{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T06:10:06Z","timestamp":1756707006258,"version":"3.44.0"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Bioeng. Biotechnol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To compare the biomechanical characteristics of axial traction and suspensory traction in the process of preoperative correction of cervical kyphosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>An intact three-dimensional finite element digital model of C2-T2 with cervical kyphosis was established. The head gravity and moment were applied to the finite element model to simulate the force of skull traction and the force of suspensory traction. The changes of cervical kyphotic angle, the length of cervical spinal canal and the stress distribution of each vertebral body were analyzed under two traction modes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The kyphotic angles of the kyphotic segments were reduced by both tractions. The C2-C5 kyphotic angle was 41\u00b0 before traction, and decreased to 32\u00b0 and 26\u00b0 after axial traction and suspensory traction, respectively. The length of C3-C7 cervical spinal canal was 61.3 mm before traction. After axial traction, the length of C3-C7 cervical spinal canal increased to 61.8 mm; after suspensory traction, it decreased to 59. 6 mm. The high stress area of each vertebral body was located in the anterior longitudinal ligament attachment area of the vertebral body during both two kinds of traction. The maximum Mises stress of C2-C7 vertebral body in suspensory traction is generally small relative to axial traction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Compared with axial traction, suspensory traction has better kyphotic corrective effect, while reduces the length of the cervical spinal canal and the stress on the cervical vertebral body, which decreases the possibility of nerve damage and iatrogenic fracture during traction from a biomechanical point of view.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fbioe.2025.1594207","type":"journal-article","created":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T05:30:10Z","timestamp":1756704610000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Biomechanical comparison of suspensory traction and axial traction in preoperative correction of cervical kyphosis: a finite element study"],"prefix":"10.3389","volume":"13","author":[{"given":"Hongyu","family":"Chen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tianchi","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shengfa","family":"Pan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanbin","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xin","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu","family":"Sun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William W.","family":"Lu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Feifei","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,9,1]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"587","DOI":"10.1097\/00007632-199903150-00020","article-title":"Spondyloptosis of the cervical spine in neurofibromatosis. A case report","volume":"24","author":"Goffin","year":"1999","journal-title":"Spine (Phila Pa 1976)"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2016\/8056273","article-title":"Halo gravity traction is associated with reduced bone mineral density of patients with severe kyphoscoliosis","volume":"2016","author":"Han","year":"2016","journal-title":"Biomed. Res. Int."},{"key":"B3","doi-asserted-by":"publisher","first-page":"182","DOI":"10.3171\/2019.7.spine18651","article-title":"Predicting the combined occurrence of poor clinical and radiographic outcomes following cervical deformity corrective surgery","volume":"32","author":"Horn","year":"2019","journal-title":"J. Neurosurg. Spine"},{"key":"B4","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1097\/00007632-199701150-00019","article-title":"Traction-induced rupture of an extracranial vertebral artery aneurysm associated with neurofibromatosis. A case report","volume":"22","author":"Horsley","year":"1997","journal-title":"Spine (Phila Pa 1976)"},{"key":"B5","doi-asserted-by":"publisher","first-page":"105352","DOI":"10.1016\/j.cmpb.2020.105352","article-title":"Biomechanical evaluation of adjacent segment degeneration after one- or two-level anterior cervical discectomy and fusion versus cervical disc arthroplasty: a finite element analysis","volume":"189","author":"Hua","year":"2020","journal-title":"Comput. Methods Programs Biomed."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1174","DOI":"10.1097\/00007632-199605150-00009","article-title":"Is the nucleus pulposus a solid or a fluid? Mechanical behaviors of the nucleus pulposus of the human intervertebral disc","volume":"21","author":"Iatridis","year":"1996","journal-title":"Spine (Phila Pa 1976)"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1419","DOI":"10.1097\/00007632-200207010-00009","article-title":"Cervical kyphosis: predictive factors for progression of kyphosis and myelopathy","volume":"27","author":"Iwasaki","year":"2002","journal-title":"Spine (Phila Pa 1976)"},{"key":"B8","doi-asserted-by":"publisher","first-page":"274","DOI":"10.3171\/2012.11.spine12417","article-title":"Surgical correction of severe cervical kyphosis in patients with neurofibromatosis type 1","volume":"18","author":"Kawabata","year":"2013","journal-title":"J. Neurosurg. Spine"},{"key":"B9","doi-asserted-by":"publisher","first-page":"E579","DOI":"10.1097\/01.brs.0000229228.62627.75","article-title":"The length of the cervical cord: effects of postural changes in healthy volunteers using positional magnetic resonance imaging","volume":"31","author":"Kuwazawa","year":"2006","journal-title":"Spine (Phila Pa 1976)"},{"key":"B10","doi-asserted-by":"publisher","first-page":"318","DOI":"10.1186\/s12891-020-03350-x","article-title":"Iatrogenic biological fracture of the cervical spine during gradual halo traction for kyphotic deformity correction: case report","volume":"21","author":"Lim","year":"2020","journal-title":"BMC Musculoskelet. Disord."