Abstract Posterior ligamentous complex (PLC) and intervertebral disc (IVD) injuries are common cervical spine flexion-distraction injuries, but the residual stability following their disruption is misknown. The objective of this study was to evaluate the effect of PLC and IVD disruption on post-traumatic cervical spine stability under low flexion moment (2 Nm) using a finite element (FE) model of C2-T1. The PLC was removed first and a progressive disc rupture (one third, two thirds and complete rupture) was modeled to simulate IVD disruption at C2-C3, C4-C5 and C6-C7. At each step, a non-traumatic flexion moment was applied and the change in stability was evaluated. PLC removal had little impact at C2-C3 but increased local range of motion (ROM) at the injured level by 77.2% and 190.7% at C4-C5 and C6-C7, respectively. Complete IVD rupture had the largest impact on C2-C3, increasing C2-C3 ROM by 181% and creating a large antero-posterior displacement of the C2-C3 segment. The FE analysis showed PLC and disc injuries create spinal instability. However, the PLC played a bigger role in the stability of the middle and lower cervical spine while the IVD was more important at the upper cervical spine. Stabilization appears important when managing patients with soft tissue injuries.

中文翻译：

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后韧带复合体和椎间盘损伤对颈椎创伤后不稳定的影响

摘要 后韧带复合体 (PLC) 和椎间盘 (IVD) 损伤是常见的颈椎屈曲-牵引损伤，但其断裂后的残余稳定性尚不清楚。本研究的目的是使用 C2-T1 的有限元 (FE) 模型评估 PLC 和 IVD 中断对低屈曲力矩 (2 Nm) 下创伤后颈椎稳定性的影响。首先移除 PLC，并对渐进性椎间盘破裂（三分之一、三分之二和完全破裂）进行建模以模拟 C2-C3、C4-C5 和 C6-C7 处的 IVD 破裂。在每一步，施加非创伤性屈曲力矩并评估稳定性的变化。PLC 去除对 C2-C3 几乎没有影响，但在 C4-C5 和 C6-C7 处分别使受伤水平的局部运动范围 (ROM) 增加了 77.2% 和 190.7%。完全 IVD 破裂对 C2-C3 的影响最大，使 C2-C3 ROM 增加了 181%，并造成 C2-C3 段的大前后位移。有限元分析显示 PLC 和椎间盘损伤造成脊柱不稳定。然而，PLC在中下颈椎稳定性方面的作用更大，而IVD在上颈椎处的作用更为重要。在处理软组织损伤患者时，稳定似乎很重要。