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Xu C, Bai X, Ruan D, Zhang C. Comparative finite element analysis of posterior short segment fixation constructs with or without intermediate screws in the fractured vertebrae for the treatment of type a thoracolumbar fracture. Comput Methods Biomech Biomed Engin 2024; 27:1398-1409. [PMID: 37553841 DOI: 10.1080/10255842.2023.2243360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 07/18/2023] [Accepted: 07/27/2023] [Indexed: 08/10/2023]
Abstract
Six-screw short-segment posterior fixation for thoracolumbar fractures, which involves intermediate screws at the fractured vertebrae has been proposed to reduce the rates of kyphosis recurrence and implant failure. Yet, little is known about the mechanisms and biomechanical responses by which intermediate screws at the fracture vertebrae enhance fixation strength. The objective of this study was to investigate the biomechanical properties that are associated with the augmentation of intermediate screws in relation to the severity of type A thoracolumbar fracture using finite element analysis. Short-segment stabilization models with or without augmentation screws at fractured vertebrae were established based on finite element model of moderate compressive fractures, severe compressive fractures and burst fractures. The spinal stiffness, stresses at the implanted hardware, and axial displacement of the bony defect were measured and compared under mechanical loading conditions. All six-screw stabilization showed a decreased range of motion in extension, lateral bending, and axial rotation compared to the traditional four-screw fixation models. Burst thoracolumbar fracture benefited more from augmentation of intermediate screws at the fracture vertebrae. The stress of the rod in six-screw models increased while decreased that of pedicle screws. Our results suggested that patients with more unstable fractures might achieve greater benefits from augmentation of intermediate screws at the fracture vertebrae. Augmentation of intermediate screws at the fracture vertebrae is recommended for patients with higher wedge-shaped or burst fractures to reduce the risk of hardware failure and postoperative re-collapse of injured vertebrae.
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Affiliation(s)
- Cheng Xu
- Department of Orthopaedic Surgery, The Sixth Medical Center, General Hospital of PLA, Beijing, China
| | - Xuedong Bai
- Department of Orthopaedic Surgery, The Sixth Medical Center, General Hospital of PLA, Beijing, China
| | - Dike Ruan
- Department of Orthopaedic Surgery, The Sixth Medical Center, General Hospital of PLA, Beijing, China
| | - Chao Zhang
- Department of Orthopaedic Surgery, The Sixth Medical Center, General Hospital of PLA, Beijing, China
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Marupudi S, Cao Q, Samala R, Petrick N. Characterization of mechanical stiffness using additive manufacturing and finite element analysis: potential tool for bone health assessment. 3D Print Med 2023; 9:32. [PMID: 37978094 PMCID: PMC10656885 DOI: 10.1186/s41205-023-00197-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 11/07/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Bone health and fracture risk are known to be correlated with stiffness. Both micro-finite element analysis (μFEA) and mechanical testing of additive manufactured phantoms are useful approaches for estimating mechanical properties of trabecular bone-like structures. However, it is unclear if measurements from the two approaches are consistent. The purpose of this work is to evaluate the agreement between stiffness measurements obtained from mechanical testing of additive manufactured trabecular bone phantoms and μFEA modeling. Agreement between the two methods would suggest 3D printing is a viable method for validation of μFEA modeling. METHODS A set of 20 lumbar vertebrae regions of interests were segmented and the corresponding trabecular bone phantoms were produced using selective laser sintering. The phantoms were mechanically tested in uniaxial compression to derive their stiffness values. The stiffness values were also derived from in silico simulation, where linear elastic μFEA was applied to simulate the same compression and boundary conditions. Bland-Altman analysis was used to evaluate agreement between the mechanical testing and μFEA simulation values. Additionally, we evaluated the fidelity of the 3D printed phantoms as well as the repeatability of the 3D printing and mechanical testing process. RESULTS We observed good agreement between the mechanically tested stiffness and μFEA stiffness, with R2 of 0.84 and normalized root mean square deviation of 8.1%. We demonstrate that the overall trabecular bone structures are printed in high fidelity (Dice score of 0.97 (95% CI, [0.96,0.98]) and that mechanical testing is repeatable (coefficient of variation less than 5% for stiffness values from testing of duplicated phantoms). However, we noticed some defects in the resin microstructure of the 3D printed phantoms, which may account for the discrepancy between the stiffness values from simulation and mechanical testing. CONCLUSION Overall, the level of agreement achieved between the mechanical stiffness and μFEA indicates that our μFEA methods may be acceptable for assessing bone mechanics of complex trabecular structures as part of an analysis of overall bone health.
