Biomechanical Comparison of the Influence of Osteoporosis on the Lumbar Spine After Lumbar Interbody Fusion Surgery or Non-fusion Dynamic Stabilization Surgery Under Whole Body Vibration

IF 5.6 4区 医学 Q1 ENGINEERING, BIOMEDICAL Irbm Pub Date : 2023-10-01 DOI:10.1016/j.irbm.2023.100797
Wei Fan , Chi Zhang , Dong-Xiang Zhang , Qing-Dong Wang , Li-Xin Guo
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Abstract

Objective

The objective of this study was to determine and compare the influence of osteoporosis on biomechanics of the spine after lumbar interbody fusion (LIF) surgery or non-fusion dynamic stabilization (NFDS) surgery under whole body vibration (WBV) which is typically present in moving vehicles.

Methods

Based on a previously validated finite element (FE) model of normal human lumbosacral spine, four surgical models including LIF, LIF with osteoporosis (LIF-OST), NFDS, and NFDS with osteoporosis (NFDS-OST) were constructed. Biomechanical responses of the surgical models to an axial cyclic load were calculated using transient dynamic analysis. Response parameters include vibration amplitudes of the endplate stress and screw stress at surgical L4–L5 level, vibration amplitudes of the disc bulge and intradiscal pressure at adjacent L3–L4 level.

Results

Osteoporosis increased vibration amplitudes of all these investigated response parameters. Further, we found that vibration amplitudes of the endplate stress and screw stress for the LIF-OST model were significantly higher than those for the NFDS-OST model, but there was very small difference in vibration amplitudes of the disc bulge and intradiscal pressure between the LIF-OST and NFDS-OST models.

Conclusions

For both the LIF and NFDS surgeries, osteoporosis might increase the risk for implant failure and accelerate adjacent segment degeneration (ASD) under WBV. When osteoporosis occurs, LIF might be associated with a higher likelihood of implant failure at the surgical level compared with NFDS, and the surgical approach (LIF or NFDS) might have little influence on biomechanics of the adjacent level.

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全身振动下腰椎椎间融合术与非融合术后骨质疏松对腰椎影响的生物力学比较
目的本研究的目的是确定和比较骨质疏松症对腰椎间融合术(LIF)或非融合术动态稳定(NFDS)手术后脊柱生物力学的影响,全身振动(WBV)通常存在于运动车辆中。方法在先前验证的正常人腰骶棘有限元(FE)模型的基础上,构建了四个手术模型,包括LIF、LIF伴骨质疏松症(LIF-OST)、NFDS和NFDS伴骨质疏松病(NFDS-OST)。使用瞬态动力学分析计算外科模型对轴向循环载荷的生物力学响应。响应参数包括L4–L5级手术终板应力和螺钉应力的振幅,邻近L3–L4级椎间盘膨出和椎间盘内压力的振幅。结果骨质疏松症增加了所有这些研究反应参数的振幅。此外,我们发现LIF-OST模型的终板应力和螺钉应力的振幅显著高于NFDS-OST模型,但LIF-OST和NFDS-OST之间的椎间盘膨出和椎间盘内压力的振幅差异非常小。结论对于LIF和NFDS手术,骨质疏松可能会增加WBV下种植体失败的风险,并加速邻近节段退变(ASD)。当骨质疏松症发生时,与NFDS相比,LIF可能与手术层面植入物失败的可能性更高有关,并且手术方法(LIF或NFDS)可能对相邻层面的生物力学几乎没有影响。
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来源期刊
Irbm
Irbm ENGINEERING, BIOMEDICAL-
CiteScore
10.30
自引率
4.20%
发文量
81
审稿时长
57 days
期刊介绍: IRBM is the journal of the AGBM (Alliance for engineering in Biology an Medicine / Alliance pour le génie biologique et médical) and the SFGBM (BioMedical Engineering French Society / Société française de génie biologique médical) and the AFIB (French Association of Biomedical Engineers / Association française des ingénieurs biomédicaux). As a vehicle of information and knowledge in the field of biomedical technologies, IRBM is devoted to fundamental as well as clinical research. Biomedical engineering and use of new technologies are the cornerstones of IRBM, providing authors and users with the latest information. Its six issues per year propose reviews (state-of-the-art and current knowledge), original articles directed at fundamental research and articles focusing on biomedical engineering. All articles are submitted to peer reviewers acting as guarantors for IRBM''s scientific and medical content. The field covered by IRBM includes all the discipline of Biomedical engineering. Thereby, the type of papers published include those that cover the technological and methodological development in: -Physiological and Biological Signal processing (EEG, MEG, ECG…)- Medical Image processing- Biomechanics- Biomaterials- Medical Physics- Biophysics- Physiological and Biological Sensors- Information technologies in healthcare- Disability research- Computational physiology- …
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