Non-adjacent Segments Research Articles

Disentangling the spinal mechanisms of illusory heat and burning sensations in the thermal grill illusion.

The thermal grill illusion (TGI), a phenomenon in which the juxtaposition of innocuous warm and cold temperatures on the skin elicits a burning sensation, offers a unique perspective to how pain occurs in response to harmless stimuli. We investigated the role of the spinal cord in the generation of the TGI across 2 experiments (total n = 80). We applied heat and cold stimuli to dermatomes, areas of skin innervated by a single spinal nerve, that mapped onto adjacent or nonadjacent spinal segments. Enhanced warm and burning ratings during the TGI were observed when cold and warm stimuli were confined within the same dermatome. Furthermore, we found the spatial organisation of warm and cold stimuli within and across dermatomes affected TGI perception. Perceived warmth and burning intensity increased when the cold stimulus projected to the segment more caudal to the warm stimulus, whereas perceived cold during the TGI decreased compared with the opposite spatial arrangement. This suggests that the perception of TGI is enhanced when cold afferents are projected to spinal segments positioned caudally in relation to those receiving warm afferents. Our results indicate distinct interaction of sensory pathways based on the segmental arrangement of afferent fibres and are consistent with current interpretations of the spread and integration of thermosensory information along the spinal cord.

Lymph node dissection in small peripheral lung cancer: Supplemental analysis of JCOG0802/WJOG4607L

ObjectiveThe optimal region of lymph node dissection (LND) during segmentectomy in patients with small peripheral non–small cell lung cancer requires clarification. Through a supplemental analysis of the Japan Clinical Oncology Group (JCOG) 0802/West Japan Oncology Group (WJOG) 4607L, we investigated the associated factors, distribution, and recurrence pattern of lymph node metastases (LNMs) and proposed the optimal LND region. MethodsOf the 1106 patients included in the JCOG0802/WJOG4607L, 1056 patients with LNDs were included in this supplemental analysis. We investigated the distribution and recurrence pattern of LNMs along with the radiologic findings (with ground-glass opacity, part-solid tumor; without ground-grass opacity component, pure-solid tumor). ResultsThe radiologic findings were the only significant factor for LNMs. Of 533 patients with part-solid tumors, 8 (1.5%) had LNMs. Further, only 3 (0.5%) patients had pN2 disease, and no patients had interlobar LNMs from nonadjacent segments. Of the 523 patients with pure-solid tumors, 55 (10.5%) had LNMs, and 28 (5.4%) had pN2 disease. Five patients had metastases to nonadjacent interlobar lymph nodes (LNs). Two (2.0%) patients with S6 tumors had upper mediastinal LNMs. In addition, the incidence of mediastinal LN recurrence in patients with S6 lung cancer was greater in those who underwent selective LND than those who underwent systematic LND (P = .0455). ConclusionsNonadjacent interlobar and mediastinal LND have little impact on pathologic nodal staging in patients with part-solid tumors. In contrast, selective LND is recommended at least for patients with pure-solid tumors.

Road traffic flow prediction based on dynamic spatiotemporal graph attention network

To improve the prediction accuracy of traffic flow under the influence of nearby time traffic flow disturbance, a dynamic spatiotemporal graph attention network traffic flow prediction model based on the attention mechanism was proposed. Considering the macroscopic periodic characteristics of traffic flow, the spatiotemporal features are extracted by constructing spatiotemporal blocks with an adjacent period, daily period, and weekly period respectively. The spatiotemporal block is mainly composed of a two-layer graph attention network and a gated recurrent unit to capture the hidden features of space and time. In space, based on considering adjacent road segments, the Pearson correlation coefficient is used to capture the hidden correlation characteristics between non-adjacent road segments according to a certain time step. In terms of time, due to the random disturbance of traffic flow at the micro level, the attention mechanism is introduced to use the adjacent time as the query matrix to weight the output characteristics of daily cycle and weekly cycle, and the three are connected in series to output the prediction results through the linear layer. Finally, the experimental results on the public data sets show that the proposed model is superior to the six baseline models.

