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Biomechanical Evaluation of the Effect of Minimally Invasive Spine Surgery Compared with Traditional Approaches in Lifting Tasks
Fusion of spinal vertebrae can be accomplished by different surgical approaches. We investigated Traditional Open Spine Surgery (TOSS) versus Minimally Invasive Spine Surgery (MISS). While TOSS sacrifices spine muscles originating or inserting on the affected vertebrae, MISS seeks to minimize the ap...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8558419/ https://www.ncbi.nlm.nih.gov/pubmed/34733828 http://dx.doi.org/10.3389/fbioe.2021.724854 |
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author | Rasmussen, John Iversen, Kristoffer Engelund, Bjørn Keller Rasmussen, Sten |
author_facet | Rasmussen, John Iversen, Kristoffer Engelund, Bjørn Keller Rasmussen, Sten |
author_sort | Rasmussen, John |
collection | PubMed |
description | Fusion of spinal vertebrae can be accomplished by different surgical approaches. We investigated Traditional Open Spine Surgery (TOSS) versus Minimally Invasive Spine Surgery (MISS). While TOSS sacrifices spine muscles originating or inserting on the affected vertebrae, MISS seeks to minimize the approach-related morbidity and preserve the tendon attachments of the muscles in the area. We captured 3-D motions of the full body of one healthy subject performing a variety of 10 kg box lifting operations representing activities-of-daily-living that are likely to challenge the spine biomechanically. The motion data were transferred to a full-body biomechanical model with a detailed representation of the biomechanics of the spine, and simulations of the internal spine loads and muscle forces were performed under a baseline configuration and muscle configurations typical for TOSS respectively MISS for the cases of L3/L4, L4/L5, L5/S1, L4/S1 and L3/L5 fusions. The computational model was then used to investigate the biomechanical differences between surgeries. The simulations revealed that joint reaction forces are more affected by both surgical approaches for lateral lifting motions than for sagittal plane motions, and there are indications that individuals with fused joints, regardless of the approach, should be particularly careful with asymmetrical lifts. The MISS and TOSS approaches shift the average loads of different muscle groups in different ways. TOSS generally leads to higher post-operative muscle loads than MISS in the investigated cases, but the differences are smaller than could be expected, given the differences of surgical technique. |
format | Online Article Text |
id | pubmed-8558419 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-85584192021-11-02 Biomechanical Evaluation of the Effect of Minimally Invasive Spine Surgery Compared with Traditional Approaches in Lifting Tasks Rasmussen, John Iversen, Kristoffer Engelund, Bjørn Keller Rasmussen, Sten Front Bioeng Biotechnol Bioengineering and Biotechnology Fusion of spinal vertebrae can be accomplished by different surgical approaches. We investigated Traditional Open Spine Surgery (TOSS) versus Minimally Invasive Spine Surgery (MISS). While TOSS sacrifices spine muscles originating or inserting on the affected vertebrae, MISS seeks to minimize the approach-related morbidity and preserve the tendon attachments of the muscles in the area. We captured 3-D motions of the full body of one healthy subject performing a variety of 10 kg box lifting operations representing activities-of-daily-living that are likely to challenge the spine biomechanically. The motion data were transferred to a full-body biomechanical model with a detailed representation of the biomechanics of the spine, and simulations of the internal spine loads and muscle forces were performed under a baseline configuration and muscle configurations typical for TOSS respectively MISS for the cases of L3/L4, L4/L5, L5/S1, L4/S1 and L3/L5 fusions. The computational model was then used to investigate the biomechanical differences between surgeries. The simulations revealed that joint reaction forces are more affected by both surgical approaches for lateral lifting motions than for sagittal plane motions, and there are indications that individuals with fused joints, regardless of the approach, should be particularly careful with asymmetrical lifts. The MISS and TOSS approaches shift the average loads of different muscle groups in different ways. TOSS generally leads to higher post-operative muscle loads than MISS in the investigated cases, but the differences are smaller than could be expected, given the differences of surgical technique. Frontiers Media S.A. 2021-10-18 /pmc/articles/PMC8558419/ /pubmed/34733828 http://dx.doi.org/10.3389/fbioe.2021.724854 Text en Copyright © 2021 Rasmussen, Iversen, Engelund and Rasmussen. 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 Rasmussen, John Iversen, Kristoffer Engelund, Bjørn Keller Rasmussen, Sten Biomechanical Evaluation of the Effect of Minimally Invasive Spine Surgery Compared with Traditional Approaches in Lifting Tasks |
title | Biomechanical Evaluation of the Effect of Minimally Invasive Spine Surgery Compared with Traditional Approaches in Lifting Tasks |
title_full | Biomechanical Evaluation of the Effect of Minimally Invasive Spine Surgery Compared with Traditional Approaches in Lifting Tasks |
title_fullStr | Biomechanical Evaluation of the Effect of Minimally Invasive Spine Surgery Compared with Traditional Approaches in Lifting Tasks |
title_full_unstemmed | Biomechanical Evaluation of the Effect of Minimally Invasive Spine Surgery Compared with Traditional Approaches in Lifting Tasks |
title_short | Biomechanical Evaluation of the Effect of Minimally Invasive Spine Surgery Compared with Traditional Approaches in Lifting Tasks |
title_sort | biomechanical evaluation of the effect of minimally invasive spine surgery compared with traditional approaches in lifting tasks |
topic | Bioengineering and Biotechnology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8558419/ https://www.ncbi.nlm.nih.gov/pubmed/34733828 http://dx.doi.org/10.3389/fbioe.2021.724854 |
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