Biomechanical analysis of lumbar fusion with proximal interspinous process device implantation

2021 ◽  
Author(s):  
Hangkai Shen ◽  
Guy R. Fogel ◽  
Jia Zhu ◽  
Zhenhua Liao ◽  
Weiqiang Liu
Keyword(s):  
Lumbar Fusion ◽  
Biomechanical Analysis ◽  
Device Implantation ◽  
Interspinous Process Device

A Study to Compare the Efficacy of a Biodegradable Dynamic Fixation System With Titanium Devices in Posterior Spinal Fusion Between Articular Processes in a Canine Model

2020 ◽  
Vol 143 (3) ◽  
Author(s):  
Tailong Yu ◽  
Leyu Zheng ◽  
Guanghua Chen ◽  
Nanxiang Wang ◽  
Xiaoyan Wang ◽  
...  
Keyword(s):  
Lumbar Fusion ◽  
Biomechanical Analysis ◽  
Adjacent Segment ◽  
Rigid Fixation ◽  
Initial Shape ◽  
Posterior Lumbar Fusion ◽  
Dynamic Fixation ◽  
Flexion Extension ◽  
Biomechanical Tests ◽  
Fixation System

Abstract The objective of this study was to apply a biodegradable dynamic fixation system (BDFS) for lumbar fusion between articular processes and compare the fusion results and biomechanical changes with those of conventional rigid fixation. Twenty-four mongrel dogs were randomly assigned to 2 groups and subjected to either posterior lumbar fusion surgery with a BDFS or titanium rods (TRs) at the L5–L6 segments. Six animals in each group were sacrificed at 8 or 16 weeks. Fusion conditions were evaluated by computed tomography (CT), manual palpation, biomechanical tests, and histological analysis. Biomechanical tests were performed at the L4–7 (for range of motion (ROM)) and L5–6 (for fusion stiffness) segments. Histological examination was performed on organs, surrounding tissues, and the fused area. The magnesium alloy components maintained their initial shape 8 weeks after the operation, but the meshing teeth were almost completely degraded at 16 weeks. The biomechanical analysis revealed an increased lateral bending ROM at 8 weeks and axial torsion ROM at 16 weeks. The L4–5 extension–flexion ROMs in the BDFS group were 2.29 ± 0.86 deg and 3.17 ± 1.08 deg at 16 weeks, respectively, compared with 3.22 ± 0.56 deg and 5.55 ± 1.84 deg in TR group. However, both groups showed similar fusion results. The BDFS design is suitable, and its degradation in vivo is safe. The BDFS can be applied for posterior lumbar fusion between articular processes to complete the fusion well. Additionally, the BDFS can reduce the decline in lateral motion and hypermotion of the cranial adjacent segment in flexion–extension motion.

Biomechanical Analysis and Review of Lateral Lumbar Fusion Constructs

Spine ◽  
2010 ◽  
Vol 35 (Supplement) ◽  
pp. S361-S367 ◽  
Author(s):  
Andrew Cappuccino ◽  
G. Bryan Cornwall ◽  
Alexander W. L. Turner ◽  
Guy R. Fogel ◽  
Huy T. Duong ◽  
...  
Keyword(s):  
Lumbar Fusion ◽  
Biomechanical Analysis

scholarly journals Biomechanical analysis of a newly developed interspinous process device conjunction with interbody cage based on a finite element model

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243771
Author(s):  
In-Suk Bae ◽  
Koang-Hum Bak ◽  
Hyoung-Joon Chun ◽  
Je Il Ryu ◽  
Sung-Jae Park ◽  
...  
Keyword(s):  
Finite Element ◽  
Lumbar Spine ◽  
Finite Element Model ◽  
Element Model ◽  
Axial Rotation ◽  
Biomechanical Analysis ◽  
Interbody Cage ◽  
Lateral Bending ◽  
Flexion Extension ◽  
Interspinous Process Device

Purpose This study aimed to investigate the biomechanical effects of a newly developed interspinous process device (IPD), called TAU. This device was compared with another IPD (SPIRE) and the pedicle screw fixation (PSF) technique at the surgical and adjacent levels of the lumbar spine. Materials and methods A three-dimensional finite element model analysis of the L1-S1 segments was performed to assess the biomechanical effects of the proposed IPD combined with an interbody cage. Three surgical models—two IPD models (TAU and SPIRE) and one PSF model—were developed. The biomechanical effects, such as range of motion (ROM), intradiscal pressure (IDP), disc stress, and facet loads during extension were analyzed at surgical (L3-L4) and adjacent levels (L2-L3 and L4-L5). The study analyzed biomechanical parameters assuming that the implants were perfectly fused with the lumbar spine. Results The TAU model resulted in a 45%, 49%, 65%, and 51% decrease in the ROM at the surgical level in flexion, extension, lateral bending, and axial rotation, respectively, when compared to the intact model. Compared to the SPIRE model, TAU demonstrated advantages in stabilizing the surgical level, in all directions. In addition, the TAU model increased IDP at the L2-L3 and L4-L5 levels by 118.0% and 78.5% in flexion, 92.6% and 65.5% in extension, 84.4% and 82.3% in lateral bending, and 125.8% and 218.8% in axial rotation, respectively. Further, the TAU model exhibited less compensation at adjacent levels than the PSF model in terms of ROM, IDP, disc stress, and facet loads, which may lower the incidence of the adjacent segment disease (ASD). Conclusion The TAU model demonstrated more stabilization at the surgical level than SPIRE but less stabilization than the PSF model. Further, the TAU model demonstrated less compensation at adjacent levels than the PSF model, which may lower the incidence of ASD in the long term. The TAU device can be used as an alternative system for treating degenerative lumbar disease while maintaining the physiological properties of the lumbar spine and minimizing the degeneration of adjacent segments.

