1
|
Cho M, Han JS, Kang S, Ahn CH, Kim DH, Kim CH, Kim KT, Kim AR, Hwang JM. Biomechanical Effects of Different Sitting Postures and Physiologic Movements on the Lumbar Spine: A Finite Element Study. Bioengineering (Basel) 2023; 10:1051. [PMID: 37760153 PMCID: PMC10525568 DOI: 10.3390/bioengineering10091051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 08/30/2023] [Accepted: 09/05/2023] [Indexed: 09/29/2023] Open
Abstract
This study used the finite element method(FEM) to investigate how pressure on the lumbar spine changes during dynamic movements in different postures: standing, erect sitting on a chair, slumped sitting on a chair, and sitting on the floor. Three load modes (flexion, lateral bending, and axial rotation) were applied to the FEM, simulating movements of the lumbar spine. Results showed no significant difference in pressure distribution on the annulus fiber and nucleus pulposus, representing intradiscal pressure, as well as on the cortical bone during movements between standing and erect sitting postures. However, both slumped sitting on a chair and sitting on the floor postures significantly increased pressure on the nucleus pulposus, annulus fibrosus, and cortical bone in all three movements when compared to standing or erect sitting on a chair. Notably, sitting on the floor resulted in even higher pressure on the nucleus pulposus and annulus fibers compared to slumped sitting on a chair. The decreased lumbar lordosis while sitting on the floor led to the highest increase in pressure on the annulus fiber and nucleus pulposus in the lumbar spine. In conclusion, maintaining an erect sitting position with increased lumbar lordosis during seated activities can effectively reduce intradiscal pressure and cortical bone stress associated with degenerative disc diseases and spinal deformities.
Collapse
Affiliation(s)
- Mingoo Cho
- Precision Mechanical Process and Control R&D Group, Korea Institute of Industrial Technology, Jinju-si 52845, Republic of Korea; (M.C.); (S.K.)
| | - Jun-Sang Han
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu 41944, Republic of Korea; (J.-S.H.); (C.-H.A.); (C.-H.K.)
| | - Sungwook Kang
- Precision Mechanical Process and Control R&D Group, Korea Institute of Industrial Technology, Jinju-si 52845, Republic of Korea; (M.C.); (S.K.)
| | - Chang-Hwan Ahn
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu 41944, Republic of Korea; (J.-S.H.); (C.-H.A.); (C.-H.K.)
| | - Dong-Hee Kim
- Department of Orthopaedic Surgery, Gyeongsang National University, College of Medicine, Jinju-si 52727, Republic of Korea;
| | - Chul-Hyun Kim
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu 41944, Republic of Korea; (J.-S.H.); (C.-H.A.); (C.-H.K.)
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea
| | - Kyoung-Tae Kim
- Department of Neurosurgery, Kyungpook National University Hospital, Daegu 41944, Republic of Korea;
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea
| | - Ae-Ryoung Kim
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu 41944, Republic of Korea; (J.-S.H.); (C.-H.A.); (C.-H.K.)
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea
| | - Jong-Moon Hwang
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu 41944, Republic of Korea; (J.-S.H.); (C.-H.A.); (C.-H.K.)
