Analysis of biomechanical change of adjacent motion segment of the lumbar spine with an implanted artificial disc

인공추간판 적용 시 인접 운동 분절에서의 변화 분석

Although several artificial disc designs have been developed for the treatment of discogenic low back pain and used clinically, biomechanical change with its implantation seldom studied. To evaluate the effect of artificial disc implantation on the biomechanics of lumbar spinal unit, nonlinear three-dimensional finite element model of L1-L5, S1 was developed and strain and stress of vertebral body and surrounding spinal ligaments were predicted. Intact osteoligamentous L1-L5, S1 model was created with 1-mm CT scan of a volunteer and known material property of each element were applied. This model also includes the effect of local muscles which was modeled with pre-strained spring elements. The intact model was validated with reported biomechanical data. Two models implanted with artificial discs, SB Charite or Prodisc, at L4/5 via anterior approach were also developed. The implanted model predictions were compared with that of intact model. Angular motion of vertebral body, force on spinal ligaments, facet joint contact force with $2\sim12$ Nm flexion-extension moment.