Combinations of Biomechanical Metrics Involving Single and Multi Level Lumbar Posterior Dynamic Spinal Treatments

2012 ◽  
Author(s):  
Boyle C. Cheng ◽  
Daniel J. Cook ◽  
Matt Yeager ◽  
Bin Lu ◽  
Donald M. Whiting
Keyword(s):  
Lumbar Spine ◽  
Range Of Motion ◽  
Dynamic Systems ◽  
Tissue Response ◽  
Motion Preservation ◽  
Fixation Devices ◽  
Biomechanical Parameters ◽  
Multi Level ◽  
New Devices

The subtle effects of motion preservation devices are comparatively more difficult to detect based wholly on the range of motion (RoM) parameter, despite the historical success in characterizing fixation devices. Additional approaches such as descriptive facet techniques, i.e., facet translations analysis, and newly defined metrics, i.e., interpedicular displacement (ID) must first be established, verified and standardized. Ideally, more complete biomechanical parameters would facilitate clinical understanding of specific new devices. The recent focus in our lab has been to measure the RoM in conjunction with other parameters, including ID, to more completely characterize a lumbar spine treated with a posterior dynamic systems (PDS). Furthermore, understanding the construct and which components dominate overall tissue response is important for PDS systems.

Impairment Tutorial: Recurrent Radioculpathy: Recurrent Radioculpathy and Apportionment

2002 ◽  
Vol 7 (4) ◽  
pp. 8-10
Author(s):  
Christopher R. Brigham ◽  
Leon H. Ensalada
Keyword(s):  
Lumbar Spine ◽  
Range Of Motion ◽  
Disk Herniation ◽  
Fourth Edition ◽  
Recurrent Injury ◽  
Injury Model ◽  
Whole Person ◽  
Spinal Region

Abstract Recurrent radiculopathy is evaluated by a different approach in the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, compared to that in the Fourth Edition. The AMA Guides, Fifth Edition, specifies several occasions on which the range-of-motion (ROM), not the Diagnosis-related estimates (DRE) method, is used to rate spinal impairments. For example, the AMA Guides, Fifth Edition, clarifies that ROM is used only for radiculopathy caused by a recurrent injury, including when there is new (recurrent) disk herniation or a recurrent injury in the same spinal region. In the AMA Guides, Fourth Edition, radiculopathy was rated using the Injury Model, which is termed the DRE method in the Fifth Edition. Also, in the Fourth Edition, for the lumbar spine all radiculopathies resulted in the same impairment (10% whole person permanent impairment), based on that edition's philosophy that radiculopathy is not quantifiable and, once present, is permanent. A rating of recurrent radiculopathy suggests the presence of a previous impairment rating and may require apportionment, which is the process of allocating causation among two or more factors that caused or significantly contributed to an injury and resulting impairment. A case example shows the divergent results following evaluation using the Injury Model (Fourth Edition) and the ROM Method (Fifth Edition) and concludes that revisions to the latter for rating permanent impairments of the spine often will lead to different results compared to using the Fourth Edition.

scholarly journals A Scoring System for Anterior Longitudinal Ligament Ossification of the Lumbar Spine in Diffuse Idiopathic Skeletal Hyperostosis: Relationship Between the Extent of Ligament Ossification and the Range of Motion

2021 ◽  
pp. 219256822199668
Author(s):  
Yusuke Murakami ◽  
Tadao Morino ◽  
Masayuki Hino ◽  
Hiroshi Misaki ◽  
Hiroshi Imai ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Intervertebral Disc ◽  
Range Of Motion ◽  
Scoring System ◽  
Diffuse Idiopathic Skeletal Hyperostosis ◽  
Disc Height ◽  
Rater Reliability ◽  
Canal Stenosis ◽  
Intervertebral Disc Height ◽  
The Relationship

Study Design: Retrospective observational study. Objective: To investigate the relationship between the extent of ligament ossification and the range of motion (ROM) of the lumbar spine and develop a new scoring system. Methods: Forty-three patients (30 men and 13 women) with lumbar spinal canal stenosis who underwent decompression from January to December 2018. Ligament ossification at L1/2 to L5/S was assessed on plain X-ray (Xp) and computed tomography (CT) using a modified Mata scoring system (0 point: no ossification, 1 point: ossification of less than half of the intervertebral disc height, 2 points: ossification of half or more of the intervertebral disc height, 3 points: complete bridging), and the intra-rater and inter-rater reliability of the scoring was assessed. The relationship of the scores with postoperative lumbar ROM was investigated. Result: Intra-rater reliability was high (Cronbach’s α was 0.74 for L5/S on Xp but 0.8 or above for other sections), as was inter-rater reliability (Cronbach’s α was 0.8 or above for all the segments). ROM significantly decreased as the score increased (scores 1 to 2, and 2 to 3). A significant moderate negative correlation was found between the sum of the scores at L1/2-L5/S and the ROM at L1-S (ρ = − 0.4493, P = 0.025). Conclusion: Our scoring system reflects lumbar mobility and is reproducible. It is effective for assessing DISH in fractures and spinal conditions, and monitoring effects on treatment outcomes and changes over time.

scholarly journals Wound Closure After Posterior Multi-level Lumbar Spine Surgery: An Anatomical Cadaver Study and Technical Note

Cureus ◽  
2018 ◽  
Author(s):  
Emre Yilmaz ◽  
Tamir Tawfik ◽  
Thomas M O'Lynnger ◽  
Joe Iwanaga ◽  
Ronen Blecher ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Spine Surgery ◽  
Wound Closure ◽  
Cadaver Study ◽  
Technical Note ◽  
Lumbar Spine Surgery ◽  
Multi Level