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Affiliation(s)
- Sriharsha Marupudi
- Division of Imaging, Diagnostics, and Software Reliability, Office of Science and Engineering Labs, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Qian Cao
- Division of Imaging, Diagnostics, and Software Reliability, Office of Science and Engineering Labs, U.S. Food and Drug Administration, Silver Spring, MD, USA.
| | - Ravi Samala
- Division of Imaging, Diagnostics, and Software Reliability, Office of Science and Engineering Labs, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Nicholas Petrick
- Division of Imaging, Diagnostics, and Software Reliability, Office of Science and Engineering Labs, U.S. Food and Drug Administration, Silver Spring, MD, USA
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Pokorni AJ, Turbucz M, Kiss RM, Eltes PE, Lazary A. Comparison of anterior column reconstruction techniques after en bloc spondylectomy: a finite element study. Sci Rep 2023; 13:18767. [PMID: 37907570 PMCID: PMC10618450 DOI: 10.1038/s41598-023-45736-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 10/23/2023] [Indexed: 11/02/2023] Open
Abstract
Total en bloc spondylectomy (TES) effectively treats spinal tumors. The surgery requires a vertebral body replacement (VBR), for which several solutions were developed, whereas the biomechanical differences between these devices still need to be completely understood. This study aimed to compare a femur graft, a polyetheretherketone implant (PEEK-IMP-C), a titan mesh cage (MESH-C), and a polymethylmethacrylate replacement (PMMA-C) using a finite element model of the lumbar spine after a TES of L3. Several biomechanical parameters (rotational stiffness, segmental range of motion (ROM), and von Mises stress) were assessed to compare the VBRs. All models provided adequate initial stability by increasing the rotational stiffness and decreasing the ROM between L2 and L4. The PMMA-C had the highest stiffness for flexion-extension, lateral bending, and axial rotation (215%, 216%, and 170% of intact model), and it had the lowest segmental ROM in the instrumented segment (0.2°, 0.5°, and 0.7°, respectively). Maximum endplate stress was similar for PMMA-C and PEEK-IMP-C but lower for both compared to MESH-C across all loading directions. These results suggest that PMMA-C had similar or better primary spinal stability than other VBRs, which may be related to the larger contact surface and the potential to adapt to the patient's anatomy.
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Affiliation(s)
- Agoston Jakab Pokorni
- In Silico Biomechanics Laboratory, National Center for Spinal Disorders, Királyhágó St. 1-3, Budapest, 1126, Hungary
- School of PhD Studies, Semmelweis University, Budapest, Hungary
| | - Mate Turbucz
- In Silico Biomechanics Laboratory, National Center for Spinal Disorders, Királyhágó St. 1-3, Budapest, 1126, Hungary
- School of PhD Studies, Semmelweis University, Budapest, Hungary
| | - Rita Maria Kiss
- Department of Mechatronics, Optics and Mechanical Engineering Informatics, Faculty of Mechanical Engineering, Budapest University of Technology and Economics, Műegyetem Rkp. 3., Budapest, 1111, Hungary
| | - Peter Endre Eltes
- In Silico Biomechanics Laboratory, National Center for Spinal Disorders, Királyhágó St. 1-3, Budapest, 1126, Hungary.
- Department of Spine Surgery, Department of Orthopaedics, Semmelweis University, Budapest, Hungary.
