Effects of the level of mono-segmental dynamic stabilization on the whole lumbar spine

Hae Won Choi, Young Eun Kim, Soo Won Chae

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Little biomechanical data has been gathered for the biomechanical effects of pedicle-based dynamic stabilization system (PBDS) and fusion (a conventional titanium rod and cage) to the whole lumbar spine according to the instrumentation level. A previously validated three-dimensional, intact osteoligamentous L1-S1 finite element model was modified to incorporate three different PBDS (Dynesys, Nflex, or PEEK) and fusion at three different levels (L3-L4, L4-L5, and L5-S1). A new loading method that can create the segmental motion similar to an in-vivo measurement was applied to the model. The biomechanical changes in the stabilized models were compared with those of the intact model during sagittal plane motion. The simulation results demonstrated that Dynesys generated relatively larger motion when it was instrumented at the L3-L4 segment, whereas the Nflex was the most appropriate device for L4-L5 stabilization. Depending on the stabilization device and instrumented level, whole-lumbar segmental motion also varied. During flexion, stabilization at the L3-L4 level or L4-L5 level produced a relatively higher increase in the motion at all cranial levels. Stabilization at the L5-S1 level generated a slight decrease in the motion at the adjacent cranial level without respect to the type of fixation. In cases of fusion, the change in the motion was higher relative to that with PBDS. Given the biomechanical change at each level after stabilization, adjacent segment degeneration was expected cranially rather caudally, and the probability of this degeneration differed depending on the stabilization level and device.

Original languageEnglish
Pages (from-to)603-611
Number of pages9
JournalInternational Journal of Precision Engineering and Manufacturing
Volume17
Issue number5
DOIs
Publication statusPublished - 2016 May 1

Fingerprint

Stabilization
Fusion reactions
Polyether ether ketones
Titanium

Keywords

  • Adjacent segment degeneration
  • Dynamic stabilization
  • Finite element spine model
  • Fusion
  • Instrumentation level

ASJC Scopus subject areas

  • Electrical and Electronic Engineering
  • Industrial and Manufacturing Engineering
  • Mechanical Engineering

Cite this

Effects of the level of mono-segmental dynamic stabilization on the whole lumbar spine. / Choi, Hae Won; Kim, Young Eun; Chae, Soo Won.

In: International Journal of Precision Engineering and Manufacturing, Vol. 17, No. 5, 01.05.2016, p. 603-611.

Research output: Contribution to journalArticle

@article{59f91a9328c64596a94d100e09a9fde2,
title = "Effects of the level of mono-segmental dynamic stabilization on the whole lumbar spine",
abstract = "Little biomechanical data has been gathered for the biomechanical effects of pedicle-based dynamic stabilization system (PBDS) and fusion (a conventional titanium rod and cage) to the whole lumbar spine according to the instrumentation level. A previously validated three-dimensional, intact osteoligamentous L1-S1 finite element model was modified to incorporate three different PBDS (Dynesys, Nflex, or PEEK) and fusion at three different levels (L3-L4, L4-L5, and L5-S1). A new loading method that can create the segmental motion similar to an in-vivo measurement was applied to the model. The biomechanical changes in the stabilized models were compared with those of the intact model during sagittal plane motion. The simulation results demonstrated that Dynesys generated relatively larger motion when it was instrumented at the L3-L4 segment, whereas the Nflex was the most appropriate device for L4-L5 stabilization. Depending on the stabilization device and instrumented level, whole-lumbar segmental motion also varied. During flexion, stabilization at the L3-L4 level or L4-L5 level produced a relatively higher increase in the motion at all cranial levels. Stabilization at the L5-S1 level generated a slight decrease in the motion at the adjacent cranial level without respect to the type of fixation. In cases of fusion, the change in the motion was higher relative to that with PBDS. Given the biomechanical change at each level after stabilization, adjacent segment degeneration was expected cranially rather caudally, and the probability of this degeneration differed depending on the stabilization level and device.",
keywords = "Adjacent segment degeneration, Dynamic stabilization, Finite element spine model, Fusion, Instrumentation level",
author = "Choi, {Hae Won} and Kim, {Young Eun} and Chae, {Soo Won}",
year = "2016",
month = "5",
day = "1",
doi = "10.1007/s12541-016-0073-1",
language = "English",
volume = "17",
pages = "603--611",
journal = "International Journal of Precision Engineering and Manufacturing",
issn = "1229-8557",
publisher = "Korean Society of Precision Engineering",
number = "5",

