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Effect of graded posterior element and ligament removal on annulus stress and segmental stability in lumbar spine stenosis: a finite element analysis study

The study aimed to investigate the impact of posterior element and ligament removal on the maximum von Mises stress, and maximum shear stress of the eight-layer annulus for treating stenosis at the L3-L4 and L4-L5 levels in the lumbar spine. Previous studies have indicated that laminectomy alone can...

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Autores principales: Lin, Maohua, Doulgeris, James, Dhar, Utpal Kanti, O’Corner, Timothy, Papanastassiou, Ioannis Dimitri, Tsai, Chi-Tay, Vrionis, Frank D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10543754/
https://www.ncbi.nlm.nih.gov/pubmed/37790254
http://dx.doi.org/10.3389/fbioe.2023.1237702
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author Lin, Maohua
Doulgeris, James
Dhar, Utpal Kanti
O’Corner, Timothy
Papanastassiou, Ioannis Dimitri
Tsai, Chi-Tay
Vrionis, Frank D.
author_facet Lin, Maohua
Doulgeris, James
Dhar, Utpal Kanti
O’Corner, Timothy
Papanastassiou, Ioannis Dimitri
Tsai, Chi-Tay
Vrionis, Frank D.
author_sort Lin, Maohua
collection PubMed
description The study aimed to investigate the impact of posterior element and ligament removal on the maximum von Mises stress, and maximum shear stress of the eight-layer annulus for treating stenosis at the L3-L4 and L4-L5 levels in the lumbar spine. Previous studies have indicated that laminectomy alone can result in segmental instability unless fusion is performed. However, no direct correlations have been established regarding the impact of posterior and ligament removal. To address this gap, four models were developed: Model 1 represented the intact L2-L5 model, while model 2 involved a unilateral laminotomy involving the removal of a section of the L4 inferior lamina and 50% of the ligament flavum between L4 and L5. Model 3 consisted of a complete laminectomy, which included the removal of the spinous process and lamina of L4, as well as the relevant connecting ligaments between L3-L4 and L4-L5 (ligament flavum, interspinous ligament, supraspinous ligament). In the fourth model, a complete laminectomy with 50% facetectomy was conducted. This involved the same removals as in model 3, along with a 50% removal of the inferior/superior facets of L4 and a 50% removal of the facet capsular ligaments between L3-L4 and L4-L5. The results indicated a significant change in the range of motion (ROM) at the L3-L4 and L4-L5 levels during flexion and torque situations, but no significant change during extension and bending simulation. The ROM increased by 10% from model 1 and 2 to model 3, and by 20% to model 4 during flexion simulation. The maximum shear stress and maximum von-Mises stress of the annulus and nucleus at the L3-L4 levels exhibited the greatest increase during flexion. In all eight layers of the annulus, there was an observed increase in both the maximum shear stress and maximum von-Mises stress from model 1&2 to model 3 and model 4, with the highest rate of increase noted in layers 7&8. These findings suggest that graded posterior element and ligament removal have a notable impact on stress distribution and range of motion in the lumbar spine, particularly during flexion.
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spelling pubmed-105437542023-10-03 Effect of graded posterior element and ligament removal on annulus stress and segmental stability in lumbar spine stenosis: a finite element analysis study Lin, Maohua Doulgeris, James Dhar, Utpal Kanti O’Corner, Timothy Papanastassiou, Ioannis Dimitri Tsai, Chi-Tay Vrionis, Frank D. Front Bioeng Biotechnol Bioengineering and Biotechnology The study aimed to investigate the impact of posterior element and ligament removal on the maximum von Mises stress, and maximum shear stress of the eight-layer annulus for treating stenosis at the L3-L4 and L4-L5 levels in the lumbar spine. Previous studies have indicated that laminectomy alone can result in segmental instability unless fusion is performed. However, no direct correlations have been established regarding the impact of posterior and ligament removal. To address this gap, four models were developed: Model 1 represented the intact L2-L5 model, while model 2 involved a unilateral laminotomy involving the removal of a section of the L4 inferior lamina and 50% of the ligament flavum between L4 and L5. Model 3 consisted of a complete laminectomy, which included the removal of the spinous process and lamina of L4, as well as the relevant connecting ligaments between L3-L4 and L4-L5 (ligament flavum, interspinous ligament, supraspinous ligament). In the fourth model, a complete laminectomy with 50% facetectomy was conducted. This involved the same removals as in model 3, along with a 50% removal of the inferior/superior facets of L4 and a 50% removal of the facet capsular ligaments between L3-L4 and L4-L5. The results indicated a significant change in the range of motion (ROM) at the L3-L4 and L4-L5 levels during flexion and torque situations, but no significant change during extension and bending simulation. The ROM increased by 10% from model 1 and 2 to model 3, and by 20% to model 4 during flexion simulation. The maximum shear stress and maximum von-Mises stress of the annulus and nucleus at the L3-L4 levels exhibited the greatest increase during flexion. In all eight layers of the annulus, there was an observed increase in both the maximum shear stress and maximum von-Mises stress from model 1&2 to model 3 and model 4, with the highest rate of increase noted in layers 7&8. These findings suggest that graded posterior element and ligament removal have a notable impact on stress distribution and range of motion in the lumbar spine, particularly during flexion. Frontiers Media S.A. 2023-09-18 /pmc/articles/PMC10543754/ /pubmed/37790254 http://dx.doi.org/10.3389/fbioe.2023.1237702 Text en Copyright © 2023 Lin, Doulgeris, Dhar, O’Corner, Papanastassiou, Tsai and Vrionis. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Bioengineering and Biotechnology
Lin, Maohua
Doulgeris, James
Dhar, Utpal Kanti
O’Corner, Timothy
Papanastassiou, Ioannis Dimitri
Tsai, Chi-Tay
Vrionis, Frank D.
Effect of graded posterior element and ligament removal on annulus stress and segmental stability in lumbar spine stenosis: a finite element analysis study
title Effect of graded posterior element and ligament removal on annulus stress and segmental stability in lumbar spine stenosis: a finite element analysis study
title_full Effect of graded posterior element and ligament removal on annulus stress and segmental stability in lumbar spine stenosis: a finite element analysis study
title_fullStr Effect of graded posterior element and ligament removal on annulus stress and segmental stability in lumbar spine stenosis: a finite element analysis study
title_full_unstemmed Effect of graded posterior element and ligament removal on annulus stress and segmental stability in lumbar spine stenosis: a finite element analysis study
title_short Effect of graded posterior element and ligament removal on annulus stress and segmental stability in lumbar spine stenosis: a finite element analysis study
title_sort effect of graded posterior element and ligament removal on annulus stress and segmental stability in lumbar spine stenosis: a finite element analysis study
topic Bioengineering and Biotechnology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10543754/
https://www.ncbi.nlm.nih.gov/pubmed/37790254
http://dx.doi.org/10.3389/fbioe.2023.1237702
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