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http://dx.doi.org/10.9718/JBER.2008.29.2.139

Biomechanical Effects of Posterior Dynamic Stabilization System on Lumbar Kinematics: A Finite Element Analysis  

Ahn, Y.H. (Korea Orthopedics and Rehabilitation Engineering Center)
Chen, Wen-Ming (Division of Bioengineering, National University of Singapore)
Jung, D.Y. (National Institute of Health Sciences)
Park, K.W. (Department of Neurosurgery, Kwang-Hye Spine Hospital)
Lee, S.J. (Department of Biomedical Engineering, Inje University)
Publication Information
Journal of Biomedical Engineering Research / v.29, no.2, 2008 , pp. 139-145 More about this Journal
Abstract
Many recent studies suggest that the posterior dynamic stabilization(PDS) can be a more physiologically-relevant alternative to the rigid fixation for the patients suffering from low back pain. However, its biomechanical effects or clinically proven efficacies still remain unknown. In this study, we evaluated kinematic behaviors of the lower lumbar spine with the PDS system and then compared to those of the rigid fixation system using finite element (FE) analysis. A validated FE model of intact lumbar spine(L2-L5) was developed. The implanted model was then constructed after modification from the intact to simulate two kinds of pedicle screw systems (PDS and the rigid fixation). Hybrid protocol was used to flex, extend, laterally bend and axially rotate the FE model. Results showed that the PDS systems are more flexible than rigid fixation systems, yet not flexible enough to preserve motion. PDS system allowed $16.2{\sim}42.2%$ more intersegmental rotation than the rigid fixation at the implanted level. One the other hand, at the adjacent level it allowed more range of motion ($2.0%{\sim}8.3%$) than the rigid fixation. The center of rotation of the PDS model remained closer to that of the intact spine. These results suggest that the PDS system could be able to prevent excessive motion at the adjacent levels and restore the spinal kinematics.
Keywords
posterior dynamic stabilization system; lumbar spine; kinematics; range of motion; center of rotation;
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