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首页> 外文期刊>Journal of Biomechanics >A comprehensive approach for the validation of lumbar spine finite element models investigating post-fusion adjacent segment effects
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A comprehensive approach for the validation of lumbar spine finite element models investigating post-fusion adjacent segment effects

机译：腰椎有限元模型验证综合方法，调查融合后相邻段效应

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摘要

Spinal fusion surgery is usually followed by accelerated degenerative changes in the unfused segments above and below the treated segment(s), i.e., adjacent segment disease (ASD). While a number of risk factors for ASD have been suggested, its exact pathogenesis remains to be identified. Finite element (FE) models are indispensable tools to investigate mechanical effects of fusion surgeries on post-fusion changes in the adjacent segment kinematics and kinetics. Existing modeling studies validate only their intact FE model against in vitro data and subsequently simulate post-fusion in vivo conditions. The present study provides a novel approach for the comprehensive validation of a lumbar (T12-S1) FE model in post-fusion conditions. Sixteen simulated fusion surgeries, performed on cadaveric specimens using various testing and loading conditions, were modeled by this FE model. Predictions for adjacent segment range of motion (RoM) and intradiscal pressure (IDP) were compared with those obtained from the corresponding in vitro tests. Overall, 70% of the predicted adjacent segment RoMs were within the range of in vitro data for both intact and post-fusion conditions. Correlation (r) values between model and in vitro findings for the adjacent segment RoMs were positive and greater than 0.84. Most of the predicted IDPs were, however, out of the narrow range of in vitro IDPs at the adjacent segments but with great positive correlations (r > 0.89). FE modeling studies investigating the effect of fusion surgery on in vivo adjacent segment biomechanics are encouraged to use post-surgery in vitro data to validate their FE model.
机译：脊柱融合术后，治疗节段上方和下方未融合节段的退行性变通常会加速，即相邻节段疾病（ASD）。虽然已经提出了许多ASD的风险因素，但其确切的发病机制仍有待确定。有限元（FE）模型是研究融合手术对邻近节段运动学和动力学的融合后变化的力学影响的不可或缺的工具。现有的建模研究仅根据体外数据验证其完整的FE模型，并随后模拟体内融合后的条件。本研究为融合后腰椎（T12-S1）有限元模型的全面验证提供了一种新方法。利用该有限元模型对16例模拟融合手术进行了建模，这些手术是在不同的测试和加载条件下在尸体标本上进行的。将相邻节段运动范围（RoM）和椎间盘内压（IDP）的预测结果与相应的体外试验结果进行比较。总的来说，70%的预测相邻节段ROM在完整和融合后条件下的体外数据范围内。相邻节段ROM的模型和体外结果之间的相关性（r）值为正，大于0.84。然而，大多数预测的IDPs超出了相邻节段的体外IDPs的狭窄范围，但具有很大的正相关性（r>0.89）。研究融合手术对体内邻近节段生物力学影响的有限元建模研究被鼓励使用术后体外数据来验证其有限元模型。

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