| | - Aron Lazary
- In Silico Biomechanics Laboratory, National Center for Spinal Disorders, Királyhágó St. 1-3, Budapest, 1126, Hungary
- Department of Spine Surgery, Department of Orthopaedics, Semmelweis University, Budapest, Hungary
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Huang Y, Maimaiti A, Tian Y, Li Z, Kahaer A, Rexiti P. Biomechanical investigation of the hybrid lumbar fixation technique with traditional and cortical bone trajectories in transforaminal lumbar interbody fusion: finite element analysis. J Orthop Surg Res 2023; 18:549. [PMID: 37525283 PMCID: PMC10388474 DOI: 10.1186/s13018-023-04027-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 07/17/2023] [Indexed: 08/02/2023] Open
Abstract
OBJECTIVE To compare the biomechanical performance of the hybrid lumbar fixation technique with the traditional and cortical bone trajectory techniques using the finite element method. METHODS Four adult wet lumbar spine specimens were provided by the Department of Anatomy and Research of Xinjiang Medical University, and four L1-S1 lumbar spine with transforaminal lumbar interbody fusion (TLIF) models at L4-L5 segment and four different fixation techniques were established: bilateral traditional trajectory screw fixation (TT-TT), bilateral cortical bone trajectory screw fixation (CBT-CBT), hybrid CBT-TT (CBT screws at L4 and TT screws at L5) and TT-CBT (TT screws at L4 and CBT screws at L5). The range of motion (ROM) of the L4-L5 segment, von Mises stress of cage, internal fixation, and rod were compared in flexion, extension, left and right bending, and left and right rotation. RESULTS Compared with the TT-TT group, the TT-CBT group exhibited lower ROM of L4-L5 segment, especially in left-sided bending; the CBT-TT group had the lowest ROM of L4-L5 segment in flexion and extension among the four fixation methods. Compared with the CBT-CBT group, the peak cage stress in the TT-CBT group was reduced by 9.9%, 18.1%, 21.5%, 23.3%, and 26.1% in flexion, left bending, right bending, left rotation, and right rotation conditions, respectively, but not statistically significant (P > 0.05). The peak stress of the internal fixation system in the TT-CBT group was significantly lower than the other three fixation methods in all five conditions except for extension, with a statistically significant difference between the CBT-TT and TT-CBT groups in the left rotation condition (P = 0.017). In addition, compared with the CBT-CBT group, the peak stress of the rod in the CBT-TT group decreased by 34.8%, 32.1%, 28.2%, 29.3%, and 43.0% under the six working conditions of flexion, extension, left bending, left rotation, and right rotation, respectively, but not statistically significant (P > 0.05). CONCLUSIONS Compared with the TT-TT and CBT-CBT fixation methods in TLIF, the hybrid lumbar fixation CBT-TT and TT-CBT techniques increase the biomechanical stability of the internal fixation structure of the lumbar fusion segment to a certain extent and provide a corresponding theoretical basis for further development in the clinic.
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Affiliation(s)
- Ying Huang
- Xinjiang Medical University, Urumqi, China
| | - Abulikemu Maimaiti
- Department of Spine Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | | | | | - Alafate Kahaer
- Department of Spine Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Paerhati Rexiti
- Department of Spine Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
- Key Laboratory of High Incidence Disease Research in Xingjiang (Xinjiang Medical University), Ministry of Education, Urumqi, China.
- Xinjiang Clinical Research Center for Orthopedics, Urumqi, China.
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Biomechanical and clinical studies on lumbar spine fusion surgery: a review. Med Biol Eng Comput 2023; 61:617-634. [PMID: 36598676 DOI: 10.1007/s11517-022-02750-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 12/22/2022] [Indexed: 01/05/2023]
Abstract
Low back pain is associated with degenerative disc diseases of the spine. Surgical treatment includes fusion and non-fusion types. The gold standard is fusion surgery, wherein the affected vertebral segment is fused. The common complication of fusion surgery is adjacent segment degeneration (ASD). The ASD often leads to revision surgery, calling for a further fusion of adjacent segments. The existing designs of nonfusion type implants are associated with clinical problems such as subsidence, difficulty in implantation, and the requirement of revision surgeries. Various surgical approaches have been adopted by the surgeons to insert the spinal implants into the affected segment. Over the years, extensive biomechanical investigations have been reported on various surgical approaches and prostheses to predict the outcomes of lumbar spine implantations. Computer models have been proven to be very effective in identifying the best prosthesis and surgical procedure. The objective of the study was to review the literature on biomechanical studies for the treatment of lumbar spinal degenerative diseases. A critical review of the clinical and biomechanical studies on fusion spine surgeries was undertaken. The important modeling parameters, challenges, and limitations of the current studies were identified, showing the future research directions.
