Finite Element Analysis for Comparison of Spinous Process Osteotomies Technique with Conventional Laminectomy as Lumbar Decompression Procedure
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Purpose: The purpose of this study was to evaluate and compare the biomechanicalbehavior of the lumbar spine after posterior decompression with the spinous process osteotomy (SPiO) technique or the conventional laminectomy (CL) techniqueusing a finite element (FE) model. Materials and Methods: Three validated lumbar FE models (L2‒5) which represented intact spine and two decompression models using SPiO and CL techniques at the L3‒4 segment were developed. In each model, the ranges of motion, the maximal von Mises stress of the annulus fibrosus,and the intradiscal pressures at the index segment (L3‒4) and adjacent segments(L2‒3 and L4‒5) under 7.5 Nm moments were analyzed. Facet contact forces were also compared among three models under the extension and torsion moments. Results: Compared to the intact model, the CL and SPiO models had increased range of motion and annulus stress at both the index segment (L3‒4) and the adjacent segments under flexion and torsion. However, the SPiO model demonstrateda reduced range of motion and annulus stress than the CL model. Both CL and SPiO models had an increase of facet contact force at the L3‒4 segment under the torsion moment compared to that of the intact model. Under the extensionmoment, however, three models demonstrated a similar facet contact force even at the L3‒4 model. Conclusion: Both decompression methods lead to postoperativesegmental instability compared to the intact model. However, SPiO techniqueleads to better segmental stability compared to the CL technique.
Abstract
Purpose: The purpose of this study was to evaluate and compare the biomechanicalbehavior of the lumbar spine after posterior decompression with the spinous process osteotomy (SPiO) technique or the conventional laminectomy (CL) techniqueusing a finite element (FE) model. Materials and Methods: Three validated lumbar FE models (L2‒5) which represented intact spine and two decompression models using SPiO and CL techniques at the L3‒4 segment were developed. In each model, the ranges of motion, the maximal von Mises stress of the annulus fibrosus,and the intradiscal pressures at the index segment (L3‒4) and adjacent segments(L2‒3 and L4‒5) under 7.5 Nm moments were analyzed. Facet contact forces were also compared among three models under the extension and torsion moments. Results: Compared to the intact model, the CL and SPiO models had increased range of motion and annulus stress at both the index segment (L3‒4) and the adjacent segments under flexion and torsion. However, the SPiO model demonstrateda reduced range of motion and annulus stress than the CL model. Both CL and SPiO models had an increase of facet contact force at the L3‒4 segment under the torsion moment compared to that of the intact model. Under the extensionmoment, however, three models demonstrated a similar facet contact force even at the L3‒4 model. Conclusion: Both decompression methods lead to postoperativesegmental instability compared to the intact model. However, SPiO techniqueleads to better segmental stability compared to the CL technique.
참고문헌 (30)
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