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Post-traumatic instability can cause aggravation of the secondary SCI during patient care. However, there is little information on how the pattern of disco-ligamentous injury affects the SCI severity and mechanism. This study objective was to analyze how posterior disco-ligamentous injuries affect spinal cord compression and stress and strain patterns in the spinal cord during post-traumatic flexion and extension. A cervical spine finite element model including the spinal cord was used and different combinations of partial or complete intervertebral disc (IVD) rupture and disruption of various posterior ligaments were modeled at C4\u2013C5, C5\u2013C6, or C6\u2013C7. In flexion, complete IVD rupture combined with posterior ligamentous complex rupture was the most severe injury leading to the highest von Mises stress (47\u201366\u2009kPa), principal strains p1 (0.32\u20130.41 in white matter) and p3 (\u22120.78 to \u22120.96 in white matter) in the spinal cord and the highest spinal cord compression (35\u201348%). The main post-trauma SCI mechanism was identified as the compression of the anterior white matter at the injured level combined with distraction of the posterior spinal cord during flexion. There was also a concentration of the maximum stresses in the gray matter during post-traumatic flexion. Finally, in extension, the injuries tested had little impact on the spinal cord. The capsular ligament was the most important structure to protect the spinal cord. Its status should be carefully examined during the patient's management.<\/jats:p>","DOI":"10.1115\/1.4052003","type":"journal-article","created":{"date-parts":[[2021,8,9]],"date-time":"2021-08-09T13:44:31Z","timestamp":1628516671000},"update-policy":"https:\/\/doi.org\/10.1115\/crossmarkpolicy-asme","source":"Crossref","is-referenced-by-count":14,"title":["Numerical Investigation of Spinal Cord Injury After Flexion-Distraction Injuries at the Cervical Spine"],"prefix":"10.1115","volume":"144","author":[{"given":"Marie-H\u00e9l\u00e8ne","family":"Beaus\u00e9jour","sequence":"first","affiliation":[{"name":"Research Center, H\u00f4pital du Sacr\u00e9-Coeur de Montr\u00e9al, International Laboratory on Spine Imaging and Biomechanics, Laboratoire de Biom\u00e9canique Appliqu\u00e9e-Universit\u00e9 Gustave-Eiffel, Aix-Marseille Universit\u00e9, Department of Mechanical Engineering, \u00c9cole de technologie sup\u00e9rieure, 1100, rue Notre-Dame Ouest, Montreal, QC H3C 1K3, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric","family":"Wagnac","sequence":"additional","affiliation":[{"name":"Research Center, H\u00f4pital du Sacr\u00e9-Coeur de Montr\u00e9al, International Laboratory on Spine Imaging and Biomechanics, Department of Mechanical Engineering, \u00c9cole de technologie sup\u00e9rieure, 1100, rue Notre-Dame Ouest, Montreal, QC H3C 1K3, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pierre-Jean","family":"Arnoux","sequence":"additional","affiliation":[{"name":"International Laboratory on Spine Imaging and Biomechanics, Laboratoire de Biom\u00e9canique Appliqu\u00e9e-Universit\u00e9 Gustave-Eiffel, Aix-Marseille Universit\u00e9 Facult\u00e9 de M\u00e9decine Secteur Nord, Boulevard P. 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