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Biomechanical Comparison of Multilevel Lumbar Instrumented Fusions in Adult Spinal Deformity According to the Upper and Lower Fusion Levels: A Finite Element Analysis. BIOMED RESEARCH INTERNATIONAL 2022; 2022:2534350. [PMID: 36506913 PMCID: PMC9729043 DOI: 10.1155/2022/2534350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 11/11/2022] [Accepted: 11/14/2022] [Indexed: 12/03/2022]
Abstract
Multilevel lumbar fusion with posterior pedicle screw fixation is a widely performed surgical procedure for the management of adult spinal deformity. However, there has not been a comprehensive biomechanical study on the different types of fusion levels in terms of stability and possible complications. We aimed to investigate the biomechanical properties of multilevel lumbar fusion according to different types of upper and lower fusion levels. Six different types of fusions were performed using three-dimensional finite element models. Type A and B referred to the group of which upper fusion level was L1 and T10, respectively. Subtype 1, 2, and 3 referred to the group of which lower fusion level was L5, S1, and ilium, respectively (A1, L1-L5; A2, L1-S1; A3, L1-ilium; B1, T10-L5; B2, T10-S1; B3, T10-ilium). Flexion, extension, axial rotation, and lateral bending moments were applied, and the risk of screw loosening and failure and adjacent segment degeneration (ASD) was analyzed. Stress at the bone-screw interface of type B3 was lowest in overall motions. The risk of screw failure showed increasing pattern as the upper and lower levels extended in all motions. Proximal range of motion (ROM) increased as the lower fusion level changed from L5 to S1 and the ilium. For axial rotation, type B3 showed higher proximal ROM (16.2°) than type A3 (11.8°). In multilevel lumbar fusion surgery for adult spinal deformity, adding iliac screws and increasing the fusion level to T10-ilium may lower the risk of screw loosening. In terms of screw failure and proximal ASD, however, T10-ilium fusion has a higher potential risk compared with other fusion types. These results will contribute for surgeons to provide adequate patient education regarding screw failure and proximal ASD, when performing multilevel lumbar fusion.
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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]
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Abbasi-Ghiri A, Ebrahimkhani M, Arjmand N. Novel force-displacement control passive finite element models of the spine to simulate intact and pathological conditions; comparisons with traditional passive and detailed musculoskeletal models. J Biomech 2022; 141:111173. [PMID: 35705381 DOI: 10.1016/j.jbiomech.2022.111173] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 05/08/2022] [Accepted: 06/01/2022] [Indexed: 10/18/2022]
Abstract
Passive finite element (FE) models of the spine are commonly used to simulate intact and various pre- and postoperative pathological conditions. Being devoid of muscles, these traditional models are driven by simplistic loading scenarios, e.g., a constant moment and compressive follower load (FL) that do not properly mimic the complex in vivo loading condition under muscle exertions. We aim to develop novel passive FE models that are driven by more realistic yet simple loading scenarios, i.e., in vivo vertebral rotations and pathological-condition dependent FLs (estimated based on detailed musculoskeletal finite element (MS-FE) models). In these novel force-displacement control FE models, unlike the traditional passive FE models, FLs vary not only at different spine segments (T12-S1) but between intact, pre- and postoperative conditions. Intact, preoperative degenerated, and postoperative fused conditions at the L4-L5 segment for five static in vivo activities in upright and flexed postures were simulated by the traditional passive FE, novel force-displacement control FE, and gold-standard detailed MS-FE spine models. Our findings indicate that, when compared to the MS-FE models, the force-displacement control passive FE models could accurately predict the magnitude of disc compression force, intradiscal pressure, annulus maximal von Mises stress, and vector sum of all ligament forces at adjacent segments (L3-L4 and L5-S1) but failed to predict disc shear and facet joint forces. In this regard, the force-displacement control passive FE models were much more accurate than the traditional passive FE models. Clinical recommendations made based on traditional passive FE models should, therefore, be interpreted with caution.
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Affiliation(s)
- A Abbasi-Ghiri
- Department of Mechanical Engineering, Sharif University of Technology, Tehran, Iran
| | - M Ebrahimkhani
- Department of Mechanical Engineering, Sharif University of Technology, Tehran, Iran
| | - N Arjmand
- Department of Mechanical Engineering, Sharif University of Technology, Tehran, Iran.