Biomechanical analysis of combination Ti/PEEK fusion cage designed with topology optimization

2020 ◽  
Vol 64 (1-4) ◽  
pp. 1245-1252
Author(s):  
Hongwei Wang ◽  
Yi Wan ◽  
Xinyu Liu ◽  
Zhanqiang Liu ◽  
Xiao Zhang ◽  
...  
Keyword(s):  
Topology Optimization ◽  
Lumbar Fusion ◽  
Stress Shielding ◽  
Peak Stress ◽  
Biomechanical Analysis ◽  
Shielding Effect ◽  
Peek Cage ◽  
Fusion Procedure ◽  
Cage Subsidence ◽  
Fusion Cage

Fusion cage has been used in lumbar fusion procedure to treat degenerative disc disorders for decades. To address the drawback of Titanium (Ti) and polyetheretherketone (PEEK) cage, a combination Ti/PEEK cage was proposed in present study. Topology optimization was performed to tailor the topological structure of Ti/PEEK cage. The biomechanical performance was comprehensively assessed using finite element method under simulated physiological load conditions. The volume of optimized cage was reduced by 9.7%. The increased volume for bone graft might improve the fusion performance. The lower peak stress was observed on superior and inferior bone endplates of Ti/PEEK cage model, which reduced the risk of cage subsidence. Meanwhile, Ti/PEEK cage effectively reduced the stress shielding effect associated with over-stiffness of Ti cage. In conclusion, the combination Ti/PEEK cage might be a better choice for fusion surgery in relation to Ti or PEEK cage.

The influence of facet joint orientation and tropism on the stress at the adjacent segment after lumbar fusion surgery: a biomechanical analysis

2015 ◽  
Vol 15 (8) ◽  
pp. 1841-1847 ◽  
Author(s):  
Ho-Joong Kim ◽  
Kyoung-Tak Kang ◽  
Juhyun Son ◽  
Choon-Ki Lee ◽  
Bong-Soon Chang ◽  
...  
Keyword(s):  
Facet Joint ◽  
Lumbar Fusion ◽  
Biomechanical Analysis ◽  
Adjacent Segment ◽  
Joint Orientation ◽  
Fusion Surgery ◽  
Lumbar Fusion Surgery

Case Example: Adjacent Segment Disease: What Is It, and How Is It Rated?

2011 ◽  
Vol 16 (2) ◽  
pp. 8-9
Author(s):  
Marjorie Eskay-Auerbach
Keyword(s):  
Clinical Symptoms ◽  
Lumbar Fusion ◽  
Adjacent Segment Degeneration ◽  
Adjacent Segment Disease ◽  
Adjacent Segment ◽  
Disc Space Narrowing ◽  
Disc Disease ◽  
Disc Space ◽  
Radiographic Findings ◽  
Asymptomatic Patients

Abstract The incidence of cervical and lumbar fusion surgery has increased in the past twenty years, and during follow-up some of these patients develop changes at the adjacent segment. Recognizing that adjacent segment degeneration and disease may occur in the future does not alter the rating for a cervical or lumbar fusion at the time the patient's condition is determined to be at maximum medical improvement (MMI). The term adjacent segment degeneration refers to the presence of radiographic findings of degenerative disc disease, including disc space narrowing, instability, and so on at the motion segment above or below a cervical or lumbar fusion. Adjacent segment disease refers to the development of new clinical symptoms that correspond to these changes on imaging. The biomechanics of adjacent segment degeneration have been studied, and, although the exact mechanism is uncertain, genetics may play a role. Findings associated with adjacent segment degeneration include degeneration of the facet joints with hypertrophy and thickening of the ligamentum flavum, disc space collapse, and translation—but the clinical significance of these radiographic degenerative changes remains unclear, particularly in light of the known presence of abnormal findings in asymptomatic patients. Evaluators should not rate an individual in anticipation of the development of changes at the level above a fusion, although such a development is a recognized possibility.

Biomechanical Analysis of Tool Use

2012 ◽  
Vol 220 (1) ◽  
pp. 53-54 ◽  
Author(s):  
Elena Biryukova ◽  
Blandine Bril
Keyword(s):  
Tool Use ◽  
Biomechanical Analysis
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