Effect of a Degenerated C5-C6 Disc on the Biomechanics of Adjacent Levels: A Poroelastic Finite Element Investigation

Degenerative changes in the cervical spine due to aging are very common causes of neck pain in general population. Although many investigators have quantified the gross morphological changes in the disc with progressive degeneration, the biomechanical changes due to degenerative pathologies of the disc and its effect on the adjacent levels are not well understood. Despite many in vivo and in vitro techniques used to study such complex phenomena, the finite element (FE) method is still a powerful tool to investigate the internal mechanics and complex clinical situations under various physiological loadings particularly when large numbers of parameters are involved. The objective of the present study was to develop and validate a poroelastic FE model of a healthy C3-T1 segment of the cervical spine under physiologic moment loads. The model included the regional effect of change in the fixed charged density of proteoglycan concentration and change in the permeability and porosity due to change in the axial strain of disc tissues. The model was further modified to include various degrees of disc degeneration at the C5-C6 level. Outcomes of this study provided a better understanding on the progression of degeneration along the cervical spine by investigating the biomechanical response of the adjacent segments with an intermediate degenerated C5-C6 level.