Cargando…
Influence of configuration and anchor in ligamentous augmentation to prevent proximal junctional kyphosis: A finite element study
Ligament augmentation has been applied during spinal surgery to prevent proximal junctional kyphosis (PJK), but the configuration and distal anchor strategies are diverse and inconsistent. The biomechanics of different ligament augmentation strategies are, therefore, unclear. We aimed to create a fi...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9672075/ https://www.ncbi.nlm.nih.gov/pubmed/36406207 http://dx.doi.org/10.3389/fbioe.2022.1014487 |
_version_ | 1784832678357368832 |
---|---|
author | Liu, Wei Zang, Lei Kang, Nan Yang, Lihui An, Likun Zhu, Wenyi Hai, Yong |
author_facet | Liu, Wei Zang, Lei Kang, Nan Yang, Lihui An, Likun Zhu, Wenyi Hai, Yong |
author_sort | Liu, Wei |
collection | PubMed |
description | Ligament augmentation has been applied during spinal surgery to prevent proximal junctional kyphosis (PJK), but the configuration and distal anchor strategies are diverse and inconsistent. The biomechanics of different ligament augmentation strategies are, therefore, unclear. We aimed to create a finite element model of the spine for segments T6–S1. Model Intact was the native form, and Model IF was instrumented with a pedicle screw from segments T10 to S1. The remaining models were based on Model IF, with ligament augmentation configurations as common (CM), chained (CH), common and chained (CHM); and distal anchors to the spinous process (SP), crosslink (CL), and pedicle screw (PS), creating SP-CH, PS-CHM, PS-CH, PS-CM, CL-CHM, CL-CH, and CL-CM models. The range of motion (ROM) and maximum stress on the intervertebral disc (IVD), PS, and interspinous and supraspinous ligaments (ISL/SSL) was measured. In the PS-CH model, the ROM for segments T9–T10 was 73% (of Model Intact). In the CL-CHM, CL-CH, CL-CM, PS-CM, and PS-CHM models, the ROM was 8%, 17%, 7%, 13%, and 30%, respectively. The PS-CH method had the highest maximum stress on IVD and ISL/SSL, at 80% and 72%, respectively. The crosslink was more preferable as the distal anchor. In the uppermost instrumented vertebrae (UIV) + 1/UIV segment, the CM was the most effective configuration. The PS-CH model had the highest flexion load on the UIV + 1/UIV segment and the CL-CM model provided the greatest reduction. The CL-CM model should be verified in a clinical trial. The influence of configuration and anchor in ligament augmentation is important for the choice of surgical strategy and improvement of technique. |
format | Online Article Text |
id | pubmed-9672075 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-96720752022-11-19 Influence of configuration and anchor in ligamentous augmentation to prevent proximal junctional kyphosis: A finite element study Liu, Wei Zang, Lei Kang, Nan Yang, Lihui An, Likun Zhu, Wenyi Hai, Yong Front Bioeng Biotechnol Bioengineering and Biotechnology Ligament augmentation has been applied during spinal surgery to prevent proximal junctional kyphosis (PJK), but the configuration and distal anchor strategies are diverse and inconsistent. The biomechanics of different ligament augmentation strategies are, therefore, unclear. We aimed to create a finite element model of the spine for segments T6–S1. Model Intact was the native form, and Model IF was instrumented with a pedicle screw from segments T10 to S1. The remaining models were based on Model IF, with ligament augmentation configurations as common (CM), chained (CH), common and chained (CHM); and distal anchors to the spinous process (SP), crosslink (CL), and pedicle screw (PS), creating SP-CH, PS-CHM, PS-CH, PS-CM, CL-CHM, CL-CH, and CL-CM models. The range of motion (ROM) and maximum stress on the intervertebral disc (IVD), PS, and interspinous and supraspinous ligaments (ISL/SSL) was measured. In the PS-CH model, the ROM for segments T9–T10 was 73% (of Model Intact). In the CL-CHM, CL-CH, CL-CM, PS-CM, and PS-CHM models, the ROM was 8%, 17%, 7%, 13%, and 30%, respectively. The PS-CH method had the highest maximum stress on IVD and ISL/SSL, at 80% and 72%, respectively. The crosslink was more preferable as the distal anchor. In the uppermost instrumented vertebrae (UIV) + 1/UIV segment, the CM was the most effective configuration. The PS-CH model had the highest flexion load on the UIV + 1/UIV segment and the CL-CM model provided the greatest reduction. The CL-CM model should be verified in a clinical trial. The influence of configuration and anchor in ligament augmentation is important for the choice of surgical strategy and improvement of technique. Frontiers Media S.A. 2022-11-04 /pmc/articles/PMC9672075/ /pubmed/36406207 http://dx.doi.org/10.3389/fbioe.2022.1014487 Text en Copyright © 2022 Liu, Zang, Kang, Yang, An, Zhu and Hai. 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 Liu, Wei Zang, Lei Kang, Nan Yang, Lihui An, Likun Zhu, Wenyi Hai, Yong Influence of configuration and anchor in ligamentous augmentation to prevent proximal junctional kyphosis: A finite element study |
title | Influence of configuration and anchor in ligamentous augmentation to prevent proximal junctional kyphosis: A finite element study |
title_full | Influence of configuration and anchor in ligamentous augmentation to prevent proximal junctional kyphosis: A finite element study |
title_fullStr | Influence of configuration and anchor in ligamentous augmentation to prevent proximal junctional kyphosis: A finite element study |
title_full_unstemmed | Influence of configuration and anchor in ligamentous augmentation to prevent proximal junctional kyphosis: A finite element study |
title_short | Influence of configuration and anchor in ligamentous augmentation to prevent proximal junctional kyphosis: A finite element study |
title_sort | influence of configuration and anchor in ligamentous augmentation to prevent proximal junctional kyphosis: a finite element study |
topic | Bioengineering and Biotechnology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9672075/ https://www.ncbi.nlm.nih.gov/pubmed/36406207 http://dx.doi.org/10.3389/fbioe.2022.1014487 |
work_keys_str_mv | AT liuwei influenceofconfigurationandanchorinligamentousaugmentationtopreventproximaljunctionalkyphosisafiniteelementstudy AT zanglei influenceofconfigurationandanchorinligamentousaugmentationtopreventproximaljunctionalkyphosisafiniteelementstudy AT kangnan influenceofconfigurationandanchorinligamentousaugmentationtopreventproximaljunctionalkyphosisafiniteelementstudy AT yanglihui influenceofconfigurationandanchorinligamentousaugmentationtopreventproximaljunctionalkyphosisafiniteelementstudy AT anlikun influenceofconfigurationandanchorinligamentousaugmentationtopreventproximaljunctionalkyphosisafiniteelementstudy AT zhuwenyi influenceofconfigurationandanchorinligamentousaugmentationtopreventproximaljunctionalkyphosisafiniteelementstudy AT haiyong influenceofconfigurationandanchorinligamentousaugmentationtopreventproximaljunctionalkyphosisafiniteelementstudy |