Cargando…

Kinematic and biomechanical responses of the spine to distraction surgery in children with early onset scoliosis: A 3-D finite element analysis

Periodical and consecutive distraction is an effective treatment for severe early onset scoliosis (EOS), which enables the spinal coronal and sagittal plane deformity correction. However, the rate of rod fractures and postoperative complications was still high mainly related to the distraction proce...

Descripción completa

Detalles Bibliográficos
Autores principales: Pei, Baoqing, Lu, Da, Wu, Xueqing, Xu, Yangyang, Ma, Chenghao, Wu, Shuqin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9336159/
https://www.ncbi.nlm.nih.gov/pubmed/35910017
http://dx.doi.org/10.3389/fbioe.2022.933341
_version_ 1784759485838917632
author Pei, Baoqing
Lu, Da
Wu, Xueqing
Xu, Yangyang
Ma, Chenghao
Wu, Shuqin
author_facet Pei, Baoqing
Lu, Da
Wu, Xueqing
Xu, Yangyang
Ma, Chenghao
Wu, Shuqin
author_sort Pei, Baoqing
collection PubMed
description Periodical and consecutive distraction is an effective treatment for severe early onset scoliosis (EOS), which enables the spinal coronal and sagittal plane deformity correction. However, the rate of rod fractures and postoperative complications was still high mainly related to the distraction process. Previous studies have primarily investigated the maximum safe distraction force without a rod broken, neglecting the spinal re-imbalance and distraction energy consumption, which is equally vital to evaluate the operative value. This study aimed to reveal the kinematic and biomechanical responses occurring after spinal distraction surgery, which were affected by traditional bilateral fixation. The spinal models (C6-S1) before four distractions were reconstructed based on CT images and the growing rods were applied with the upward displacement load of 0–25 mm at an interval of 5 mm. Relationships between the distraction distance, the distraction force and the thoracic and lumbar Cobb angle were revealed, and the spinal displacement and rotation in three-dimensional directions were measured. The spinal overall imbalance would also happen during the distraction process even under the safe force, which was characterized by unexpected cervical lordosis and lateral displacement. Additionally, the law of diminishing return has been confirmed by comparing the distraction energy consumption in different distraction distances, which suggests that more attention paid to the spinal kinematic and biomechanical changes is better than to the distraction force. Notably, the selection of fixed segments significantly impacts the distraction force at the same distraction distance. Accordingly, some results could provide a better understanding of spinal distraction surgery.
format Online
Article
Text
id pubmed-9336159
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-93361592022-07-30 Kinematic and biomechanical responses of the spine to distraction surgery in children with early onset scoliosis: A 3-D finite element analysis Pei, Baoqing Lu, Da Wu, Xueqing Xu, Yangyang Ma, Chenghao Wu, Shuqin Front Bioeng Biotechnol Bioengineering and Biotechnology Periodical and consecutive distraction is an effective treatment for severe early onset scoliosis (EOS), which enables the spinal coronal and sagittal plane deformity correction. However, the rate of rod fractures and postoperative complications was still high mainly related to the distraction process. Previous studies have primarily investigated the maximum safe distraction force without a rod broken, neglecting the spinal re-imbalance and distraction energy consumption, which is equally vital to evaluate the operative value. This study aimed to reveal the kinematic and biomechanical responses occurring after spinal distraction surgery, which were affected by traditional bilateral fixation. The spinal models (C6-S1) before four distractions were reconstructed based on CT images and the growing rods were applied with the upward displacement load of 0–25 mm at an interval of 5 mm. Relationships between the distraction distance, the distraction force and the thoracic and lumbar Cobb angle were revealed, and the spinal displacement and rotation in three-dimensional directions were measured. The spinal overall imbalance would also happen during the distraction process even under the safe force, which was characterized by unexpected cervical lordosis and lateral displacement. Additionally, the law of diminishing return has been confirmed by comparing the distraction energy consumption in different distraction distances, which suggests that more attention paid to the spinal kinematic and biomechanical changes is better than to the distraction force. Notably, the selection of fixed segments significantly impacts the distraction force at the same distraction distance. Accordingly, some results could provide a better understanding of spinal distraction surgery. Frontiers Media S.A. 2022-07-15 /pmc/articles/PMC9336159/ /pubmed/35910017 http://dx.doi.org/10.3389/fbioe.2022.933341 Text en Copyright © 2022 Pei, Lu, Wu, Xu, Ma and Wu. 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
Pei, Baoqing
Lu, Da
Wu, Xueqing
Xu, Yangyang
Ma, Chenghao
Wu, Shuqin
Kinematic and biomechanical responses of the spine to distraction surgery in children with early onset scoliosis: A 3-D finite element analysis
title Kinematic and biomechanical responses of the spine to distraction surgery in children with early onset scoliosis: A 3-D finite element analysis
title_full Kinematic and biomechanical responses of the spine to distraction surgery in children with early onset scoliosis: A 3-D finite element analysis
title_fullStr Kinematic and biomechanical responses of the spine to distraction surgery in children with early onset scoliosis: A 3-D finite element analysis
title_full_unstemmed Kinematic and biomechanical responses of the spine to distraction surgery in children with early onset scoliosis: A 3-D finite element analysis
title_short Kinematic and biomechanical responses of the spine to distraction surgery in children with early onset scoliosis: A 3-D finite element analysis
title_sort kinematic and biomechanical responses of the spine to distraction surgery in children with early onset scoliosis: a 3-d finite element analysis
topic Bioengineering and Biotechnology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9336159/
https://www.ncbi.nlm.nih.gov/pubmed/35910017
http://dx.doi.org/10.3389/fbioe.2022.933341
work_keys_str_mv AT peibaoqing kinematicandbiomechanicalresponsesofthespinetodistractionsurgeryinchildrenwithearlyonsetscoliosisa3dfiniteelementanalysis
AT luda kinematicandbiomechanicalresponsesofthespinetodistractionsurgeryinchildrenwithearlyonsetscoliosisa3dfiniteelementanalysis
AT wuxueqing kinematicandbiomechanicalresponsesofthespinetodistractionsurgeryinchildrenwithearlyonsetscoliosisa3dfiniteelementanalysis
AT xuyangyang kinematicandbiomechanicalresponsesofthespinetodistractionsurgeryinchildrenwithearlyonsetscoliosisa3dfiniteelementanalysis
AT machenghao kinematicandbiomechanicalresponsesofthespinetodistractionsurgeryinchildrenwithearlyonsetscoliosisa3dfiniteelementanalysis
AT wushuqin kinematicandbiomechanicalresponsesofthespinetodistractionsurgeryinchildrenwithearlyonsetscoliosisa3dfiniteelementanalysis