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea
| |
Collapse
|
2
|
Liu J, Gong X, Wang K, Li X, Zhang X, Sun J, Zhu Y, Ai Y, Ren J, Xiu J, Ji W. A comparison of the biomechanical properties of three different lumbar internal fixation methods in the treatment of lumbosacral spinal tuberculosis: finite element analysis. Sci Rep 2023; 13:11354. [PMID: 37443369 PMCID: PMC10344955 DOI: 10.1038/s41598-023-32624-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 03/30/2023] [Indexed: 07/15/2023] Open
Abstract
There are various internal fixation methods in treating lumbosacral spinal tuberculosis. The study compared the stability and stress distribution in surrounding tissues/implants, such as discs, endplates and screw-rod internal fixation system, etc. when applying three different lumbar internal fixation methods to treat lumbosacral spinal tuberculosis. A finite element model was constructed and validated. The spinal stability was restored using three methods: a titanium cage with lateral double screw-rod fixation (group 1), autologous bone with posterior double screw-rod fixation (group 2), and a titanium cage with posterior double screw-rod fixation (group 3). For comparison, group 4 represented the intact L3-S1 spine. Finally, a load was applied, and the ranges of motion and Von Mises stresses in the cortical endplates, screw-rod internal fixation system and cortical bone around the screws in the different groups were recorded and analyzed. All six ranges of motion (flexion, extension, left/right lateral bending, left/right rotation) of the surgical segment were substantially lower in groups 1 (0.53° ~ 1.41°), 2 (0.68° ~ 1.54°) and 3 (0.55° ~ 0.64°) than in group 4 (4.48° ~ 10.12°). The maximum stress in the screw-rod internal fixation system was clearly higher in group 2 than in groups 1 and 3 under flexion, left/right lateral bending, and left/right rotation. However, in extension, group 1 had the highest maximum stress in the screw-rod internal fixation system. Group 2 had the lowest peak stresses in the cortical endplates in all directions. The peak stresses in the cortical bone around the screws were higher in group 1 and group 2 than in group 3 in all directions. Thus, titanium cage with posterior double screw-rod fixation has more advantages in immediate reconstruction of lumbosacral spinal stability and prevention of screw loosening.
Collapse
Affiliation(s)
- Jiantao Liu
- Department of Orthopedics, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China.
| | - Xi Gong
- Xi'an Jiaotong University, Xi'an, 710049, China
| | - Kao Wang
- Medical School of Yan'an University, Yan'an, 716000, China
| | - Xingyuan Li
- Xi'an Jiaotong University, Xi'an, 710049, China
| | - Xiwei Zhang
- Xi'an Jiaotong University, Xi'an, 710049, China
| | - Jiajun Sun
- Xi'an Jiaotong University, Xi'an, 710049, China
| | - Yihan Zhu
- Xi'an Jiaotong University, Xi'an, 710049, China
| | - Yixiang Ai
- Xi'an Jiaotong University, Xi'an, 710049, China
| | - Jing Ren
- Department of Orthopedics, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China
| | - Jintao Xiu
- Department of Orthopedics, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China
| | - Wenchen Ji
- Department of Orthopedics, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China
| |
Collapse
|
3
|
Lu Y, Hang G, Feng Y, Chen B, Ma S, Wang Y, Xie T. Biomechanical comparison of anterior axis-atlanto-occipital transarticular fixation and anterior atlantoaxial transarticular fixation after odontoidectomy: A finite element analysis. Front Bioeng Biotechnol 2023; 11:1067049. [PMID: 36959905 PMCID: PMC10027935 DOI: 10.3389/fbioe.2023.1067049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 02/23/2023] [Indexed: 03/09/2023] Open
Abstract
Background: Anterior axis-atlanto-occipital transarticular fixation (AAOF) and anterior atlanto-axial transarticular fixation (AAF) are two common anterior screw fixation techniques after odontoidectomy, but the biomechanical discrepancies between them remain unknown. Objectives: To investigate the biomechanical properties of craniovertebral junction (CVJ) after odontoidectomy, with AAOF or AAF. Methods: A validated finite element model of the intact occipital-cervical spine (from occiput to T1) was modified to investigate biomechanical changes, resulting from odontoidectomy, odontoidectomy with AAOF, and odontoidectomy with AAF. Results: After odontoidectomy, the range of motion (ROM) at C1-C2 increased in all loading directions, and the ROM at the Occiput-C1 elevated by 66.2%, 57.5%, and 41.7% in extension, lateral bending, and torsion, respectively. For fixation models, the ROM at the C1-C2 junction was observably reduced after odontoidectomy with AAOF and odontoidectomy with AAF. In addition, at the Occiput-C1, the ROM of odontoidectomy with AAOF model was notably lower than the normal model in extension (94.9%), flexion (97.6%), lateral bending (91.8%), and torsion (96.4%). But compared with the normal model, in the odontoidectomy with AAF model, the ROM of the Occiput-C1 increased by 52.2%, -0.1%, 92.1%, and 34.2% in extension, lateral bending, and torsion, respectively. Moreover, there were no distinctive differences in the stress at the screw-bone interface or the C2-C3 intervertebral disc between the two fixation systems. Conclusion: AAOF can maintain CVJ stability at the Occiput-C1 after odontoidectomy, but AAF cannot. Thus, for patients with pre-existing atlanto-occipital joint instability, AAOF is more suitable than AAF in the choice of anterior fixation techniques.
