-cheng, Ye Lin-qiang, Liang De, Wang Qian-li, Yu Wei-bo, Jiang Xiao-bing

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1 Chinese Journal of Tissue Engineering Research ( ) DOI: /j.issn ORCID: () () () :R318 A CT Mimics10.01Geomagic Studio Solidworks 14.0 C CAD Ansys Workbench mm 0.77 mm 0.71 mm 0.43 mm ( ) (2016JY03) Effect of cervical rotatory direction on the displacement of cervical disc and the volume of intervertebral foramen in a three-dimensional finite element model Huang Xue-cheng, Ye Lin-qiang, Liang De, Wang Qian-li, Yu Wei-bo, Jiang Xiao-bing ( First Clinical Medicine School, Guangdong Province, China; First Affiliated Hospital, Guangdong Province, China) Huang Xue-cheng, Studying for doctorate, First Clinical Medicine School, Guangdong Province, China; First Affiliated Hospital, Guangdong Province, China Corresponding author: Jiang Xiao-bing, M.D., Associate chief physician, Associate professor, Master s supervisor, First Affiliated Hospital, Guangdong Province, China 404 : (2018)

2 Huang XC, Ye LQ, Liang D, Wang QL, Yu WB, Jiang XB. Effect of cervical rotatory direction on the displacement of cervical disc and the volume of intervertebral foramen in a three-dimensional finite element model Zhongguo Zuzhi Gongcheng Yanjiu. 2018;22(3): DOI: /j.issn Abstract BACKGROUND: Cervical spondylotic radiculopathy could be effectively treated by cervical rotatory manipulation, but the symptoms may be exacerbated when rotated to the wrong direction. OBJECTIVE: To simulate the cervical rotatory manipulation in left/right rotation by three-dimensional finite element, and then investigate the effect of this manipulation on the displacement of cervical disc and the volume of intervertebral foramen so as to provide a basis for effectiveness and safety of cervical rotatory manipulation in treating cervical spondylotic radiculopathy. METHODS: With Mimics10.01, Geomagic Studio and Solidworks 14.0 software, a three-dimensional geometric CAD model of C was developed from the CT scan images of a 25-year-old normal adult female. The model was imported into Ansys Workbench 14.5, and a three-dimensional finite element model was verified and simulated the cervical rotatory manipulation. The cervical rotatory manipulation was decomposed by principium of manipulation in left lateral flexion and rotated to the left/right side. The parameter of mechanics was analyzed with the finite element system. The change of displacement in cervical disc and volume in intervertebral foramen simultaneously were displayed during simulating the manipulation. RESULTS AND CONCLUSION: In left lateral flexion and rotated to the left side, the posterior part of the left side of annulus fibers was expanded 0.46 mm into posterior, and the posterior part of the right side of annulus fibers was retracted 0.77 mm. The volume of left intervertebral foramen became small and the right side became large. However, in left lateral flexion and rotated to the right side, the posterior part of the left side of annulus fibers was retracted 0.71 mm, and the posterior part of the right side of annulus fibers was expanded 0.43 mm into posterior. The volume of left intervertebral foramen became large and the right side became small. Therefore, the posterior part of the rotated side of cervical disc was expanded into posterior, while the posterior part of the contralateral side of cervical disc was retracted. The volume of intervertebral foramen in rotated side became small, while the volume of intervertebral foramen in contralateral side became large. We should rotate to the contralateral side when cervical spondylotic radiculopathy was treated with cervical rotatory manipulation. Subject headings: Tissue Engineering; Biomechanics; Three-Dimensional Finite Element Funding: the National Natural Science Foundation of China, No ; the Application and Promotion Project of Characteristic Diagnosis and Treatment Technique of South of the Five Ridges of First Affiliated Hospital of No. 2016JY03. 0 Introduction 60%70% [1-2] 90% [3-4] [5] / [6-7] [8] [9-11] [12] [13] 1Subjects and methods cm 55 kg CT 289CT0.625 mm120 kv ma DIOM Intel(R) Core(TM) i CPU 3.40 GHz32 GRadeon(TM) RX 460 Graphics 8 GWindows7 64 Mimics10.01 (Materialis)Geomagic Studio(Geomagic)Solidwords 2014(Solidword)Ansys Workbench 14.5 (Ansys) C 5 6 Mimics 10.01DICOM C 5 C 6 C 5 C 6 Mimics10.01Geomagic Studio stp C 5 6Solidwords2014 C 5 C 6 P.O. Box 10002, Shenyang

