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http://dx.doi.org/10.3340/jkns.2016.59.2.91

Biomechanical Comparison of Spinal Fusion Methods Using Interspinous Process Compressor and Pedicle Screw Fixation System Based on Finite Element Method  

Choi, Jisoo (Department of Medical System Engineering, Gwangju Institute of Science and Technology (GIST))
Kim, Sohee (Department of Medical System Engineering, Gwangju Institute of Science and Technology (GIST))
Shin, Dong-Ah (Department of Neurosurgery, Yonsei University College of Medicine)
Publication Information
Journal of Korean Neurosurgical Society / v.59, no.2, 2016 , pp. 91-97 More about this Journal
Abstract
Objective : To investigate the biomechanical effects of a newly proposed Interspinous Process Compressor (IPC) and compare with pedicle screw fixation at surgical and adjacent levels of lumbar spine. Methods : A three dimensional finite element model of intact lumbar spine was constructed and two spinal fusion models using pedicle screw fixation system and a new type of interspinous devices, IPC, were developed. The biomechanical effects such as range of motion (ROM) and facet contact force were analyzed at surgical level (L3/4) and adjacent levels (L2/3, L4/5). In addition, the stress in adjacent intervertebral discs (D2, D4) was investigated. Results : The entire results show biomechanical parameters such as ROM, facet contact force, and stress in adjacent intervertebral discs were similar between PLIF and IPC models in all motions based on the assumption that the implants were perfectly fused with the spine. Conclusion : The newly proposed fusion device, IPC, had similar fusion effect at surgical level, and biomechanical effects at adjacent levels were also similar with those of pedicle screw fixation system. However, for clinical applications, real fusion effect between spinous process and hooks, duration of fusion, and influence on spinous process need to be investigated through clinical study.
Keywords
Intervertebral disc degeneration; Pedicle screw; Interspinous device; Finite element analysis; Range of motion;
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Times Cited By KSCI : 3  (Citation Analysis)
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1 Anasetti F, Galbusera F, Aziz HN, Bellini CM, Addis A, Villa T, et al. : Spine stability after implantation of an interspinous device : an in vitro and finite element biomechanical study. J Neurosurg Spine 13 : 568-575, 2010   DOI
2 Bono CM, Lee CK : Critical analysis of trends in fusion for degenerative disc disease over the past 20 years : influence of technique on fusion rate and clinical outcome. Spine (Phila Pa 1976) 29 : 455-463; discussion Z5, 2004   DOI
3 Byun DH, Shin DA, Kim JM, Kim SH, Kim HI : Finite element analysis of the biomechanical effect of coflexTM on the lumbar spine. Korean J Spine 9 : 131-136, 2012   DOI
4 Carreon LY, Puno RM, Dimar JR 2nd, Glassman SD, Johnson JR : Perioperative complications of posterior lumbar decompression and arthrodesis in older adults. J Bone Joint Surg Am 85-A : 2089-2092, 2003
5 Chen SH, Zhong ZC, Chen CS, Chen WJ, Hung C : Biomechanical comparison between lumbar disc arthroplasty and fusion. Med Eng Phys 31 : 244-253, 2009   DOI
6 Chosa E, Goto K, Totoribe K, Tajima N : Analysis of the effect of lumbar spine fusion on the superior adjacent intervertebral disk in the presence of disk degeneration, using the three-dimensional finite element method. J Spinal Disord Tech 17 : 134-139, 2004   DOI
7 Erbulut DU, Zafarparandeh I, Hassan CR, Lazoglu I, Ozer AF : Determination of the biomechanical effect of an interspinous process device on implanted and adjacent lumbar spinal segments using a hybrid testing protocol : a finite-element study. J Neurosurg Spine 23 : 200-208, 2015   DOI
8 Fischgrund JS, Mackay M, Herkowitz HN, Brower R, Montgomery DM, Kurz LT : 1997 Volvo Award winner in clinical studies. Degenerative lumbar spondylolisthesis with spinal stenosis : a prospective, randomized study comparing decompressive laminectomy and arthrodesis with and without spinal instrumentation. Spine (Phila Pa 1976) 22 : 2807-2812, 1997   DOI
9 Gaines RW Jr : The use of pedicle-screw internal fixation for the operative treatment of spinal disorders. J Bone Joint Surg Am 82-A : 1458-1476, 2000
