Stress analysis of the disc adjacent to interbody fusion in lumbar spine.

After anterior interbody fusion in the lumbar spine, the accelerated degeneration of the disc adjacent to the fusion levels was clinically observed. To understand the stress distribution of the adjacent disc, this study created a finite element model of the lumbar spine from L1-L5 vertebral body. The fusion model modified from the intact model was used to simulate the anterior interbody fusion. Various loading conditions, which included flexion, extension, lateral bending, and torsion, were applied to the finite element model to study the corresponding stress distribution. From the finite element model calculation, at a lower fusion site or more fusion levels, the stress of the disc adjacent to interbody fusion increased more than upper fusion site or single fusion level under flexion, torsion and lateral bending. Larger stress increase was estimated at the upper disc adjacent to interbody fusion than the lower disc adjacent to interbody fusion. In stress distribution, the upper disc adjacent to interbody fusion had a little alteration under torsion.

[1]  Y. E. Kim,et al.  An Analytical Investigation of the Mechanics of Spinal Instrumentation , 1988, Spine.

[2]  M M Panjabi,et al.  Three-Dimensional Movements of the Whole Lumbar Spine and Lumbosacral Joint , 1989, Spine.

[3]  J W Frymoyer,et al.  A Comparison of Radiographic Findings in Fusion and Nonfusion Patients Ten or More Years Following Lumbar Disc Surgery , 1979, Spine.

[4]  Lars G. Gilbertson,et al.  A combined finite element and optimization investigation of lumbar spine mechanics with and without muscles. , 1993, Spine.

[5]  R L Spilker,et al.  Mechanical behavior of a simple model of an intervertebral disk under compressive loading. , 1980, Journal of biomechanics.

[6]  P. Brinckmann,et al.  Interlaminar Shear Stresses and Laminae Separation in a Disc: Finite Element Analysis of the L3‐L4 Motion Segment Subjected to Axial Compressive Loads , 1995, Spine.

[7]  V K Goel,et al.  Effect of Disc Degeneration at One Level on the Adjacent Level in Axial Mode , 1991, Spine.

[8]  N Yoganandan,et al.  Biomechanical effect of anterior cervical spine fusion on adjacent segments. , 1999, Bio-medical materials and engineering.

[9]  H. Wu,et al.  Mechanical behavior of the human annulus fibrosus. , 1976, Journal of biomechanics.

[10]  A. Shirazi-Adl.  Nonlinear stress analysis of the whole lumbar spine in torsion--mechanics of facet articulation. , 1994, Journal of biomechanics.

[11]  F. Marchand,et al.  Investigation of the Laminate Structure of Lumbar Disc Anulus Fibrosus , 1990, Spine.

[12]  A Shirazi-Adl,et al.  Biomechanics of the Lumbar Spine in Sagittal/Lateral Moments , 1994, Spine.

[13]  J. Weinstein,et al.  Long-term Follow-up of Lower Lumbar Fusion Patients , 1987, Spine.

[14]  CASEY K. LEE,et al.  Accelerated Degeneration of the Segment Adjacent to a Lumbar Fusion , 1988, Spine.

[15]  K. Takahashi,et al.  Degenerative spondylolisthesis. Pathophysiology and results of anterior interbody fusion. , 1988, Clinical orthopaedics and related research.

[16]  Kazuhisa Takahashi,et al.  Long-Term Results of Anterior Interbody Fusion for Treatment of Degenerative Spondylolisthesis , 1990, Spine.

[17]  N. Langrana,et al.  Lumbosacral spinal fusion. A biomechanical study. , 1984, Spine.

[18]  A. Schultz,et al.  Mechanical Properties of Human Lumbar Spine Motion Segments: Influences of Age, Sex, Disc Level, and Degeneration , 1979, Spine.

[19]  A. M. Ahmed,et al.  Stress analysis of the lumbar disc-body unit in compression. A three-dimensional nonlinear finite element study. , 1984, Spine.

[20]  MALCOLM H. POPE,et al.  Water Content in Human Intervertebral Discs: Part I. Measurement by Magnetic Resonance Imaging , 1987, Spine.

[21]  J. Schlegel,et al.  Lumbar Motion Segment Pathology Adjacent to Thoracolumbar, Lumbar, and Lumbosacral Fusions , 1996, Spine.

[22]  R. Fraser,et al.  Magnetic Resonance Imaging Assessment of Disc Degeneration 10 Years After Anterior Lumbar Interbody Fusion , 1995, Spine.

[23]  V. Goel,et al.  Prediction of Load Sharing Among Spinal Components of a C5‐C6 Motion Segment Using the Finite Element Approach , 1998, Spine.

[24]  M. Krismer,et al.  Motion in Lumbar Functional Spine Units During Side Bending and Axial Rotation Moments Depending on the Degree of Degeneration , 2000, Spine.

[25]  J. Frymoyer,et al.  Disc Excision and Spine Fusion in the Management of Lumbar Disc Disease: A Minimum Ten-Year Followup , 1978, Spine.