3 . [J] (3): DOI: /j.issn mm0.5 mm 43% 20% [14-16] (1) Ansys Workbench 14.5 [17-18] C C 6 C N1.8 Nm [19-20] C 6 C 5 6 Y3 C 5 6 Z sz Results 2.1 C 5 6 C C 5 6C 5 6CAD C 5 6 C 5 62 C 5 6 C (3a )Y 0.46 mm(3c) (3a)Y 0.77 mm(3d) (3e) (3f) (3b)Y 0.71 mm (3b )Y0.43 mm (3g) (3h) 3Discussion [21-22] [23-24] [25-26] C 5-6 C mm 0.71 mmwu [27] ( mm) 406 ISSN CN /R CODEN: ZLKHAH

4 Huang XC, Ye LQ, Liang D, Wang QL, Yu WB, Jiang XB. Effect of cervical rotatory direction on the displacement of cervical disc and the volume of intervertebral foramen in a three-dimensional finite element model Zhongguo Zuzhi Gongcheng Yanjiu. 2018;22(3): DOI: /j.issn Figure 1 Composition of the annulus fibrosus C Figure 2 Three-dimensional finite element model of C 3 Figure 3 Changes in displacement of cervical disc and the volume of intervertebral foramen in left/right rotation ab cd e f gh APLR 1 C Table 1 Material properties of the C finite element model (MPa) (mm ) C ( ) Table 2 Comparison of range of motion in C model between the present study and other studies Moroney Ganbat [28-29] ( XCTMRI) [3] ( ) (2016JY03) (STROBE ) CNKI 3 P.O. Box 10002, Shenyang

