Biomechanical study of proximal adjacent segment degeneration after posterior lumbar interbody fusion and fixation: a finite element analysis
Abstract Purpose To investigate the biomechanical changes in the proximal adjacent segment with different grades of degeneration after posterior lumbar interbody fusion (PLIF). Methods We created three finite element models of the L3–5 with different grades of degeneration (healthy, mild, and modera...
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doaj-506f1917ee9b49b2a4d84e06888b767a2020-11-25T03:27:45ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2019-05-011411710.1186/s13018-019-1150-9Biomechanical study of proximal adjacent segment degeneration after posterior lumbar interbody fusion and fixation: a finite element analysisShuai Jiang0Weishi Li1Department of Orthopaedics, Peking University Third HospitalDepartment of Orthopaedics, Peking University Third HospitalAbstract Purpose To investigate the biomechanical changes in the proximal adjacent segment with different grades of degeneration after posterior lumbar interbody fusion (PLIF). Methods We created three finite element models of the L3–5 with different grades of degeneration (healthy, mild, and moderate) at the L3–4 that were developed by changing the disc height and material properties of the nucleus pulposus. The L4–5 were operated by interbody fusion cages and pedicle screws. All models were loaded with a compressive pre-load of 400 N and a bending moment of 10 N a in three planes to recreate flexion, extension, lateral bending, and axial rotation. The range of motion (ROM), nucleus pressure, and annulus fibrosus pressure of the L3–4 were evaluated. Results The ROM, nucleus pressure, and annulus fibrosus pressure increased at the L3–4 after PLIF. As the degeneration progressed in the L3–4, the ROM of the L3–4 decreased while the nucleus pressure and annulus fibrosus pressure increased. Conclusions Adjacent segment degeneration (ASD) may be related to the ROM and intradiscal pressure after PLIF. However, as the degeneration of the proximal adjacent segment increases, the ROM in the proximal adjacent segment gradually decreases, but the pressure on the nucleus pulposus and annulus fibrosus gradually increases. Degeneration of the proximal adjacent segment before operation is a risk factor for the ASD after PLIF.http://link.springer.com/article/10.1186/s13018-019-1150-9Adjacent segment degeneration; Finite element analysisRange of motionIntervertebral disc pressure |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Shuai Jiang Weishi Li |
spellingShingle |
Shuai Jiang Weishi Li Biomechanical study of proximal adjacent segment degeneration after posterior lumbar interbody fusion and fixation: a finite element analysis Journal of Orthopaedic Surgery and Research Adjacent segment degeneration; Finite element analysis Range of motion Intervertebral disc pressure |
author_facet |
Shuai Jiang Weishi Li |
author_sort |
Shuai Jiang |
title |
Biomechanical study of proximal adjacent segment degeneration after posterior lumbar interbody fusion and fixation: a finite element analysis |
title_short |
Biomechanical study of proximal adjacent segment degeneration after posterior lumbar interbody fusion and fixation: a finite element analysis |
title_full |
Biomechanical study of proximal adjacent segment degeneration after posterior lumbar interbody fusion and fixation: a finite element analysis |
title_fullStr |
Biomechanical study of proximal adjacent segment degeneration after posterior lumbar interbody fusion and fixation: a finite element analysis |
title_full_unstemmed |
Biomechanical study of proximal adjacent segment degeneration after posterior lumbar interbody fusion and fixation: a finite element analysis |
title_sort |
biomechanical study of proximal adjacent segment degeneration after posterior lumbar interbody fusion and fixation: a finite element analysis |
publisher |
BMC |
series |
Journal of Orthopaedic Surgery and Research |
issn |
1749-799X |
publishDate |
2019-05-01 |
description |
Abstract Purpose To investigate the biomechanical changes in the proximal adjacent segment with different grades of degeneration after posterior lumbar interbody fusion (PLIF). Methods We created three finite element models of the L3–5 with different grades of degeneration (healthy, mild, and moderate) at the L3–4 that were developed by changing the disc height and material properties of the nucleus pulposus. The L4–5 were operated by interbody fusion cages and pedicle screws. All models were loaded with a compressive pre-load of 400 N and a bending moment of 10 N a in three planes to recreate flexion, extension, lateral bending, and axial rotation. The range of motion (ROM), nucleus pressure, and annulus fibrosus pressure of the L3–4 were evaluated. Results The ROM, nucleus pressure, and annulus fibrosus pressure increased at the L3–4 after PLIF. As the degeneration progressed in the L3–4, the ROM of the L3–4 decreased while the nucleus pressure and annulus fibrosus pressure increased. Conclusions Adjacent segment degeneration (ASD) may be related to the ROM and intradiscal pressure after PLIF. However, as the degeneration of the proximal adjacent segment increases, the ROM in the proximal adjacent segment gradually decreases, but the pressure on the nucleus pulposus and annulus fibrosus gradually increases. Degeneration of the proximal adjacent segment before operation is a risk factor for the ASD after PLIF. |
topic |
Adjacent segment degeneration; Finite element analysis Range of motion Intervertebral disc pressure |
url |
http://link.springer.com/article/10.1186/s13018-019-1150-9 |
work_keys_str_mv |
AT shuaijiang biomechanicalstudyofproximaladjacentsegmentdegenerationafterposteriorlumbarinterbodyfusionandfixationafiniteelementanalysis AT weishili biomechanicalstudyofproximaladjacentsegmentdegenerationafterposteriorlumbarinterbodyfusionandfixationafiniteelementanalysis |
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