Biomechanical Analysis of the Reasonable Cervical Range of Motion to Prevent Non-Fusion Segmental Degeneration After Single-Level ACDF

The compensatory increase in intervertebral range of motion (ROM) after cervical fusion can increase facet joint force (FJF) and intradiscal pressure (IDP) in non-fusion segments. Guiding the post-ACDF patient cervical exercise within a specific ROM (defined as reasonable ROM) to offset the increase in FJF and IDP may help prevent segmental degeneration. This study aimed to determine the reasonable total C0–C7 ROM without an increase in FJF and IDP in non-fusion segments after anterior cervical discectomy and fusion (ACDF). A three-dimensional intact finite element model of C0–C7 generated healthy cervical conditions. This was modified to the ACDF model by simulating the actual surgery at C5–C6. A 1.0 Nm moment and 73.6 N follower load were applied to the intact model to determine the ROMs. A displacement load was applied to the ACDF model under the same follower load, resulting in a total C0–C7 ROM similar to that of the intact model. The reasonable ROMs in the ACDF model were calculated using the fitting function. The results indicated that the intervertebral ROM of all non-fusion levels was increased in the ACDF model in all motion directions. The compensatory increase in ROM in adjacent segments (C4/5 and C6/7) was more significant than that in non-adjacent segments, except for C3/4 during lateral bending. The intervertebral FJF and IDP of C0–C7 increased with increasing ROM. The reasonable ROMs in the ACDF model were 42.4°, 52.6°, 28.4°, and 42.25° in flexion, extension, lateral bending, and axial rotation, respectively, with a decreased ROM of 4.4–7.2%. The postoperative increase in FJF and IDP in non-fusion segments can be canceled out by reducing the intervertebral ROM within reasonable ROMs. This study provided a new method to estimate the reasonable ROMs after ACDF from a biomechanical perspective, and further in vitro and clinical studies are needed to confirm this.

Are Congenital Cervical Block Vertebrae a Risk Factor for Adjacent Segment Disease? A Retrospective Cross-Sectional CT and MR Imaging Study.

Adjacent segment disease (ASDI) is a well-described complication of spinal fusion surgery that may ultimately lead to spinal stenosis and repeated surgical intervention. Although congenital block vertebrae also present with degenerative changes in the adjacent segments, this has not yet been systematically investigated. The aim of this study was to assess the presence and degree of ASDI in congenital cervical block vertebrae. Methods: A total of 51 patients with congenital vertebral fusion in one cervical segment were analysed in this IRB-approved retrospective cross-sectional study using available CT/MR imaging. Exclusion criteria were prior spinal surgery and the presence of additional hereditary abnormalities. We assessed the severity of degenerative changes using a sum score. The sum score for adjacent and non-adjacent segments was then divided by the highest possible degeneration score, which resulted in a ratio of severity for adjacent and remaining segments (ranging from 0 to 1). Results: Overall, 35 of 51 patients (68.6%) showed evidence of ASDI, and 34 of 51 patients (66.7%) also showed degenerative changes in the remaining segments. The severity score was significantly higher (p = 0.025) in the segments adjacent to the congenital block vertebrae (mean value 0.307) compared to the non-adjacent segments (mean value 0.188). Conclusions: Our results suggest that ASDI is also caused by congenital block vertebrae of the cervical spine.

Influence of reducing anterior pelvic tilt on shoulder posture and the electromyographic activity of scapular upward rotators

BackgroundModifications of posture in a segment may influence the posture of adjacent and nonadjacent segments and muscular activity. The spine–shoulder and spine–pelvis relationships suggest that the pelvis may influence shoulder posture. ObjectiveTo investigate the effect of the active reduction of the anterior pelvic tilt on shoulder and trunk posture during static standing posture and on the electromyographic activity of the scapular upward rotators during elevation and lowering of the arm. MethodsThirty-one young adults were assessed in a relaxed standing position and a standing position with 30% active reduction of the anterior pelvic tilt. The pelvic tilt, trunk posture, and forward shoulder posture during the static standing posture and the electromyographic activity during elevation and lowering of the arm were assessed. ResultsPaired t-tests indicated that the active reduction of the anterior pelvic tilt reduced the trunk extension (MD=1.09; 95%CI=−2.79 to −1.03). There were no effects on the forward shoulder posture (MD=0.09; 95%CI=−0.92 to 1.09). Repeated measures of analyses of variance indicated an increase in lower trapezius electromyographic activity (MD=3.6; 95%CI=1.28 to 5.92). There was a greater reduction in upper trapezius activity after pelvic tilt reduction during arm elevation (MD=1.52%; 95%CI=−2.79 to −0.25) compared to that during the lowering phase. There were no effects of pelvic tilt reduction on the electromyographic activity of the serratus anterior (MD=3.26; 95%CI=−3.36 to 9.87). ConclusionThe influence of pelvic posture on the trunk posture and lower trapezius activation should be considered when assessing or planning exercise for individuals with shoulder or trunk conditions.

