ORIGINAL RESEARCH article
Front. Bioeng. Biotechnol.
Sec. Biomechanics
Effect of Rear Impact on the Instrumented Cervical Spine: A Finite Element Study
Provisionally accepted
- 1Medical College of Wisconsin, Milwaukee, United States
- 2Vellore Institute of Technology - Chennai Campus, Chennai, India
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Degenerative cervical myelopathy (DCM) is the leading cause of spinal cord dysfunction in adults and often requires surgical decompression and instrumentation. While Anterior Cervical Discectomy and Fusion (ACDF) is the most performed procedure, the biomechanical behavior of instrumented spines during rear impact trauma remains poorly characterized. This study investigates the biomechanical response of the cervical spine following three surgical interventions ACDF, Posterior Cervical Laminectomy and Fusion (PCLF), and laminoplasty (LP) using a validated finite element (FE) model of the head-neck complex. The model incorporates active musculature, spinal cord, and instrumentation, and simulates a low-speed rear impact corresponding to a velocity change of 2.6 m/s. Key parameters including spinal cord stress and strain, ligament strain, and implant stress were evaluated at the superior, index, and inferior levels. Compared to ACDF, both PCLF and LP significantly reduced spinal cord stress and strain, with PCLF showing the most pronounced decrease at the index level with reduction up to 81% in the stress levels and 57% in the strain levels. LP preserved the highest range of motion but produced elevated capsular ligament strain at the index level (44.7%), exceeding the ~35% sub-traumatic failure threshold, whereas PCLF remained below this threshold (32.4%); anterior longitudinal ligament strains remained below 36%, within the reported 40–45% failure range. PCLF screws exceeded the 900 MPa yield strength of Ti–6Al–4V at all levels except C4, indicating a reduced hardware safety margin, while ACDF and LP implants remained within safe stress limits. Despite using a low-speed impact and long fusion, this is the first study to quantify spinal cord, ligament, and implant responses in instrumented spines during rear impact. Clinically, these findings suggest that PCLF may be preferred when minimizing spinal cord loading under rear-impact conditions is a priority, whereas LP may be selected when motion preservation is critical but with awareness of increased facet capsular strain, and ACDF offers construct stability with less spinal cord unloading in this trauma scenario.
Keywords: cervical spine, Spinal Cord Compression, spinal cord injury, finite element model, Spinal Cord, Strain, Whiplash injury, Cervical stenosis
Received: 06 Aug 2025; Accepted: 01 Dec 2025.
Copyright: © 2025 HARINATHAN, Jebaseelan and Yoganandan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Davidson Jebaseelan
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