Impact of lumbar lordosis on the adjoining phase in transforaminal lumbar interbody fusion: A finite component evaluation.
World Neurosurg. 2018 Feb 21;:
Authors: Zhao X, Du L, Xie Y, Zhao J
OBJECTIVE: Right here we used a finite component (FE) evaluation to research the biomechanical adjustments attributable to transforaminal lumbar interbody fusion (TLIF) on the L4-L5 degree by lumbar lordosis (LL) diploma.
METHODS: A lumbar FE mannequin (L1-S5) was constructed primarily based on computed tomography scans of a 30-year-old wholesome male volunteer (pelvic incidence = 50°, LL = 52°). We investigated the affect of LL on the biomechanical habits of the lumbar backbone after TLIF in L4-L5 fusion fashions with 57°, 52°, 47°, and 40° LL. The LL was outlined because the angle between the superior endplate of L1 and the superior endplate of S1. A 150-N vertical axial pre-load was imposed on the superior floor of L3. A 10-N·m second was concurrently utilized on the L3 superior floor alongside the radial path to simulate the 4 primary physiological motions of flexion, extension, lateral bending, and torsion within the numerical simulations. The vary of movement (ROM) and intradiscal stress (IDP) of L3-L4 have been evaluated and in contrast within the simulated circumstances.
RESULTS: In all movement patterns, the ROM and IDP have been each elevated after TLIF. As well as, the lower in lordosis usually elevated the ROM and IDP in all movement patterns.
CONCLUSIONS: The present FE evaluation indicated that decreased spinal lordosis could evoke overstress of the adjoining phase and enhance the danger of the pathological improvement of adjoining phase degeneration (ASD); thus, ASD ought to be thought-about when planning a spinal fusion process.
PMID: 29477002 [PubMed – as supplied by publisher]