{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T00:26:13Z","timestamp":1788049573813,"version":"build-2784847793"},"reference-count":30,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2024,7,12]],"date-time":"2024-07-12T00:00:00Z","timestamp":1720742400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"AO Spine North America"},{"name":"North American Spine Society (NASS)"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Cervical laminoplasty is an established motion-preserving procedure for degenerative cervical myelopathy (DCM). However, patients with pre-existing cervical kyphosis often experience inferior outcomes compared to those with straight or lordotic spines. Limited dorsal spinal cord shift in kyphotic spines post-decompression and increased spinal cord tension may contribute to poor neurological recovery and spinal cord injury. This study aims to quantify the biomechanical impact of cervical sagittal alignment on spinal cord stress and strain post-laminoplasty using a validated 3D finite element model of the C2\u2013T1 spine. Three models were created based on the C2\u2013C7 Cobb angle: lordosis (20 degrees), straight (0 degrees), and kyphosis (\u22129 degrees). Open-door laminoplasty was simulated at C4, C5, and C6 levels, followed by physiological neck flexion and extension. The results showed that spinal cord stress and strain were highest in kyphotic curvature compared to straight and lordotic curvatures across all cervical segments, despite similar segmental ROM. In flexion, kyphotic spines exhibited 103.3% higher stress and 128.9% higher strain than lordotic spines and 16.7% higher stress and 26.8% higher strain than straight spines. In extension, kyphotic spines showed 135.4% higher stress and 241.7% higher strain than lordotic spines and 21.5% higher stress and 43.2% higher strain than straight spines. The study shows that cervical kyphosis leads to increased spinal cord stress and strain post-laminoplasty, underscoring the need to address sagittal alignment in addition to decompression for optimal patient outcomes.<\/jats:p>","DOI":"10.3390\/diagnostics14141497","type":"journal-article","created":{"date-parts":[[2024,7,12]],"date-time":"2024-07-12T08:16:57Z","timestamp":1720772217000},"page":"1497","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Using Finite Element Models to Assess Spinal Cord Biomechanics after Cervical Laminoplasty for Degenerative Cervical Myelopathy"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3981-7619","authenticated-orcid":false,"given":"Mahmudur","family":"Rahman","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI 53226, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Palmer","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI 53226, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9243-5746","authenticated-orcid":false,"given":"Balaji","family":"Harinathan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI 53226, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3990-677X","authenticated-orcid":false,"given":"Karthik","family":"Banurekha Devaraj","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI 53226, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3376-4456","authenticated-orcid":false,"given":"Narayan","family":"Yoganandan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI 53226, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aditya","family":"Vedantam","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI 53226, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,7,12]]},"reference":[{"key":"ref_1","first-page":"28","article-title":"Differences in Spinal Cord Biomechanics after Laminectomy, Laminoplasty, and Laminectomy with Fusion for Degenerative Cervical Myelopathy","volume":"39","author":"Vedantam","year":"2023","journal-title":"J. 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