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Biomechanical Analysis of Adjacent Segments after Spinal Fusion Surgery Using a Geometrically Parametric Patient-Specific Finite Element Model – Lumbar Fusion

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This article presents a study that aimed to analyze the mechanical effects on adjacent segments after spinal fusion surgery. The researchers used a patient-specific finite element model to understand the mechanism of adjacent segment degeneration (ASD) and provide evidence for early disease prevention. They extracted parameters from a preoperative computed tomography scan and established a patient-specific model of the spine. The postoperative model after surgery was constructed, and range of motion (ROM) and stress changes were analyzed. The study found that fusion surgery reduced overall ROM but increased ROM and stress in the facet joints and intervertebral disc of adjacent segments. It also showed that the proximal adjacent segment had a higher risk of degeneration compared to the distal adjacent segment due to increased stress. Overall, this research highlights the importance of considering the mechanical effects of spinal fusion surgery on adjacent segments to prevent ASD

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
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Published article

This study aimed to perform a mechanical analysis of adjacent segments after spinal fusion surgery using a geometrically parametric patient-specific finite element model to elucidate the mechanism of adjacent segment degeneration (ASD), thereby providing theoretical evidence for early disease prevention. Fourteen parameters based on patient-specific spinal geometry were extracted from a patient’s preoperative computed tomography (CT) scan, and the relative positions of each spinal segment were…

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J Vis Exp. 2024 Jan 19;(203). doi: 10.3791/66247.ABSTRACTThis study aimed to perform a mechanical analysis of adjacent segments after spinal fusion surgery using a geometrically parametric patient-specific finite element model to elucidate the mechanism of adjacent segment degeneration (ASD), thereby providing theoretical evidence for early disease prevention. Fourteen parameters based on patient-specific spinal geometry were,

J Vis Exp. 2024 Jan 19;(203). doi:10.3791/66247.

ABSTRACT

This study aimed to perform a mechanical analysis of adjacent segments after spinal fusion surgery using a geometrically parametric patient-specific finite element model to elucidate the mechanism of adjacent segment degeneration (ASD), thereby providing theoretical evidence for early disease prevention. Fourteen parameters based on patient-specific spinal geometry were extracted from a patient’s preoperative computed tomography (CT) scan, and the relative positions of each spinal segment were determined using the image match method. A preoperative patient-specific model of the spine was established through the above method. The postoperative model after L4-L5 posterior lumbar interbody fusion (PLIF) surgery was constructed using the same method except that the lamina and intervertebral disc were removed, and a cage, 4 pedicle screws, and 2 connecting rods were inserted. Range of motion (ROM) and stress changes were determined by comparing the values of each anatomical structure between the preoperative and postoperative models. The overall ROM of the lumbar spine decreased after fusion, while the ROM, stress in the facet joints, and stress in the intervertebral disc of adjacent segments all increased. An analysis of the stress distribution in the annulus fibrosus, nucleus pulposus, and facet joints also showed that not only was the maximum stress in these tissues elevated, but the areas of moderate-to-high stress were also expanded. During torsion, the stress in the facet joints and annulus fibrosus of the proximal adjacent segment (L3-L4) increased to a larger extent than that in the distal adjacent segment (L5-S1). While fusion surgery causes an overall restriction of motion in the lumbar spine, it also causes more load sharing by the adjacent segments to compensate for the fused segment, thus increasing the risk of ASD. The proximal adjacent segment is more prone to degeneration than the distal adjacent segment after spinal fusion due to the significant increase in stress.

PMID:38314842 | DOI:10.3791/66247

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Biomechanical Analysis of Adjacent Segments after Spinal Fusion Surgery Using a Geometrically Parametric Patient-Specific Finite Element Model

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J Vis Exp. 2024 Jan 19;(203). doi: 10.3791/66247.ABSTRACTThis study aimed to perform a mechanical analysis of adjacent segments after spinal fusion surgery using a geometrically parametric patient-specific finite element model to elucidate the mechanism of adjacent segment degeneration (ASD), thereby providing theoretical evidence for early disease prevention. Fourteen parameters based on patient-specific spinal geometry were

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