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MDCT-Based Finite Element Analysis for the Prediction of Functional Spine Unit Strength-An In Vitro Study. MATERIALS 2021; 14:ma14195791. [PMID: 34640187 PMCID: PMC8510093 DOI: 10.3390/ma14195791] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 09/16/2021] [Accepted: 09/29/2021] [Indexed: 11/23/2022]
Abstract
(1) Objective: This study aimed to analyze the effect of ligaments on the strength of functional spine unit (FSU) assessed by finite element (FE) analysis of anatomical models developed from multi-detector computed tomography (MDCT) data. (2) Methods: MDCT scans for cadaveric specimens were acquired from 16 donors (7 males, mean age of 84.29 ± 6.06 years and 9 females, mean age of 81.00 ± 11.52 years). Two sets of FSU models (three vertebrae + two disks), one with and another without (w/o) ligaments, were generated. The vertebrae were segmented semi-automatically, intervertebral disks (IVD) were generated manually, and ligaments were modeled based on the anatomical location. FE-predicted failure loads of FSU models (with and w/o ligaments) were compared with the experimental failure loads obtained from the uniaxial biomechanical test of specimens. (3) Results: The mean and standard deviation of the experimental failure load of FSU specimens was 3513 ± 1029 N, whereas of FE-based failure loads were 2942 ± 943 N and 2537 ± 929 N for FSU models with ligaments and without ligament attachments, respectively. A good correlation (ρ = 0.79, and ρ = 0.75) was observed between the experimental and FE-based failure loads for the FSU model with and with ligaments, respectively. (4) Conclusions: The FE-based FSU model can be used to determine bone strength, and the ligaments seem to have an effect on the model accuracy for the failure load calculation; further studies are needed to understand the contribution of ligaments.
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Warren JM, Mazzoleni AP, Hey LA. Development and Validation of a Computationally Efficient Finite Element Model of the Human Lumbar Spine: Application to Disc Degeneration. Int J Spine Surg 2020; 14:502-510. [PMID: 32986570 DOI: 10.14444/7066] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
INTRODUCTION This study develops and validates an accurate, computationally efficient, 3-dimensional finite element model (FEM) of the human lumbar spine. Advantages of this simplified model are shown by its application to a disc degeneration study that we demonstrate is completed in one-sixth the time required when using more complicated computed tomography (CT) scan-based models. METHODS An osseoligamentous FEM of the L1-L5 spine is developed using simple shapes based on average anatomical dimensions of key features of the spine rather than CT scan images. Pure moments of 7.5 Nm and a compressive follower load of 1000 N are individually applied to the L1 vertebra. Validation is achieved by comparing rotations and intradiscal pressures to other widely accepted FEMs and in vitro studies. Then degenerative disc properties are modeled and rotations calculated. Required computation times are compared between the model presented in this paper and other models developed using CT scans. RESULTS For the validation study, parameter values for a healthy spine were used with the loading conditions described above. Total L1-L5 rotations for flexion, extension, lateral bending, and axial rotation under pure moment loading were calculated as 20.3°, 10.7°, 19.7°, and 10.3°, respectively, and under a compressive follower load, maximum intradiscal pressures were calculated as 0.68 MPa. These values compare favorably with the data used for validation. When studying the effects of disc degeneration, the affected segment is shown to experience decreases in rotations during flexion, extension, and lateral bending (24%-56%), while rotations are shown to increase during axial rotation (14%-40%). Adjacent levels realize relatively minor changes in rotation (1%-6%). This parametric study required 17.5 hours of computation time compared to more than 4 days required if utilizing typical published CT scan-based models, illustrating one of the primary advantages of the model presented in this article. CONCLUSIONS The FEM presented in this article produces a biomechanical response comparable to widely accepted, complex, CT scan-based models and in vitro studies while requiring much shorter computation times. This makes the model ideal for conducting parametric studies of spinal pathologies and spinal correction techniques.