Risk factors for non-fusion segment disease after anterior cervical spondylosis surgery: a retrospective study with long-term follow-up of 171 patients

BackgroundThe purpose of this study was to investigate the incidence and causes of non-fusion segment disease (NFSD), both adjacent and non-adjacent to a fused segment, after anterior cervical arthrodesis.MethodsThis is a single-center study. Between January 1998 and January 2011, two surgeons’ 171 patients who had an anterior cervical decompression and fusion were followed clinically for more than 5 years. The correlation between the incidence of symptomatic non-fusion segment disease and the following clinical parameters (age at operation, fusion levels,) and radiological parameters (number of patients who had a plate, anterior cervical decompression and fusion (ACDF) or corpectomies, preoperative and postoperative cervical spine alignment, Pavlov’s ratio at the C5 level, and preoperative existence of a non-fusion segment degeneration on magnetic resonance imaging) was evaluated.ResultsOf the 171 patients reviewed, 16 patients had non-fusion segment disease (9.36%), of which 12 had adjacent segment disease and 4 had non-adjacent segment disease. Postoperative cervical lordosis in the non-fusion segment disease group was significantly smaller than that of the disease-free group (P < 0.001). Fusion levels in the NFSD group were 1.69 whereas 2.26 in disease-free group (P = 0.005). The incidences of disc degeneration in unfused segments was more severe in the NFSD group than in the disease-free group (P = 0.004). The results of binary logistic regression showed that the major factor affecting NFSD is postoperative cervical lordosis (P = 0.000) followed by disc degeneration (P = 0.024). The other parameters did not show a statistically significant difference.ConclusionsThe incidence of symptomatic non-fusion segment disease after anterior cervical arthrodesis has multifactorial causes. Postoperative cervical lordosis and disc degeneration in non-fusion segments were major factors in the incidence of NFSD.

On the dynamics of non-local fractional viscoelastic beams under stochastic agencies

Abstract Non-local viscoelasticity is a subject of great interest in the context of non-local theories. In a recent study, the authors have proposed a non-local fractional beam model where non-local effects are represented as viscoelastic long-range volume forces and moments, exchanged by non-adjacent beam segments depending on their relative motion, while local effects are modelled by elastic classical stress resultants. Long-range interactions have been given a fractional constitutive law, involving the Caputo's fractional derivative. This paper introduces a comprehensive numerical approach to calculate the stochastic response of the non-local fractional beam model under Gaussian white noise. The approach combines a finite-element discretization with a fractional-order state-variable expansion and a complex modal transformation to decouple the discretized equations of motion. While closed-form expressions are derived for the finite-element matrices associated with elastic and fractional terms, fractional calculus is used to solve the decoupled equations of motion, in both time and frequency domain. Remarkably, closed-form expressions are obtained for the power spectral density, cross power spectral density, variance and covariance of the beam response along the whole axis. Time-domain solutions are obtained by time-step numerical integration methods involving analytical expressions of impulse response functions. Numerical examples show versatility of the non-local fractional beam model as well as computational advantages of the proposed solution procedure.

The encoding of the thermal grill illusion in the human spinal cord

Abstract Aims The spatial alternation of innocuous cold and warm stimuli on the skin can paradoxically provoke a hot, burning sensation, known as the thermal-grill illusion (TGI). Whether the TGI depends on spinal or supraspinal integration mechanisms is still debated. To assess whether the TGI can be accounted by integration of cold and warm afferent signals in the spinal cord, we leveraged anatomical knowledge on the spatial arrangement of dermatomes and spinal segmental projections. Methods We stimulated a series of skin locations on the right arm using one cold (∼20 °C) and one warm thermode (∼40°C). The two stimulus locations had identical physical distance on the skin. However, the distance between the cold and heat projection signals in the spinal cord varied across three conditions. Cold and warm inputs were delivered (1) within the same dermatome (e.g., C5–C5); (2) across the dermatome boundary of two adjacent spinal segments (e.g., C5–C6); (3) across the dermatome boundary of two non-adjacent spinal segments (e.g., C5–T1). In two experiments, we obtained an estimate of the strength of the TGI by asking 32 healthy participants to complete a temperature matching task. Results Participants overestimated the actual average temperature of the two thermodes (Exp. 1) and the cold temperature of one of the two thermodes (Exp. 2). However, this effect was significantly larger when cold and heat stimuli were delivered within the same dermatome (+6.57 ± 3.99°C and +9.88 ± 5.60 °C) or between dermatomes projecting to adjacent spinal segments (+6.26 ±4.44°C and +9.48 ± 5.83 °C), compared to when cold and heat stimuli projected to non-adjacent spinal segments (+3.46 ± 4.46 °C and +4.80 ± 3.21 °C). Conclusions These results demonstrate that the strength of the illusion is modulated by the segmental distance between cold and heat spinal signals, and show that the perceived quality and intensity of thermal stimuli depends upon low-level spatial summation mechanisms in the spinal cord.

