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Preserving Posterior Complex Can Prevent Adjacent Segment Disease following Posterior Lumbar Interbody Fusion Surgeries: A Finite Element Analysis

OBJECTIVE: To investigate the biomechanical effects of the lumbar posterior complex on the adjacent segments after posterior lumbar interbody fusion (PLIF) surgeries. METHODS: A finite element model of the L1–S1 segment was modified to simulate PLIF with total laminectomy (PLIF-LAM) and PLIF with he...

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Autores principales: Huang, Yun-Peng, Du, Cheng-Fei, Cheng, Cheng-Kung, Zhong, Zheng-Cheng, Chen, Xuan-Wei, Wu, Gui, Li, Zhe-Cheng, Ye, Jin-Duo, Lin, Jian-Hua, Wang, Li Zhen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5117648/
https://www.ncbi.nlm.nih.gov/pubmed/27870867
http://dx.doi.org/10.1371/journal.pone.0166452
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author Huang, Yun-Peng
Du, Cheng-Fei
Cheng, Cheng-Kung
Zhong, Zheng-Cheng
Chen, Xuan-Wei
Wu, Gui
Li, Zhe-Cheng
Ye, Jin-Duo
Lin, Jian-Hua
Wang, Li Zhen
author_facet Huang, Yun-Peng
Du, Cheng-Fei
Cheng, Cheng-Kung
Zhong, Zheng-Cheng
Chen, Xuan-Wei
Wu, Gui
Li, Zhe-Cheng
Ye, Jin-Duo
Lin, Jian-Hua
Wang, Li Zhen
author_sort Huang, Yun-Peng
collection PubMed
description OBJECTIVE: To investigate the biomechanical effects of the lumbar posterior complex on the adjacent segments after posterior lumbar interbody fusion (PLIF) surgeries. METHODS: A finite element model of the L1–S1 segment was modified to simulate PLIF with total laminectomy (PLIF-LAM) and PLIF with hemilaminectomy (PLIF-HEMI) procedures. The models were subjected to a 400N follower load with a 7.5-N.m moment of flexion, extension, torsion, and lateral bending. The range of motion (ROM), intradiscal pressure (IDP), and ligament force were compared. RESULTS: In Flexion, the ROM, IDP and ligament force of posterior longitudinal ligament, intertransverse ligament, and capsular ligament remarkably increased at the proximal adjacent segment in the PLIF-LAM model, and slightly increased in the PLIF-HEMI model. There was almost no difference for the ROM, IDP and ligament force at L5-S1 level between the two PLIF models although the ligament forces of ligamenta flava remarkably increased compared with the intact lumbar spine (INT) model. For the other loading conditions, these two models almost showed no difference in ROM, IDP and ligament force on the adjacent discs. CONCLUSIONS: Preserved posterior complex acts as the posterior tension band during PLIF surgery and results in less ROM, IDP and ligament forces on the proximal adjacent segment in flexion. Preserving the posterior complex during decompression can be effective on preventing adjacent segment degeneration (ASD) following PLIF surgeries.
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spelling pubmed-51176482016-12-15 Preserving Posterior Complex Can Prevent Adjacent Segment Disease following Posterior Lumbar Interbody Fusion Surgeries: A Finite Element Analysis Huang, Yun-Peng Du, Cheng-Fei Cheng, Cheng-Kung Zhong, Zheng-Cheng Chen, Xuan-Wei Wu, Gui Li, Zhe-Cheng Ye, Jin-Duo Lin, Jian-Hua Wang, Li Zhen PLoS One Research Article OBJECTIVE: To investigate the biomechanical effects of the lumbar posterior complex on the adjacent segments after posterior lumbar interbody fusion (PLIF) surgeries. METHODS: A finite element model of the L1–S1 segment was modified to simulate PLIF with total laminectomy (PLIF-LAM) and PLIF with hemilaminectomy (PLIF-HEMI) procedures. The models were subjected to a 400N follower load with a 7.5-N.m moment of flexion, extension, torsion, and lateral bending. The range of motion (ROM), intradiscal pressure (IDP), and ligament force were compared. RESULTS: In Flexion, the ROM, IDP and ligament force of posterior longitudinal ligament, intertransverse ligament, and capsular ligament remarkably increased at the proximal adjacent segment in the PLIF-LAM model, and slightly increased in the PLIF-HEMI model. There was almost no difference for the ROM, IDP and ligament force at L5-S1 level between the two PLIF models although the ligament forces of ligamenta flava remarkably increased compared with the intact lumbar spine (INT) model. For the other loading conditions, these two models almost showed no difference in ROM, IDP and ligament force on the adjacent discs. CONCLUSIONS: Preserved posterior complex acts as the posterior tension band during PLIF surgery and results in less ROM, IDP and ligament forces on the proximal adjacent segment in flexion. Preserving the posterior complex during decompression can be effective on preventing adjacent segment degeneration (ASD) following PLIF surgeries. Public Library of Science 2016-11-21 /pmc/articles/PMC5117648/ /pubmed/27870867 http://dx.doi.org/10.1371/journal.pone.0166452 Text en © 2016 Huang et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Huang, Yun-Peng
Du, Cheng-Fei
Cheng, Cheng-Kung
Zhong, Zheng-Cheng
Chen, Xuan-Wei
Wu, Gui
Li, Zhe-Cheng
Ye, Jin-Duo
Lin, Jian-Hua
Wang, Li Zhen
Preserving Posterior Complex Can Prevent Adjacent Segment Disease following Posterior Lumbar Interbody Fusion Surgeries: A Finite Element Analysis
title Preserving Posterior Complex Can Prevent Adjacent Segment Disease following Posterior Lumbar Interbody Fusion Surgeries: A Finite Element Analysis
title_full Preserving Posterior Complex Can Prevent Adjacent Segment Disease following Posterior Lumbar Interbody Fusion Surgeries: A Finite Element Analysis
title_fullStr Preserving Posterior Complex Can Prevent Adjacent Segment Disease following Posterior Lumbar Interbody Fusion Surgeries: A Finite Element Analysis
title_full_unstemmed Preserving Posterior Complex Can Prevent Adjacent Segment Disease following Posterior Lumbar Interbody Fusion Surgeries: A Finite Element Analysis
title_short Preserving Posterior Complex Can Prevent Adjacent Segment Disease following Posterior Lumbar Interbody Fusion Surgeries: A Finite Element Analysis
title_sort preserving posterior complex can prevent adjacent segment disease following posterior lumbar interbody fusion surgeries: a finite element analysis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5117648/
https://www.ncbi.nlm.nih.gov/pubmed/27870867
http://dx.doi.org/10.1371/journal.pone.0166452
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