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| ZHENG Jie,YANG Yonghong,ZHANG Dongsheng.Finite element analysis of biomechanical changes of adjacent segments of degenerative scoliosis treated with different operative methods of long-segment internal fixation and fusion[J].Chinese Journal of Spine and Spinal Cord,2011,(9):769-773. |
| Finite element analysis of biomechanical changes of adjacent segments of degenerative scoliosis treated with different operative methods of long-segment internal fixation and fusion |
| Received:March 24, 2011 Revised:July 27, 2011 |
| English Keywords:Degenerative scoliosis Long-segment fusion Internal fixation Adjacent segment Biomechanics |
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| 【Abstract】 Objective：To investigate the effect of different types of long-segment internal fixation and fusion on spine range of motion（ROM） and stress in disc as well as cartilage of facet joint of adjacent segment in patients with spine degenerative scoliosis（DS） by finite element analysis.Method：Based on the DS patients′ CT images of the consecutive spine from T12 to superior segment of S1，the E-feature Biomedical Modeler was imported.The three dimensional solid model was divided into high quality body mesh，then the special material attributing to the model was assigned according to the pathological features of DS，and the three dimensional finite element model was introduced into ANSYS 12.0 analysis software.The spinous process and whole lamina of vertebra and partial facet process of L4 were removed，and interbody fusion at L4/5 was performed，after that，3 procedures termed as：1，L2-L4 laminar fusion plus L2-L4 instrumentation（8 pedicle screws）；2，L1-L4 laminar fusion plus L1-L5 instrumenation（10 pedicle screws）；3，L1-S1 laminar fusion plus L1-S1 instrumentation（12 pedicle screws）.The model was loaded on flexion-extension，lateral bending and rotation.The spine ROM and stress in disc as well as cartilage of facet joint of adjacent segment were measured，and all these data were compared with preoperative DS model.Result：The spine ROM of three procedures decreased in the order of 3<2<1.The stress in adjacent interverbral disc was affected significantly.All three procedures had the stress in adjacent upper disc decreased on flexion and rotation，while had it increased on lateral bending；on extension the stress in the upper disc decreased obviously.The first and second procedure had the stress in adjacent lower disc increased on flexion，lateral bending and left rotation，while had it decreased on extension and right rotation.But no difference with respect to their effects on upper and lower discs was noted.The highest stress of cartilage in adjacent facet joint was 532.98MPa for procedure 3，and that for procedure 2 and 1 was 494.08MPa and 63.27MPa respectively.Higher stress focusing in facet joint was more common in procedure 2 and 3 than in procedure 1.Conclusion：The more segments fusioned，the more effect has on adjacent ROM and stress in disc and facet joint.For degenerative scoliosis，on the criteria of complete decompression and stability reconstruction，long-segment fusion should be avoided. |
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