Browsing by Author "Bangsboll, Emily Merle"

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    In vivo kinematic outcomes of cervical total disc arthroplasty using dual fluoroscopy: A longitudinal collective case study
    (2024-12-19) Bangsboll, Emily Merle; Ronsky, Janet Lenore; Swamy, Ganesh; Roach, Koren Elaine; Duncan, Neil Alexander
    Intervertebral disc degeneration of the cervical spine is prevalent in aging adults with symptomatic cases often requiring surgical intervention. Cervical total disc arthroplasty (cTDA) is a surgical treatment for disc degeneration that aims to preserve natural motion of the spine and avoid adjacent segment degeneration. Despite low re-operation rates associated with cTDA, patient outcomes vary, and kinematic effects remain poorly understood. Understanding these effects via in vivo characterization could help address complications of cTDA and improve patient outcomes. This study implemented dual fluoroscopy to evaluate pre- and post-cTDA intervertebral rotations, translations, and endplate proximities to assess the impact of cTDA on in vivo cervical spine kinematics. Five asymptomatic control participants and two surgical participants undergoing cTDA were recruited. Participants underwent computed tomography and dual fluoroscopy imaging during dynamic movements. Model-based tracking matched subject-specific vertebral bone models to each dual fluoroscopy sequence with high accuracy (0.97 mm and 1.4°) and intervertebral rotations, translations, and bone-to-bone proximities were computed. The control pilot study verified the data collection and processing protocols yielded baseline data consistent with literature, although there was notable variability for some trials. Post-cTDA rotation patterns were similar to those of the controls, suggesting increased mobility at both treated and adjacent motion segments. Translations also increased post-cTDA, with some magnitudes exceeding one standard deviation above the control means, potentially indicating instability. Proximity measures indirectly described local disc height and illustrated the coupled motion patterns throughout movement, further emphasizing the value of three-dimensional in vivo kinematic approaches for studying the cervical spine. These kinematic measures have the potential to elucidate the complex coupled motion of the cervical spine post-cTDA and will be valuable for informing future artificial disc designs.