5 . [J] (3): DOI: /j.issn () References [1] Ji YY, Jong WK, MD, Young CY, et al. Cervical interlaminar epidural steroid injection for unilateral cervical radiculopathy: comparison of midline and paramedian approaches for efficacy. Korean J Radiol. 2015; 16(3): [2] Xu W, Wang SQ, Li LH, et al. Clinical evidence of Chinese massage therapy (Tui Na) for cervical radiculopathy: a systematic review and meta-analysis. Evid Based Complement Alternat Med. 2017; 2017: [3] Alentado VJ, Lubelski D, Steinmetz MP, et al. Optimal duration of conservative management prior to surgery for cervical and lumbar radiculopathy: a Literature review. Global Spine J. 2014; 4(4): [4] Woods BI, Hilibrand AS. Cervical radiculopathy: epidemiology, etiology, diagnosis, and treatment. J Spinal Disord Tech. 2015; 28(5): e [5],,,.[J].,2013,28(2): [6] Peterson CK, Pfirrmann CW, Hodler J, et al. Symptomatic, magnetic resonance imaging confirmed cervical disk herniation patients: a comparative-effectiveness prospective observational study of 2 age- and sex-matched cohorts treated with either imaging-guided indirect cervical nerve root injections or spinal manipulative therapy. J Manipulative Physiol Ther. 2016; 39(3): [7] Peterson CK, Schmid C, Leemann S, et al. Outcomes from magnetic resonance imaging-confirmed symptomatic cervical disk herniation patients treated with high-velocity, low-amplitude spinal manipulative therapy: a prospective cohort study with 3-month follow-up. J Manipulative Physiol Ther. 2013;36(8): [8] Hubka MJ, Phelan SP, Delaney PM, et al. Rotary manipulation for cervical radiculopathy: observations on the importance of the direction of the thrust. J Manipulative Physiol Ther. 1997;20(9): [9],.[J].,2004,24(12): [10] Takasaki H, Hall T, Jull G, et al. The influence of cervical traction, compression, and spurling test on cervical intervertebral foramen size. Spine (Phila Pa 1976). 2009; 34(16): [11] Abbed KM, Coumans JV. Cervical radiculopathy: pathophysiology, presentation, and clinical evaluation. Neurosurgery. 2007; 60(Supp1): S [12] Smith AL, Benazzi S, Ledogar JA, et al. Biomechanical implications of intraspecific shape variation in chimpanzee crania: moving towards an integration of geometric morphometrics and finite element analysis.anat Rec (Hoboken). 2015;298(1): [13] Wang K, Wang H, Deng Z, et al. Cervical traction therapy with and without neck support: A finite element analysis. Musculoskelet Sci Pract. 2017; 28: 1-9. [14] Mo ZJ, Zhao YB, Wang LZ, et al. Biomechanical effects of cervical arthroplasty with U-shaped disc implant on segmental range of motion and loading of surrounding soft tissue. Eur Spine J. 2014; 23(3): [15] Denozière G, Ku DN. Biomechanical comparison between fusion of two vertebrae and implantation of an artificial intervertebral disc. J Biomech. 2006;39(4): [16] Du HG, Liao SH, Jiang Z, et al. Biomechanical analysis of press-extension technique on degenerative lumbar with disc herniation and staggered facet joint. Saudi Pharm J. 2016; 24(3): [17] Lee SH, Im YJ, Kim KT, et al. Comparison of cervical spine biomechanics after fixed- and mobile-core artificial disc replacement: a finite element analysis. Spine (Phila Pa 1976). 2011; 36(9): [18] Mo Z, Zhao Y, Du C, et al. Does location of rotation center in artificial disc affect cervical biomechanics? Spine (Phila Pa 1976). 2015; 40(8): e [19] Moroney SP, Schultz AB, Miller JA, et al. Load-displacement properties of lower cervical spine motion segments. J Biomech. 1988; 21(9): [20] Ganbat D, Kim YH, Kim K, et al. Effect of mechanical loading on heterotopic ossification in cervical total disc replacement: a three-dimensional finite element analysis. Biomech Model Mechanobiol. 2016;15(5): [21] Wei X, Wang S, Li J, et al. Complementary and alternative medicine for the management of cervical radiculopathy: an overview of systematic reviews. Evid Based Complement Alternat Med. 2015;2015: [22] Zhu L, Wei X, Wang S. Does cervical spine manipulation reduce pain in people with degenerative cervical radiculopathy? A systematic review of the evidence, and a meta-analysis. Clin Rehabil. 2016;30(2): [23],,,. [J]., 2002,24(9): [24],,,.[J].,2003,7(8): [25] Pyhtinen J, Laitinen J. Cervical intervertebral foramen narrowing and myelographic nerve root sleeve deformities. Neuroradiology.1993; 35(8): [26] de Rooij JD, Gadjradj PS, Huygen FJ, et al. Management of symptomatic cervical disk herniation: a survey among dutch neurosurgeons. Spine (Phila Pa 1976). 2017; 42(5): [27] Wu LP, Huang YQ, Manas D, et al. Real-time monitoring of stresses and displacements in cervical nuclei pulposi during cervical spine manipulation: a finite element model analysis. J Manipulative Physiol Ther. 2014; 37(8): [28] McNally DS, Shackleford IM, Goodship AE, et al. In vivo stress measurement can predict pain on discography. Spine (Phila Pa 1976). 1996; 21(22): [29] Kim HJ, Kang KT, Chun HJ, et al. The influence of intrinsic disc degeneration of the adjacent segments on its stress distribution after one-level lumbar fusion. Eur Spine J.2015; 24(4): ISSN CN /R CODEN: ZLKHAH