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首页> 外文期刊>The international journal of medical robotics + computer assisted surgery: MRCAS >Finite element analysis in adjacent segment degeneration after lumbar fusion.
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Finite element analysis in adjacent segment degeneration after lumbar fusion.

机译：腰椎融合术后邻近节段变性的有限元分析。

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BACKGROUND: Adjacent segment degeneration (ASD) following lumbar fusion has been well documented in recent years. However, the pathogenesis of ASD is not clear. To investigate this issue, we established a finite element model of segments L2-L5, simulated a single-segment posterior fixation in L3-L4 and investigated the stress variation and the effects of the instrumented lumbar posterior fixation on adjacent levels. METHODS: Models A, B and C of L2-L5 multisegment finite element intact models were established. In model A, segment L3-L4 was not fixed and was without disc degeneration in the adjacent segment (L2-L3, L4-L5); in model B there was posterior pedicle fixation in segment L3-L4 without disc degeneration in the adjacent segment (L2-L3, L4-L5); in model C there was posterior pedicle fixation in segment L3-L4 with a degenerated disc in the adjacent segment (L2-L3, L4-L5). Four levels of axial pressure, 0.3, 0.5, 1.0 and 2.0 MPa, were compared between each model of the stress variation on the discs of the adjacent segment (L2-L3, L4-L5). RESULTS: The maximum principal stress mean value of disc L2-L3 under four pressures in model A was determined. The statistical results showed that stress was not significant difference in disc L2-L3 between models A and B, but there was a significant difference in disc L2-L3 between models A and C and a significant difference between each group in disc L4-L5 under four pressure conditions. CONCLUSIONS: The preoperative degeneration of the adjacent segment of the disc is a significant risk factor for ASD.
机译：背景：近年来，腰椎融合术后相邻节段变性（ASD）已有大量文献报道。然而，ASD的发病机制尚不清楚。为了研究此问题，我们建立了L2-L5节段的有限元模型，模拟了L3-L4节段的单节后路固定，并研究了应力变化和经仪器腰椎后路固定对邻近水平的影响。方法：建立了L2-L5多段有限元完整模型的A，B和C模型。在模型A中，节段L3-L4没有固定，并且相邻节段（L2-L3，L4-L5）中没有椎间盘退变。在模型B中，在L3-L4节段中进行椎弓根后固定，而在相邻节段（L2-L3，L4-L5）中没有椎间盘退变。在模型C中，在节段L3-L4中进行后椎弓根固定，并在相邻节段（L2-L3，L4-L5）中出现退化的椎间盘。在相邻段（L2-L3，L4-L5）圆盘上的应力变化的每种模型之间，比较了四个水平的轴向压力，分别为0.3、0.5、1.0和2.0 MPa。结果：确定了模型A在四个压力下盘L2-L3的最大主应力平均值。统计结果表明，模型A和模型B之间的应力在L2-L3椎间盘上无明显差异，但是模型A和模型C之间在椎间盘L2-L3上有显着差异，而在模型L4-L5下各组之间的显着差异在四个压力条件。结论：椎间盘相邻节段的术前变性是ASD的重要危险因素。

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