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Intraoperative capsule protection can reduce the potential risk of adjacent segment degeneration acceleration biomechanically: an in silico study – Lumbar Fusion

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The article investigates the impact of iatrogenic capsule injury in posterior approach lumbar interbody fusion operations on adjacent segment degeneration acceleration biomechanically. The study used a numerical model to simulate different grades of capsule injury and found that an increase in capsule injury led to a stepwise increase in stress on the cranial motion segment. The results suggest that intraoperative capsule protection can reduce the risk of adjacent segment degeneration acceleration, emphasizing the importance of minimizing iatrogenic capsule damage for optimizing long-term patient outcomes

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
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Published article

: Intraoperative capsule protection can reduce the potential risk of adjacent segment degeneration acceleration biomechanically, and iatrogenic capsule damage on the cranial motion segment should be reduced to optimize patients’ long-term prognosis.

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J Orthop Surg Res. 2024 Feb 16;19(1):143. doi: 10.1186/s13018-024-04550-0.ABSTRACTBACKGROUND: The capsule of the zygapophyseal joint plays an important role in motion segmental stability maintenance. Iatrogenic capsule injury is a common phenomenon in posterior approach lumbar interbody fusion operations, but whether this procedure will cause a higher risk of adjacent segment degeneration acceleration biomechanically has yet,

J Orthop Surg Res. 2024 Feb 16;19(1):143. doi: 10.1186/s13018-024-04550-0.

ABSTRACT

BACKGROUND: The capsule of the zygapophyseal joint plays an important role in motion segmental stability maintenance. Iatrogenic capsule injury is a common phenomenon in posterior approach lumbar interbody fusion operations, but whether this procedure will cause a higher risk of adjacent segment degeneration acceleration biomechanically has yet to be identified.

METHODS: Posterior lumbar interbody fusion (PLIF) with different grades of iatrogenic capsule injury was simulated in our calibrated and validated numerical model. By adjusting the cross-sectional area of the capsule, different grades of capsule injury were simulated. The stress distribution on the cranial motion segment was computed under different loading conditions to judge the potential risk of adjacent segment degeneration acceleration.

RESULTS: Compared to the PLIF model with an intact capsule, a stepwise increase in the stress value on the cranial motion segment can be observed with a step decrease in capsule cross-sectional areas. Moreover, compared to the difference between models with intact and slightly injured capsules, the difference in stress values was more evident between models with slight and severe iatrogenic capsule injury.

: Intraoperative capsule protection can reduce the potential risk of adjacent segment degeneration acceleration biomechanically, and iatrogenic capsule damage on the cranial motion segment should be reduced to optimize patients’ long-term prognosis.

PMID:38365801 | PMC:PMC10870541 | DOI:10.1186/s13018-024-04550-0

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Intraoperative capsule protection can reduce the potential risk of adjacent segment degeneration acceleration biomechanically: an in silico study

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J Orthop Surg Res. 2024 Feb 16;19(1):143. doi: 10.1186/s13018-024-04550-0.ABSTRACTBACKGROUND: The capsule of the zygapophyseal joint plays an important role in motion segmental stability maintenance. Iatrogenic capsule injury is a common phenomenon in posterior approach lumbar interbody fusion operations, but whether this procedure will cause a higher risk of adjacent segment degeneration acceleration biomechanically has yet

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