Design and development of a novel expanding flexible rod device (FRD) for stability in the lumbar spine: A finite-element study

2020 ◽  
Vol 43 (12) ◽  
pp. 803-810 ◽  
Author(s):  
Masud Rana ◽  
Sandipan Roy ◽  
Palash Biswas ◽  
Shishir Kumar Biswas ◽  
Jayanta Kumar Biswas
Keyword(s):  
Finite Element ◽  
Lumbar Spine ◽  
Range Of Motion ◽  
Pedicle Screw ◽  
Axial Rotation ◽  
Von Mises Stress ◽  
Lateral Bending ◽  
Intact Bone ◽  
Flexion Extension ◽  
Von Mises

The aim of this study is to design a novel expanding flexible rod device, for pedicle screw fixation to provide dynamic stability, based on strength and flexibility. Three-dimensional finite-element models of lumbar spine (L1-S) with flexible rod device on L3-L4-L5 levels are developed. The implant material is taken to be Ti-6Al-4V. The models are simulated under different boundary conditions, and the results are compared with intact model. In natural model, total range of motion under 10 Nm moment were found 66.7°, 24.3° and 13.59°, respectively during flexion–extension, lateral bending and axial rotation. The von Mises stress at intact bone was 4 ± 2 MPa and at bone, adjacent to the screw in the implanted bone, was 6 ± 3 MPa. The von Mises stress of disc of intact bone varied from 0.36 to 2.13 MPa while that of the disc between the fixed vertebra of the fixation model reduced by approximately 10% for flexion and 25% for extension compared to intact model. The von Mises stresses of pedicle screw were 120, 135, 110 and 90 MPa during flexion, extension, lateral bending, and axial rotation, respectively. All the stress values were within the safe limit of the material. Using the flexible rod device, flexibility was significantly increased in flexion/extension but not in axial rotation and lateral bending. The results suggest that dynamic stabilization system with respect to fusion is more effective for homogenizing the range of motion of the spine.

Comparison of porcine and human lumbar spine flexion mechanics*

2003 ◽  
Vol 16 (01) ◽  
pp. 44-49 ◽  
Author(s):  
G. A. Dumas ◽  
D. A. Bednar ◽  
J. P. Dickey
Keyword(s):  
Lumbar Spine ◽  
Range Of Motion ◽  
Mechanical Tests ◽  
Neutral Position ◽  
Spinal Fixation ◽  
Potential Health ◽  
Human Lumbar Spine ◽  
Pure Moment ◽  
Low Stiffness

SummaryAnimal models have been proposed as an alternative to human spinal specimens for in vitro mechanical testing due to the limited availability, poor reproducibility, high cost, and potential health risk associated with human specimens. The purpose of this study was to directly compare the flexion biomechanics of porcine and human lumbar spines. We determined the range of motion, laxity zone and the stiffness under pure-moment flexion loading. The porcine and human specimens showed qualitative similarities in mechanical behaviour. However the porcine specimens demonstrated a number of quantitative differences including a less-stiff, more extensive, low-stiffness region around the neutral position and a larger flexion range of motion. The results suggest that the porcine lumbar spine may be a potential model for the human lumbar spine for certain in vitro mechanical tests including comparisons between spinal fixation constructs.

The influence of initial resting posture on range of motion of the lumbar spine

2001 ◽  
Vol 6 (3) ◽  
pp. 139-144 ◽  
Author(s):  
J.E. Coates ◽  
A.H. McGregor ◽  
I.D. Beith ◽  
S.P.F. Hughes
Keyword(s):  
Lumbar Spine ◽  
Range Of Motion

Effect of Different Fixation Techniques on Segmental Kinematics and Load Sharing of Lumbar Spine: A FEM Study

2012 ◽  
Author(s):  
A. Kiapour ◽  
A. M. Kiapour ◽  
H. Serhan ◽  
S. Garfin ◽  
T. Allen ◽  
...  
Keyword(s):  
Load Distribution ◽  
Interbody Fusion ◽  
Posterior Instrumentation ◽  
Fusion Rate ◽  
Vertebral Endplate ◽  
Fixation Devices ◽  
Fixation Techniques ◽  
Segmental Fixation ◽  
Biomechanical Parameters ◽  
Disc Level

Fusion has been the gold standard for treatment of various disorders associated with the spine especially at intervertebral disc level. The surgical procedure for fusion often requires fixation of the anterior column of the defected segment with interbody fixation devices such as cages. Anterior (ALIF), transforaminal (TLIF) and lateral (LIF) lumbar interbody fusion are some of the most common techniques for segmental fixation. The unacceptably low fusion rate with the interbody cages, when used as standalone, has led to the practice of combining these devices with posterior instrumentation. The segmental kinematics, the load distribution on the vertebral endplate and on the components of the posterior instrumentation are the key biomechanical parameters which can help to evaluate the performance of interbody fixation techniques with posterior instrumentation. We conducted a finite element (FE) study to compare biomechanics of these fixation methods.

Novel 3-Dimensional Motion Analysis Method for Measuring the Lumbar Spine Range of Motion

Spine ◽  
2013 ◽  
Vol 38 (21) ◽  
pp. E1327-E1333 ◽  
Author(s):  
Michio Tojima ◽  
Naoshi Ogata ◽  
Arito Yozu ◽  
Masahiko Sumitani ◽  
Nobuhiko Haga
Keyword(s):  
Lumbar Spine ◽  
Range Of Motion ◽  
Motion Analysis ◽  
Analysis Method ◽  
3 Dimensional
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