Stochastic Analysis of a Nonlocal Fractional Viscoelastic Bar Forced by Gaussian White Noise

Recently, a displacement-based nonlocal bar model has been developed. The model is based on the assumption that nonlocal forces can be modeled as viscoelastic (VE) long-range interactions mutually exerted by nonadjacent bar segments due to their relative motion; the classical local stress resultants are also present in the model. A finite element (FE) formulation with closed-form expressions of the elastic and viscoelastic matrices has also been obtained. Specifically, Caputo's fractional derivative has been used in order to model viscoelastic long-range interaction. The static and quasi-static response has been already investigated. This work investigates the stochastic response of the nonlocal fractional viscoelastic bar introduced in previous papers, discretized with the finite element method (FEM), forced by a Gaussian white noise. Since the bar is forced by a Gaussian white noise, dynamical effects cannot be neglected. The system of coupled fractional differential equations ruling the bar motion can be decoupled only by means of the fractional order state variable expansion. It is shown that following this approach Monte Carlo simulation can be performed very efficiently. For simplicity, here the work is limited to the axial response, but can be easily extended to transverse motion.

Nested data independent MS/MS acquisition.

Data independent acquisition (DIA) attempts to provide comprehensive MS/MS data while providing a cycle time that is capable of following the elution profile of chromatographic peaks. Currently available MS technology is not yet fully capable of fulfilling these expectations. This paper suggests a new multiplex-based approach to more closely achieve this objective. Customized scans have been programmed for a Q Orbitrap instrument. Multiple nonadjacent mass range segments are sequentially collected (cut out) by the quadrupole. These combined mass ranges undergo fragmentation, and the resulting product ions are analyzed as a whole by the Orbitrap analyzer. The systematical variation of the mass range segments (nested design) permits the mathematical assignment of the observed product ions within a narrow precursor mass range. The proposed approach allows the use of mass windows that are narrower than those in conventional DIA (SWATH). A unique aspect of the proposed approach is the fact that halving the mass window width requires the addition of only a single multiplexed scan. This is different from conventional DIA, which requires the number of mass windows to be doubled in order to achieve the same objective. This paper shows that for a given cycle time, the proposed nested DIA technique produces significantly less chimeric product ion spectra than conventional DIA. However, further improvements from the programming, and most likely the hardware side, are still required in order to achieve the aim of comprehensive MS/MS. Graphical Abstract Schematic of nested design.

Percutaneous vertebroplasty in treatment of upper thoracic osteoporotic compression fracture

Objective To evaluate the feasibility, safety and efficacy of percutaneous vertebroplasty (PVP) for osteoporotic compression fracture of the upper thoracic spine. Methods The study enrolled 20 patients with osteoporotic compression fracture in 25 upper thoracic segments. The subjects (5 males and 15 females) aged at (71.0±10.8) years (range, 57-89 years). Fracture occurred in 2 T1, 3 T2, 5 T3 and 15 T4 segments. The subjects were submitted to puncture process via unilateral extrapedicular approach. Operation time, volume of infused bone cement, X-ray images and CT scan were recorded after operation. Visual analogue score (VAS), mobility score and Oswestry disability index (ODI) were assessed after operation. Results The procedure was successfully accomplished in all patients. Mean operation time was (39.7±10.6)min. Infusion volume of bone cement was 2.0-6.0 ml [(3.3±1.5)ml]. Eighteen patients were available to the follow-up of 5.5-18 months [(7.6±2.7)months]. Three patients (15%) were associated with cement leakage into the epidural (n=1), paravertebral soft tissues (n=1) and disc (n=1) but remained asymptomatic. One patient (5%) had new fracture at the non-adjacent and non-operative segments within 15 days, and had no recurrence after PVP. No other serious complications such as rib fracture, pneumothorax, pulmonary embolism, vascular injury, spinal injury and infection were found. VAS, mobility score and ODI improved at 3 d, 1 month, 3 months and final follow-up compared to those at 1 d pre-operation (P<0.01). Conclusions PVP is a safe and effective treatment for upper thoracic osteoporotic compression fracture, which is associated with few complications, reduced pain and improved mobility as well as quality of life. Rational surgical position and puncture approach are beneficial to a successful surgery. Key words: Thoracic vertebrae; Percutaneous vertebroplasty; Vertebral compression fractures

