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Proceedings Paper

Decisive factor in increase of loading at adjacent segments after lumbar fusion: operative technique, pedicle screws, or fusion itself: biomechanical analysis using finite element
Author(s): Joon-Hee Park; Ho-Joong Kim; Kyoung-Tak Kang; Ka-yeon Kim; Heoung-Jae Chun; Seong-Hwan Moon; Hwan-Mo Lee
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Paper Abstract

The aim of this study is to investigate the change in biomechanical milieu following removal of pedicle screws or removal of spinous process with posterior ligament complex in instrumented single level lumbar arthrodesis. We developed and validated a finite element model (FEM) of the intact lumbar spine (L2-4). Four scenarios of L3-4 lumbar fusion were simulated: posterolateral fusion (PLF) at L3-4 using pedicle screw system with preservation of PLC (Pp WiP), L3-4 lumbar posterolateral fusion state after removal of pedicle screw system with preservation of PLC (Pp WoP), L3-4 using pedicle screw system without preservation PLC (Sp WiP), L3-4 lumbar posterolateral fusion state after removal of pedicle screw system without preservation of PLC (Sp WoP). For these models, we investigated the range of motion and maximal Von mises stress of disc in all segments under various moments. All fusion models demonstrated increase in range of motion at adjacent segments compared to the intact model.For the four fusion models, the WiP model s P had the largest increase in range of motion at each adjacent segment. This study demonstrated that removal of pedicle screw system and preservation of PLC after complete lumbar spinal fusion could reduce the stress of adjacent segments synergistically and might have beneficial effects in preventing ASD.

Paper Details

Date Published: 14 April 2010
PDF: 7 pages
Proc. SPIE 7522, Fourth International Conference on Experimental Mechanics, 75222R (14 April 2010); doi: 10.1117/12.851295
Show Author Affiliations
Joon-Hee Park, Hallym Univ. (Korea, Republic of)
Ho-Joong Kim, Yonseisarang Hospital (Korea, Republic of)
Kyoung-Tak Kang, Yonsei Univ. (Korea, Republic of)
Ka-yeon Kim, Yonsei Univ. (Korea, Republic of)
Heoung-Jae Chun, Yonsei Univ. (Korea, Republic of)
Seong-Hwan Moon, Yonsei Univ. School of Medicine (Korea, Republic of)
Hwan-Mo Lee, Yonsei Univ. School of Medicine (Korea, Republic of)


Published in SPIE Proceedings Vol. 7522:
Fourth International Conference on Experimental Mechanics
Chenggen Quan; Kemao Qian; Anand Krishna Asundi; Fook Siong Chau, Editor(s)

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