Biomechanical efficacy of a combined interspinous fusion system with a lumbar interbody fusion cage

详细信息    查看全文

• 作者：Yeong-Hyeon Kim ; Tae-Gon Jung&#8230
• 关键词：Finite element ; Interspinous fusion system ; Pedicle screw fixation ; Interbody fusion cage ; Adjacent segment disease
• 刊名：International Journal of Precision Engineering and Manufacturing
• 出版年：2015
• 出版时间：May 2015
• 年：2015
• 卷：16
• 期：5
• 页码：997-1001
• 全文大小：1,232 KB
• 参考文献：1.Hilibrand, A. S. and Rand, N., 鈥淒egenerative Lumbar Stenosis: Diagnosis and Management,鈥?Journal of the American Academy of Orthopaedic Surgeons, Vol. 7, No. 4, pp. 239鈥?49, 1999.
  2.Oda, I., Cunningham, B. W., Lee, G. A., Abumi, K., Kaneda, K., and McAfee, P. C., 鈥淏iomechanical Properties of Anterior Thoracolumbar Multisegmental Fixation: An Analysis of Construct Stiffness and Screw-Rod Strain,鈥?Spine, Vol. 25, No. 18, pp. 2303鈥?311, 2000.View Article
  3.Akamaru, T., Kawahara, N., Yoon, S. T., Minamide, A., Kim, K. S., et al., 鈥淎djacent Segment Motion after a Simulated Lumbar Fusion in Different Sagittal Alignments: A Biomechanical Analysis,鈥?Spine, Vol. 28, No. 14, pp. 1560鈥?566, 2003.
  4.Chow, D. H., Luk, K. D., Evans, J. H., and Leong, J. C., 鈥淓ffects of Short Anterior Lumbar Interbody Fusion on Biomechanics of Neighboring Unfused Segments,鈥?Spine, Vol. 21, No. 5, pp. 549鈥?55, 1996.View Article
  5.Steffee, A. D. and Sitkowski, D. J., 鈥淧osterior lumbar Interbody Fusion and Plates,鈥?Clinical Orthopaedics and Related Research, Vol. 227, pp. 99鈥?02, 1988.
  6.Voronov, L. I., Tsitsopoulos, P. P., Havey, R. M., Potluri, T., et al., 鈥淏iomechanical Assessment of a Polyaxial Interspinous Plating System as an Adjunct to Interbody Fusion,鈥?Proc. of Orthopaedic Research Society Annual Meeting, Poster No. 2146, 2012.
  7.Karahalios, D Anchor. G., Kaibara, T., Porter, R. W., Kakarla, U. K., Reyes, P. M., et al., 鈥淏iomechanics of a Lumbar Interspinous with Anterior Lumbar Interbody Fusion: Laboratory Investigation,鈥?Journal of Neurosurgery: Spine, Vol. 12, No. 4, pp. 372鈥?80, 2010.
  8.Chen, W. M., Park, C., Lee, K., and Lee, S., 鈥淚n Situ Contact Analysis of the Prosthesis Components of Prodisc-L in Lumbar Spine Following Total Disc Replacement,鈥?Spine, Vol. 34, No. 20, pp. E716鈥揈723, 2009.
  9.Ahn, Y. H., Jung, D. Y., Park, K. W., and Lee, S. J., 鈥淏iomechanical Effects of Posterior Dynamic Stabilization System on Lumbar Kinematics: A Finite Element Analysis,鈥?Journal of Biomedical Engineering Research, Vol. 29, No. 2, pp. 139鈥?45, 2008.
  10.Zander, T., Rohlmann, A., Calisse, J., and Bergmann, G., 鈥淓stimation of Muscle Forces in the Lumbar Spine during Upper-Body Inclination,鈥?Clinical Biomechanics, Vol. 16, pp. S73鈥揝80, 2001.
  11.Goel, V. K., Monroe, B. T., Gilbertson, L. G., and Brinckmann, P., 鈥淚nterlaminar Shear Stresses and Laminae Separation in a Disc: Finite Element Analysis of the L3鈥揕4 Motion Segment Subjected to Axial Compressive Loads,鈥?Spine, Vol. 20, No. 6, pp. 689鈥?98, 1995.View Article
  12.Shirazi-Adl, S. A., Shrivastava, S. C., and Ahmed, A. M., 鈥淪tress Analysis of the Lumbar Disc-Body Unit in Compression a Three- Dimensional Nonlinear Finite Element Study,鈥?Spine, Vol. 9, No. 2, pp. 120鈥?34, 1984.View Article
  13.Sharma, M., Langrana, N. A., and Rodriguez, J., 鈥淩ole of Ligaments and Facets in Lumbar Spinal Stability,鈥?Spine, Vol. 20, No. 8, pp. 887鈥?00, 1995.View Article
  14.Smit, T. H., Odgaard, A., and Schneider, E., 鈥淪tructure and Function of Vertebral Trabecular Bone,鈥?Spine, Vol. 22, No. 24, pp. 2823鈥?833, 1997.View Article
  15.Panjabi, M. M. and Goel, V. K., 鈥淎djacent-Level Effects: Design of a New Test Protocol and Finite Element Model Simulations of Disc Replacement,鈥?Roundtables in Spine Surgery; Spine Biomechanics: Evaluation of Motion Preservation Devices and Relevant Terminology, Vol. 1, No. 1, pp. 45鈥?8, 2005.
  16.Kettler, A., Drumm, J., Heuer, F., Haeussler, K., Mack, C., et al., 鈥淐an a Modified Interspinous Spacer Prevent Instability in Axial Rotation and Lateral Bending? A Biomechanical in Vitro Study Resulting in a New Idea,鈥?Clinical Biomechanics, Vol. 23, No. 2, pp. 242鈥?47, 2008.View Article
  17.Pollintine, P., Dolan, P., Tobias, J. H., and Adams, M. A., 鈥淚ntervertebral Disc Degeneration Can Lead to 鈥淪tress-Shielding鈥?of the Anterior Vertebral Body: A Cause of Osteoporotic Vertebral Fracture?鈥?Spine, Vol. 29, No. 7, pp. 774鈥?82, 2004.View Article
  18.Gertzbein, S., Chan, K., Tile, M., Seligman, J., and Kapasouri, A., 鈥淢oire Patterns: An Accurate Technique for Determination of the Locus of the Centres of Rotation,鈥?Journal of Biomechanics, Vol. 18, No. 7, pp. 501鈥?09, 1985.View Article
  19.Brodke, D. S., Gollogly, S., Bachus, K. N., Mohr, R. A., and Nguyen, B. K. N., 鈥淎nterior Thoracolumbar Instrumentation: Stiffness and Load Sharing Characteristics of Plate and Rod Systems,鈥?Spine, Vol. 28, No. 16, pp. 1794鈥?801, 2003.View Article
  20.Moumene, M. and Afshari, P., 鈥淏iomechanical Comparison of Rigid vs. Semi-rigid Rods in Spinal Fusion Constructs: A Finite Element Study,鈥?Spine Arthroplasty Society, Abstract No. 82, pp. 23鈥?4, 2007.
  
