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首页> 外文会议>International conference on experimental mechanics >Decisive factor in increase of loading at adjacent segments after lumbar fusion: operative technique, pedicle screws, or fusion itself. - biomechanical analysis using finite element
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Decisive factor in increase of loading at adjacent segments after lumbar fusion: operative technique, pedicle screws, or fusion itself. - biomechanical analysis using finite element

机译：腰椎融合术后相邻节段负荷增加的决定性因素：手术技术，椎弓根螺钉或融合本身。 -使用有限元的生物力学分析

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The aim of this study is to investigate the change in biomechanical milieu following removal of pedicle screws or removal of spinous process with posterior ligament complex in instrumented single level lumbar arthrodesis. We developed and validated a finite element model (FEM) of the intact lumbar spine (L2-4). Four scenarios of L3-4 lumbar fusion were simulated: posterolateral fusion (PLF) at L3-4 using pedicle screw system with preservation of PLC (Pp WiP), L3-4 lumbar posterolateral fusion state after removal of pedicle screw system with preservation of PLC (Pp WoP), L3-4 using pedicle screw system without preservation PLC (Sp WiP), L3-4 lumbar posterolateral fusion state after removal of pedicle screw system without preservation of PLC (Sp WoP). For these models, we investigated the range of motion and maximal Von mises stress of disc in all segments under various moments. All fusion models demonstrated increase in range of motion at adjacent segments compared to the intact model.For the four fusion models, the WiP model s P had the largest increase in range of motion at each adjacent segment. This study demonstrated that removal of pedicle screw system and preservation of PLC after complete lumbar spinal fusion could reduce the stress of adjacent segments synergistically and might have beneficial effects in preventing ASD.
机译：这项研究的目的是调查在单器械腰椎关节固定术中去除椎弓根螺钉或去除后韧带复合物的棘突后生物力学环境的变化。我们开发并验证了完整腰椎（L2-4）的有限元模型（FEM）。模拟了L3-4腰椎融合的四种情况：使用带PLC的椎弓根螺钉系统在L3-4的后外侧融合（PLF），保留PLC的带蒂螺钉系统的L3-4腰椎后外侧融合状态（Pp WoP），L3-4使用椎弓根螺钉系统而未保存PLC（Sp WiP），L3-4腰椎后外侧融合状态，移除椎弓根螺钉系统后未保留PLC（Sp WoP）。对于这些模型，我们研究了在不同时刻下所有节段的椎间盘的运动范围和最大Von mises应力。与完整模型相比，所有融合模型都证明了相邻段的运动范围增加。对于四个融合模型，WiP模型s P在每个相邻段的运动范围增加最大。这项研究表明，腰椎完全融合后移除椎弓根螺钉系统和保留PLC可以协同降低相邻节段的应力，并可能对预防ASD产生有益的作用。

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