}

TY - JOUR

T1 - Effects of the level of mono-segmental dynamic stabilization on the whole lumbar spine

AU - Choi, Hae Won

AU - Kim, Young Eun

AU - Chae, Soo Won

PY - 2016/5/1

Y1 - 2016/5/1

N2 - Little biomechanical data has been gathered for the biomechanical effects of pedicle-based dynamic stabilization system (PBDS) and fusion (a conventional titanium rod and cage) to the whole lumbar spine according to the instrumentation level. A previously validated three-dimensional, intact osteoligamentous L1-S1 finite element model was modified to incorporate three different PBDS (Dynesys, Nflex, or PEEK) and fusion at three different levels (L3-L4, L4-L5, and L5-S1). A new loading method that can create the segmental motion similar to an in-vivo measurement was applied to the model. The biomechanical changes in the stabilized models were compared with those of the intact model during sagittal plane motion. The simulation results demonstrated that Dynesys generated relatively larger motion when it was instrumented at the L3-L4 segment, whereas the Nflex was the most appropriate device for L4-L5 stabilization. Depending on the stabilization device and instrumented level, whole-lumbar segmental motion also varied. During flexion, stabilization at the L3-L4 level or L4-L5 level produced a relatively higher increase in the motion at all cranial levels. Stabilization at the L5-S1 level generated a slight decrease in the motion at the adjacent cranial level without respect to the type of fixation. In cases of fusion, the change in the motion was higher relative to that with PBDS. Given the biomechanical change at each level after stabilization, adjacent segment degeneration was expected cranially rather caudally, and the probability of this degeneration differed depending on the stabilization level and device.

AB - Little biomechanical data has been gathered for the biomechanical effects of pedicle-based dynamic stabilization system (PBDS) and fusion (a conventional titanium rod and cage) to the whole lumbar spine according to the instrumentation level. A previously validated three-dimensional, intact osteoligamentous L1-S1 finite element model was modified to incorporate three different PBDS (Dynesys, Nflex, or PEEK) and fusion at three different levels (L3-L4, L4-L5, and L5-S1). A new loading method that can create the segmental motion similar to an in-vivo measurement was applied to the model. The biomechanical changes in the stabilized models were compared with those of the intact model during sagittal plane motion. The simulation results demonstrated that Dynesys generated relatively larger motion when it was instrumented at the L3-L4 segment, whereas the Nflex was the most appropriate device for L4-L5 stabilization. Depending on the stabilization device and instrumented level, whole-lumbar segmental motion also varied. During flexion, stabilization at the L3-L4 level or L4-L5 level produced a relatively higher increase in the motion at all cranial levels. Stabilization at the L5-S1 level generated a slight decrease in the motion at the adjacent cranial level without respect to the type of fixation. In cases of fusion, the change in the motion was higher relative to that with PBDS. Given the biomechanical change at each level after stabilization, adjacent segment degeneration was expected cranially rather caudally, and the probability of this degeneration differed depending on the stabilization level and device.

KW - Adjacent segment degeneration

KW - Dynamic stabilization

KW - Finite element spine model

KW - Fusion

KW - Instrumentation level

UR - http://www.scopus.com/inward/record.url?scp=84971290105&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84971290105&partnerID=8YFLogxK

U2 - 10.1007/s12541-016-0073-1

DO - 10.1007/s12541-016-0073-1

M3 - Article

AN - SCOPUS:84971290105

VL - 17

SP - 603

EP - 611

JO - International Journal of Precision Engineering and Manufacturing

JF - International Journal of Precision Engineering and Manufacturing

SN - 1229-8557

IS - 5

ER -