Collapse
Affiliation(s)
- Yuzhao Lu
- The First Affiliated Hospital of Nanchang University, Nanchang University, Nanchang, Jiangxi, China
| | - Gai Hang
- School of Medicine, Wuhan University of Science and Technology, Wuhan, Hubei, China
| | - Yu Feng
- School of Medicine, Wuhan University of Science and Technology, Wuhan, Hubei, China
| | - Bo Chen
- Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Shenghui Ma
- School of Medicine, Wuhan University of Science and Technology, Wuhan, Hubei, China
| | - Yang Wang
- The First Affiliated Hospital of Nanchang University, Nanchang University, Nanchang, Jiangxi, China
- Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
- *Correspondence: Yang Wang, ; Tianhao Xie,
| | - Tianhao Xie
- General Hospital of Central Theater Command, Wuhan, Hubei, China
- *Correspondence: Yang Wang, ; Tianhao Xie,
| |
Collapse
|
4
|
Sanjay D, Bhardwaj JS, Kumar N, Chanda S. Expandable pedicle screw may have better fixation than normal pedicle screw: preclinical investigation on instrumented L4-L5 vertebrae based on various physiological movements. Med Biol Eng Comput 2022; 60:2501-2519. [DOI: 10.1007/s11517-022-02625-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 06/24/2022] [Indexed: 10/17/2022]
|
5
|
Analysis of the physiological load on lumbar vertebrae in patients with osteoporosis: a finite-element study. Sci Rep 2022; 12:11001. [PMID: 35768481 PMCID: PMC9243026 DOI: 10.1038/s41598-022-15241-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 06/21/2022] [Indexed: 11/08/2022] Open
Abstract
This study aims to investigate the difference in physiological loading on the spine in three different motions (flexion-extension, lateral bending, and axial rotation) between osteoporotic and normal spines, using finite element modelling. A three-dimensional finite element (FE) model centered on the lumbar spine was constructed. We applied two different material properties of osteoporotic and normal spines. For the FE analysis, three loading conditions (flexion-extension, lateral bending, and axial rotation) were applied. The von Mises stress was higher on the nucleus pulposus at all vertebral levels in all movements, in the osteoporosis group than in the normal group. On the annulus fibrosus, the von Mises stress increased at the level of L3-L4, L4-L5, and L5-S in the flexion-extension group and at L4-L5 and L5-S levels in the lateral bending group. The values of two motions, flexion-extension and lateral bending, increased in the L4 and L5 cortical bones. In axial rotation, the von Mises stress increased at the level of L5 of cortical bone. Additionally, the von Mises stress increased in the lower endplate of L5-S and L4-L5 in all movements, especially lateral bending. Even in the group with no increase, there was a part that received increased von Mises stress locally for each element in the three-dimensional reconstructed view of the pressure distribution in color. The von Mises stress on the lumbar region in the three loading conditions, was greater in most components of osteoporotic vertebrae than in normal vertebrae and the value was highest in the nucleus pulposus. Considering the increase in the measured von Mises stress and the local increase in the pressure distribution, we believe that these results can contribute to explaining discogenic pain and degeneration.
Collapse
|