},{"key":"B11","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1016\/j.jot.2021.11.008","article-title":"Automatic phantom-less QCT system with high precision of BMD measurement for osteoporosis screening: technique optimisation and clinical validation","volume":"33","author":"Liu","year":"2022","journal-title":"J. Orthop. Transl."},{"key":"B12","doi-asserted-by":"publisher","first-page":"1007","DOI":"10.4184\/asj.2016.10.6.1007","article-title":"Addressing stretch myelopathy in multilevel cervical kyphosis with posterior surgery using cervical pedicle screws","volume":"10","author":"Mahesh","year":"2016","journal-title":"Asian Spine J."},{"key":"B13","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1007\/s00402-017-2642-x","article-title":"Posterior-only surgery with preoperative skeletal traction for management of severe scoliosis","volume":"137","author":"Mehrpour","year":"2017","journal-title":"Arch. Orthop. Trauma Surg."},{"key":"B14","doi-asserted-by":"publisher","first-page":"2409","DOI":"10.1007\/s00381-020-04775-4","article-title":"Management of spinal deformities and tibial pseudarthrosis in children with neurofibromatosis type 1 (NF-1)","volume":"36","author":"Mladenov","year":"2020","journal-title":"Childs Nerv. Syst."},{"key":"B15","doi-asserted-by":"publisher","first-page":"419","DOI":"10.1016\/s0278-5919(20)30404-x","article-title":"Biochemistry of the intervertebral disc","volume":"12","author":"Oegema","year":"1993","journal-title":"Clin. Sports Med."},{"key":"B16","doi-asserted-by":"publisher","first-page":"580","DOI":"10.1016\/j.jaapos.2004.08.002","article-title":"Fourth and sixth cranial nerve injury after halo traction in children: a report of two cases","volume":"8","author":"Pinches","year":"2004","journal-title":"J. AAPOS"},{"key":"B17","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1007\/bf02427846","article-title":"Comparison of the structure of human intervertebral discs in the cervical, thoracic and lumbar regions of the spine","volume":"8","author":"Pooni","year":"1986","journal-title":"Surg. Radiol. Anat."},{"key":"B18","first-page":"166","article-title":"Estimation of mass moment of inertia of human body, when bending forward, for the design of A self-transfer robotic facility","volume":"11","author":"Ramachandran","year":"2016","journal-title":"J. Eng. Sci. Technol."},{"key":"B19","doi-asserted-by":"publisher","first-page":"e915","DOI":"10.1016\/j.wneu.2019.07.035","article-title":"Preoperative and intraoperative skull traction combined with anterior-only cervical operation in the treatment of severe cervical kyphosis (>50 degrees)","volume":"130","author":"Shen","year":"2019","journal-title":"World Neurosurg."},{"key":"B20","doi-asserted-by":"publisher","first-page":"1090199","DOI":"10.3389\/fsurg.2022.1090199","article-title":"Effect of cervical suspensory traction in the treatment of severe cervical kyphotic deformity","volume":"9","author":"Shengfa","year":"2023","journal-title":"Front. Surg."},{"key":"B21","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.1227\/01.neu.0000215553.49728.b0","article-title":"Cervical deformity correction","volume":"60","author":"Steinmetz","year":"2007","journal-title":"Neurosurgery"},{"key":"B22","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3171\/2019.10.PEDS19513","article-title":"Halo-gravity traction for the treatment of pediatric cervical spine disorders","volume":"27","author":"Verhofste","year":"2019","journal-title":"J. Neurosurg. Pediatr."},{"key":"B23","doi-asserted-by":"publisher","first-page":"E858","DOI":"10.1097\/brs.0b013e31824edd1c","article-title":"Cervical neurofibromatosis with tetraplegia: management by cervical suspensory traction","volume":"37","author":"Wu","year":"2012","journal-title":"Spine (Phila Pa 1976)"},{"key":"B24","doi-asserted-by":"publisher","first-page":"1254","DOI":"10.1016\/j.spinee.2019.02.004","article-title":"Biomechanical effects on the intermediate segment of noncontiguous hybrid surgery with cervical disc arthroplasty and anterior cervical discectomy and fusion: a finite element analysis","volume":"19","author":"Wu","year":"2019","journal-title":"Spine J."},{"key":"B25","doi-asserted-by":"publisher","first-page":"950839","DOI":"10.3389\/fbioe.2022.950839","article-title":"Patient-specific numerical investigation of the correction of cervical kyphotic deformity based on a retrospective clinical case","volume":"10","author":"Wu","year":"2022","journal-title":"Front. Bioeng. Biotechnol."},{"key":"B26","doi-asserted-by":"publisher","first-page":"48","DOI":"10.2106\/jbjs.18.00531","article-title":"Three-dimensional computed tomography analysis of spinal canal length increase after surgery for adolescent idiopathic scoliosis: a multicenter Study","volume":"101","author":"Yahara","year":"2019","journal-title":"J. Bone Jt. Surg. Am."},{"key":"B27","doi-asserted-by":"publisher","first-page":"241","DOI":"10.3928\/01477447-20100225-12","article-title":"Posterior surgery assisted by halo ring traction for the treatment of severe rigid nonangular cervical kyphosis","volume":"33","author":"Zhang","year":"2010","journal-title":"Orthopedics"},{"key":"B28","doi-asserted-by":"publisher","first-page":"E1134","DOI":"10.1097\/brs.0b013e3181f822c7","article-title":"Preoperative evaluation of the cervical spondylotic myelopathy with flexion-extension magnetic resonance imaging: about a prospective study of fifty patients","volume":"36","author":"Zhang","year":"2011","journal-title":"Spine (Phila Pa 1976)"}],"container-title":["Frontiers in Bioengineering and Biotechnology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fbioe.2025.1594207\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T05:30:11Z","timestamp":1756704611000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fbioe.2025.1594207\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,1]]},"references-count":28,"alternative-id":["10.3389\/fbioe.2025.1594207"],"URL":"https:\/\/doi.org\/10.3389\/fbioe.2025.1594207","relation":{},"ISSN":["2296-4185"],"issn-type":[{"value":"2296-4185","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,1]]},"article-number":"1594207"}}