Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: Rasmussen, John, Iversen, Kristoffer, Engelund, Bjørn Keller, Rasmussen, Sten
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
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
_version_ 1784592556866142208
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
work_keys_str_mv AT rasmussenjohn biomechanicalevaluationoftheeffectofminimallyinvasivespinesurgerycomparedwithtraditionalapproachesinliftingtasks
AT iversenkristoffer biomechanicalevaluationoftheeffectofminimallyinvasivespinesurgerycomparedwithtraditionalapproachesinliftingtasks
AT engelundbjørnkeller biomechanicalevaluationoftheeffectofminimallyinvasivespinesurgerycomparedwithtraditionalapproachesinliftingtasks
AT rasmussensten biomechanicalevaluationoftheeffectofminimallyinvasivespinesurgerycomparedwithtraditionalapproachesinliftingtasks