Finite-Element Formulation of a Nonlocal Hereditary Fractional-Order Timoshenko Beam

AbstractA mechanically-based nonlocal Timoshenko beam model, recently proposed by the authors, hinges on the assumption that nonlocal effects can be modeled as elastic long-range volume forces and moments mutually exerted by nonadjacent beam segments, which contribute to the equilibrium of any beam segment along with the classical local stress resultants. Long-range volume forces/moments linearly depend on the product of the volumes of the interacting beam segments, and on pure deformation modes of the beam, through attenuation functions governing the space decay of nonlocal effects. This paper investigates the response of this nonlocal beam model when viscoelastic long-range interactions are included, modeled by Caputo’s fractional derivatives. The finite-element method is used to discretize the pertinent fractional-order equations of motion. Closed-form solutions are obtained for creep tests by typical tools of fractional calculus. Numerical results are presented for various nonlocal parameters.

A new displacement-based framework for non-local Timoshenko beams

In this paper, a new theoretical framework is presented for modeling non-locality in shear deformable beams. The driving idea is to represent non-local effects as long-range volume forces and moments, exchanged by non-adjacent beam segments as a result of their relative motion described in terms of pure deformation modes of the beam. The use of these generalized measures of relative motion allows constructing an equivalent mechanical model of non-local effects. Specifically, long-range volume forces and moments are associated with three spring-like connections acting in parallel between couples of non-adjacent beam segments, and separately accounting for pure axial, pure bending and pure shear deformation modes. The variational consistency of the proposed non-local beam model is demonstrated by minimization of an appropriate total potential energy functional. Numerical results concerning the static behavior for different boundary and loading conditions are presented. It is shown that the proposed non-local beam model is able to capture experimental data on the static deflection of micro-beams, available in the literature.

Sagittal plane coordination dynamics of typically developing gait

BackgroundIndividuals who undergo an instrumented gait analysis often have an aberrant gait pattern due to neuromuscular impairments that adversely affect their coordination. Conventional instrumented gait analysis descriptors fail to capture the complex coordination dynamics of gait. This paper presents a straightforward methodology for generating descriptors of coordination dynamics based on dynamical systems theory and provides the largest reported dataset of sagittal plane coordination measures, including adjacent and non-adjacent segment pairings, from individuals free of gait pathology walking over-ground. MethodsTri-planar marker trajectories from 104 unimpaired subjects between the ages of 8 and 66years were collected as they walked at a self-selected speed on a level surface. Phase portraits for the pelvis, thigh, shank, and foot and continuous relative phase diagrams for the segment pairs of pelvis–thigh, thigh–shank, shank–foot, and thigh–foot were calculated. FindingsThe low coefficients of variation for each coordination curve are comparable to inter-subject coefficients of variation for kinematic curves, narrow confidence intervals for relative phase angles at four essential footfall conditions, and small standard deviation bands of the continuous relative phase diagrams are evidence that these curves characterize the coordination dynamics of normal gait. InterpretationThese findings support the use of this normative dataset as a reference for coordination studies in the clinic or research laboratory. Improving our understanding of gait strategies from the level of coordination and characterizing the natural variability in gait patterns offer a means to enhance our understanding of atypical gait patterns.

Osteotomy of the spine for multifocal deformities.

When a deformity involves more than one area of the spine, it becomes a multifocal deformity; such a deformity could either be extending on two adjacent segments, or be two separated deformities on two non-adjacent segments. The surgical management of multifocal spinal deformities is challenging and must be done through a thorough preoperative planning where spinal and pelvic parameters should accurately be determined. Different strategies should be applied depending on the type of the multifocal deformity, the area involved, the angulation and stiffness of the spine in that area, and the presence of either a pure sagittal malalignment or a combined coronal and sagittal malalignment. This paper discusses these strategies and gives guidelines regarding the use of the different osteotomy techniques depending on each different situation that the deformity spine surgeon may encounter. For instance, where is the ideal level to perform a pedicle subtraction osteotomy (PSO) in a multifocal deformity? How does one take advantage of the remaining high discs to increase the correction without the need for a second PSO? When and where does one perform an asymmetrical PSO? When and where does one perform two PSOs? How does navigation help the spine surgeon to push the surgical limits further in these complex cases? All these questions about the management of multifocal deformities will be discussed and answered with technical details and concrete examples of the different situations that may be encountered.

