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Analysis of biomechanical changes after removal of instrumentation in lumbar arthrodesis by finite element analysis

被引：55
作者：
Kim, Ho-Joong [1 ,2 ]
Chun, Heoung-Jae [3 ]
Moon, Seong-Hwan [1 ]
Kang, Kyoung-Tak [3 ]
Kim, Hak-Sun [1 ]
Park, Jin-Oh [1 ]
Moon, Eun-Su [1 ]
Sohn, Joon-Seok [2 ]
Lee, Hwan-Mo [1 ]
机构：
[1] Yonsei Univ, Coll Med, Dept Orthopaed Surg, Seoul, South Korea
[2] Yonsei Sarang Hosp, Seoul, South Korea
[3] Yonsei Univ, Dept Mech Engn, Seoul 120749, South Korea
来源：
MEDICAL & BIOLOGICAL ENGINEERING & COMPUTING | 2010年 / 48卷 / 07期
关键词：
Adjacent segment degeneration; Pedicle screws; Posterolateral fusion; Finite element method; ADJACENT-SEGMENT DEGENERATION; INTERBODY FUSION; SPINAL INSTRUMENTATION; LONG-TERM; FOLLOW-UP; LUMBOSACRAL FUSION; STRESS-ANALYSIS; DISC; FIXATION; DISEASE;
D O I：
10.1007/s11517-010-0621-2
中图分类号：
TP39 [计算机的应用];
学科分类号：
080201 [机械制造及其自动化];
摘要：
The purpose of this study is to investigate the change in biomechanical milieu following removal of pedicle screws in instrumented single level lumbar arthrodesis. Using a validated finite element (FE) model of the intact lumbar spine (L2-5), two scenarios of L3-4 lumbar fusion were simulated: posterolateral fusion (PLF) at L3-4 using pedicle screws (PLF with pedicle screws; WiP) and L3-4 lumbar posterolateral fusion state after removal of pedicle screws (PLF without pedicle screws; WoP). The WiP model had greater range of motion (ROM) at each adjacent segment than the WoP model. This phenomenon became pronounced at the proximal adjacent segment under flexion moment. Similarly, removal of pedicle screws (the WoP model) relieved the maximal von Mises stress at adjacent segments under 4 moments compared to the WiP model. This study demonstrated that removal of pedicle screws could decrease stiffness of fusion segments, which would reduce the disk stress of adjacent segments.
引用
收藏
页码：703 / 709
页数：7
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