10 Goel VK, Monroe BT, Gilbertson LG, Brinckmann P : Interlaminar shear stresses and laminae separation in a disc. Finite element analysis of the L3-L4 motion segment subjected to axial compressive loads. Spine (Phila Pa 1976) 20 : 689-698, 1995   DOI
11 Jutte PC, Castelein RM : Complications of pedicle screws in lumbar and lumbosacral fusions in 105 consecutive primary operations. Eur Spine J 11 : 594-598, 2002   DOI
12 Kang KT, Kim HJ, Son J, Yeom JS, Chun HJ : Comparing an instrumented posterior fixation system with rigid and semi-flexible rods using finite element analysis. Int J Precis Eng Manuf 16 : 163-170, 2015   DOI
13 Kim HJ, Bak KH, Chun HJ, Oh SJ, Kang TH, Yang MS : Posterior interspinous fusion device for one-level fusion in degenerative lumbar spine disease : comparison with pedicle screw fixation - preliminary report of at least one year follow up. J Korean Neurosurg Soc 52 : 359-364, 2012   DOI
14 Kim HJ, Chun HJ, Moon SH, Kang KT, Kim HS, Park JO, et al. : Analysis of biomechanical changes after removal of instrumentation in lumbar arthrodesis by finite element analysis. Med Biol Eng Comput 48 : 703-709, 2010   DOI
15 Kim TY, Kang KT, Yoon DH, Shin HC, Kim KN, Yi S, et al. : Effects of lumbar arthrodesis on adjacent segments : differences between surgical techniques. Spine (Phila Pa 1976) 37 : 1456-1462, 2012   DOI
16 Lavaste F, Skalli W, Robin S, Roy-Camille R, Mazel C : Three-dimensional geometrical and mechanical modelling of the lumbar spine. J Biomech 25 : 1153-1164, 1992   DOI
17 Lo CC, Tsai KJ, Chen SH, Zhong ZC, Hung C : Biomechanical effect after Coflex and Coflex rivet implantation for segmental instability at surgical and adjacent segments : a finite element analysis. Comput Methods Biomech Biomed Engin 14 : 969-978, 2011   DOI
18 Park SC, Yoon SH, Hong YP, Kim KJ, Chung SK, Kim HJ : Minimum 2-year follow-up result of degenerative spinal stenosis treated with interspinous u (coflex). J Korean Neurosurg Soc 46 : 292-299, 2009   DOI
19 Polikeit A, Nolte LP, Ferguson SJ : The effect of cement augmentation on the load transfer in an osteoporotic functional spinal unit : finite-element analysis. Spine (Phila Pa 1976) 28 : 991-996, 2003
20 Rohlmann A, Bauer L, Zander T, Bergmann G, Wilke HJ : Determination of trunk muscle forces for flexion and extension by using a validated finite element model of the lumbar spine and measured in vivo data. J Biomech 39 : 981-989, 2006   DOI
21 Rohlmann A, Neller S, Claes L, Bergmann G, Wilke HJ : Influence of a follower load on intradiscal pressure and intersegmental rotation of the lumbar spine. Spine (Phila Pa 1976) 26 : E557-E561, 2001   DOI
22 Rohlmann A, Zander T, Bergmann G : Spinal loads after osteoporotic vertebral fractures treated by vertebroplasty or kyphoplasty. Eur Spine J 15 : 1255-1264, 2006   DOI
23 Serhan H, Mhatre D, Defossez H, Bono CM : Motion-preserving technologies for degenerative lumbar spine : the past, present, and future horizons. SAS J 5 : 75-89, 2011   DOI
24 Shirazi-Adl SA, Shrivastava SC, Ahmed AM : Stress analysis of the lumbar disc-body unit in compression. A three-dimensional nonlinear finite element study. Spine (Phila Pa 1976) 9 : 120-134, 1984   DOI
25 Thomsen K, Christensen FB, Eiskjaer SP, Hansen ES, Fruensgaard S, Bunger CE : 1997 Volvo Award winner in clinical studies. The effect of pedicle screw instrumentation on functional outcome and fusion rates in posterolateral lumbar spinal fusion : a prospective, randomized clinical study. Spine (Phila Pa 1976) 22 : 2813-2822, 1997   DOI
26 Vadapalli S, Sairyo K, Goel VK, Robon M, Biyani A, Khandha A, et al. : Biomechanical rationale for using polyetheretherketone (PEEK) spacers for lumbar interbody fusion-a finite element study. Spine (Phila Pa 1976) 31 : E992-E998, 2006   DOI
27 Xiao Z, Wang L, Gong H, Zhu D : Biomechanical evaluation of three surgical scenarios of posterior lumbar interbody fusion by finite element analysis. Biomed Eng Online 11 : 31, 2012   DOI
28 Yamamoto I, Panjabi MM, Crisco T, Oxland T : Three-dimensional movements of the whole lumbar spine and lumbosacral joint. Spine (Phila Pa 1976) 14 : 1256-1260, 1989   DOI
29 Zhong ZC, Wei SH, Wang JP, Feng CK, Chen CS, Yu CH : Finite element analysis of the lumbar spine with a new cage using a topology optimization method. Med Eng Phys 28 : 90-98, 2006   DOI