Finite element method for a nonlocal Timoshenko beam model

A finite element method is presented for a nonlocal Timoshenko beam model recently proposed by the authors. The model relies on the key idea that nonlocal effects consist of long-range volume forces and moments exchanged by non-adjacent beam segments, which contribute to the equilibrium of a beam segment along with the classical local stress resultants. The long-range volume forces/moments are linearly depending on the product of the volumes of the interacting beam segments, and their relative motion measured in terms of the pure beam deformation modes, through appropriate attenuation functions governing the spatial decay of nonlocal effects. In this paper, the beam model is reformulated within a variational framework involving a consistent total elastic potential energy functional. The latter serves as a basis to derive a suitable finite element formulation of the equilibrium equations. A local stiffness matrix and a nonlocal stiffness matrix contribute to the global stiffness matrix. While the local stiffness matrix is obtained by a standard assemblage of the classical element stiffness matrices, the nonlocal stiffness matrix is built as the sum of component matrices, each involving the stiffness of the long-range interactions between a couple of finite elements. A remarkable result is that, for most common attenuation functions of nonlocal effects, exact closed-form solutions can be found for every element of the nonlocal stiffness matrix. Numerical applications are presented for a variety of nonlocal parameters, including a comparison with experimental data.

Mechanically Based Nonlocal Euler-Bernoulli Beam Model

AbstractThis paper presents a nonlocal Euler-Bernoulli beam model. It is assumed that the equilibrium of a beam segment is attained because of the classical local stress resultants, along with long-range volume forces and moments exchanged by the beam segment with all the nonadjacent beam segments. Elastic long-range volume forces/moments are considered, built as linearly depending on the product of the volumes of the interacting beam segments and on generalized measures of their relative motion, based on the pure deformation modes of the beam. Attenuation functions governing the space decay of the nonlocal effects are introduced. The motion equations are derived in an integro-differential form by applying Hamilton’s principle. Numerical results are presented for a variety of nonlocal parameters. A comparison with experimental data is also provided.

Prevalence of adjacent segment disc degeneration in patients undergoing anterior cervical discectomy and fusion based on pre-operative MRI findings

Anterior cervical discectomy and fusion (ACDF) is a widely accepted surgical treatment for symptomatic cervical spondylosis. Some patients develop symptomatic adjacent segment degeneration, occasionally requiring further treatment. The cause and prevalence of adjacent segment degeneration and disease is unclear at present. Proponents for motion preserving surgery such as disc arthroplasty argue that this technique may decrease the “strain” on adjacent discs and thus decrease the incidence of symptomatic adjacent segment degeneration. The purpose of this study was to assess the pre-operative prevalence of adjacent segment degeneration in patients undergoing ACDF. A database review of three surgeons’ practice was carried out to identify patients who had undergone a one- or two-level ACDF for degenerative disc disease. Patients were excluded if they were operated on for recent trauma, had an inflammatory arthropathy (for example, rheumatoid arthritis), or had previous spine surgery. The pre-operative MRI of each patient was reviewed and graded using a standardised methodology. One hundred and six patient MRI studies were reviewed. All patients showed some evidence of intervertebral disc degeneration adjacent to the planned operative segment(s). Increased severity of disc degeneration was associated with increased age and operative level, but was not associated with sagittal alignment. Disc degeneration was more common at levels adjacent to the surgical level than at non-adjacent segments, and was more severe at the superior adjacent level compared with the inferior adjacent level. These findings support the theory that adjacent segment degeneration following ACDF is due in part to the natural history of cervical spondylosis.

Non-local stiffness and damping models for shear-deformable beams

This paper presents the dynamics of a non-local Timoshenko beam. The key assumption involves modeling non-local effects as long-range volume forces and moments mutually exerted by non-adjacent beam segments, that contribute to the equilibrium of any beam segment along with the classical local stress resultants. Elastic and viscous long-range volume forces/moments are endowed in the model. They are built as linearly depending on the product of the volumes of the interacting beam segments and on generalized measures of their relative motion, based on the pure deformation modes of the beam. Attenuation functions governing the space decay of the non-local effects are introduced. Numerical results are presented for a variety of non-local parameters.