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Affiliation(s)
- Justin M Warren
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, North Carolina
| | - Andre P Mazzoleni
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, North Carolina
| | - Lloyd A Hey
- Hey Clinic for Scoliosis and Spine Surgery, Raleigh, North Carolina
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Rastegar S, Arnoux PJ, Wang X, Aubin CÉ. Biomechanical analysis of segmental lumbar lordosis and risk of cage subsidence with different cage heights and alternative placements in transforaminal lumbar interbody fusion. Comput Methods Biomech Biomed Engin 2020; 23:456-466. [DOI: 10.1080/10255842.2020.1737027] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Sajjad Rastegar
- Department of Mechanical Engineering, Polytechnique Montréal, Montréal, Canada
- Sainte-Justine University Hospital Center, Montreal, Canada
- iLab Spine - International Laboratory – Spine Imaging and Biomechanics, Montreal, Canada; and Marsheille, France
| | - Pierre-Jean Arnoux
- iLab Spine - International Laboratory – Spine Imaging and Biomechanics, Montreal, Canada; and Marsheille, France
- Laboratoire de Biomécanique Appliquée, UMRT24 IFSTTAR/Aix-Marseille Université, Marseille, France
| | - Xiaoyu Wang
- Department of Mechanical Engineering, Polytechnique Montréal, Montréal, Canada
- Sainte-Justine University Hospital Center, Montreal, Canada
- iLab Spine - International Laboratory – Spine Imaging and Biomechanics, Montreal, Canada; and Marsheille, France
| | - Carl-Éric Aubin
- Department of Mechanical Engineering, Polytechnique Montréal, Montréal, Canada
- Sainte-Justine University Hospital Center, Montreal, Canada
- iLab Spine - International Laboratory – Spine Imaging and Biomechanics, Montreal, Canada; and Marsheille, France
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Li J, Wang W, Zuo R, Zhou Y. Biomechanical Stability Before and After Graft Fusion with Unilateral and Bilateral Pedicle Screw Fixation: Finite Element Study. World Neurosurg 2019; 123:e228-e234. [DOI: 10.1016/j.wneu.2018.11.141] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 11/14/2018] [Accepted: 11/16/2018] [Indexed: 01/03/2023]
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13
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Fan W, Guo LX. The Role of Posterior Screw Fixation in Single-Level Transforaminal Lumbar Interbody Fusion During Whole Body Vibration: A Finite Element Study. World Neurosurg 2018; 114:e1086-e1093. [DOI: 10.1016/j.wneu.2018.03.150] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 03/21/2018] [Accepted: 03/21/2018] [Indexed: 01/09/2023]
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14
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Shu XN, Mu WZ, Chen JF, Zhang YJ, Tang SJ. Comparison of biomechanical effect between oblique Ban-pulling manipulation and lumbar erection-rotation manipulation in sitting position for lumbar intervertebral disc herniation. JOURNAL OF ACUPUNCTURE AND TUINA SCIENCE 2017. [DOI: 10.1007/s11726-017-1021-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Tuan Dao T. Hybrid Rigid-Deformable Model for Prediction of Neighboring Intervertebral Disk Loads During Flexion Movement After Lumbar Interbody Fusion at L3-4 Level. J Biomech Eng 2017; 139:2594573. [PMID: 27996077 DOI: 10.1115/1.4035483] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Indexed: 11/08/2022]
Abstract
Knowledge of spinal loads in neighboring disks after interbody fusion plays an important role in the clinical decision of this treatment as well as in the elucidation of its effect. However, controversial findings are still noted in the literature. Moreover, there are no existing models for efficient prediction of intervertebral disk stresses within annulus fibrosus (AF) and nucleus pulposus (NP) regions. In this present study, a new hybrid rigid-deformable modeling workflow was established to quantify the mechanical stress behaviors within AF and NP regions of the L1-2, L2-3, and L4-5 disks after interbody fusion at L3-4 level. The changes in spinal loads were compared with results of the intact model without interbody fusion. The fusion outcomes revealed maximal stress changes (10%) in AF region of L1-2 disk and in NP region of L2-3 disk. The minimal stress change (1%) is noted at the NP region of the L1-2 disk. The validation of simulation outcomes of fused and intact lumbar spine models against those of other computational models and in vivo measurements showed good agreements. Thus, this present study may be used as a novel design guideline for a specific implant and surgical scenario of the lumbar spine disorders.
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Affiliation(s)
- Tien Tuan Dao
- Sorbonne University, Université de Technologie de Compiègne, CNRS, UMR 7338 Biomechanics and Bioengineering, Centre de Recherche Royallieu, Compiègne CS 60 319, France e-mail:
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