• 作者单位：Yeong-Hyeon Kim (1)
  Tae-Gon Jung (2)
  Eun-Young Park (1)
  Guen-Woo Kang (1)
  Kyung-Ah Kim (3)
  Sung-Jae Lee (4)
  
  1. Department of Medical Device Evaluation, Ministry of Food and Drug Safety, 303 Osongsaengmyeong 5-ro, Osong-eup, Cheongju-si, Chungcheongbuk-do, 363-954, South Korea
  2. Medical Device Development Center, OSONG Medical Innovation Foundation, 123 Osongsaengmyeong ro, Osong-eup, Cheongju-si, Chungcheongbuk-do, 363-951, South Korea
  3. Development of Biomedical Engineering, College of Medicine, Chungbuk National University, 1, Chungdae-ro, Seowon-gu, Cheongju-si, Chungcheongbuk-do, 362-763, South Korea
  4. Development of Biomedical Engineering, Inje University, 197, Inje-ro, Gimhae-si, Gyeongsangnam-do, 621-749, South Korea
  
• 刊物类别：Engineering
• 刊物主题：Industrial and Production Engineering
  Materials Science
  
• 出版者：Korean Society for Precision Engineering, in co-publication with Springer Verlag GmbH
• ISSN：2005-4602

文摘

An interspinous fusion system (IFS) has been introduced as an alternative to pedicle screw fixation (PSF), commonly used in spinal fusion. In this study, a finite element analysis was performed to assess biomechanical efficacy of the combined IFS with an interbody fusion cage. post-operative models were created to compare the biomechanical efficacy of IFS to that of other fixations including: Type 1, Fusion cage only; Type 2, IFS only; Type 3, PSF only; Type 4, Type 1 plus Type 2; Type 5, Type 1 plus Type 3. All device implantations were simulated at L4-5. At the operated level, Type 4 was shown to have comparable reduction in ROM (range of motion) as Type 5 with both models effectively inducing greater stability compared to other models regardless of loading type. At the adjacent level, Type 4 showed less increase in ROM than Type 5 and was closer to the pre-operative level. In terms of the COR (center of rotation) and load sharing between the anterior and posterior parts of the spine, Type 4 remained closer to that of the intact spine. These results suggest that IFS with a cage may help reduce degeneration at adjacent levels while effectively providing stability at the operated level.