The Effect of Concave-Side Intertransverse Ligament Laxity on the Stress of AIS Lumbar Spine Based on Finite Element Method

SIMPLE SUMMARY: An effective finite element model of the lumbar spine was established to explore the effect of concave-side ITL laxity on the biomechanical properties of AIS. It was found that concave-side ITL laxity could reduce the stability of the lumbar spine, aggravate the uneven stress distribution of lumbar scoliosis, increase the risk of lumbar disc injury, and have an adverse effect on the lumbar spine with scoliosis. Simply releasing concave-side ITL is not an effective method for the treatment of scoliosis. ABSTRACT: (1) Background: Scoliosis has the mechanical characteristic of asymmetric stress distribution, which is one of the reasons for the aggravation of scoliosis. Bracing therapy is the best treatment for AIS, but it is difficult and costly to operate. Is it possible to reduce pressure in the concave side by relaxing the ITL in the concave side of scoliosis, so as to improve the abnormal stress distribution of scoliosis? In this paper, a finite element method was used to simulate the effect of the relaxation of concave-side ITL on the stress of a lumbar spine with scoliosis, which provides some guidance for the treatment of scoliosis. (2) Methods: Using CT images of a patient with scoliosis whose Cobb Angle was 43° and Lordosis Angle was 45, a scoliosis lumbar was established, and Young’s modulus of the ITL of the concave-side lumbar spine was reduced by 95% to simulate ligament relaxation. By comparing the stress condition of the model vertebral body with no ligament relaxation, the effect of concave-side ITL relaxation on the mechanical characteristics of scoliosis lumbar spine was explored. (3) Results: An effective and complete model of the lumbar spine was established. The concave ITL relaxed, which only had a great impact on the bending loads. After the ligament was relaxed, the stability of the spine was reduced. Stress concentration on the concave side of vertebrae and the IVD was aggravated. Under loads on the convex side, the maximum stress on the vertebral body and the IVD increased significantly, making lumbar vertebrae more vulnerable to injury. (4) Conclusions: Laxity of the ITL on the concave side of the AIS lumbar only affects the bending load. Laxity of the concave-side ligament will reduce the stability of the lumbar, aggravate the uneven stress distribution of scoliotic lumbar vertebrae, increase the risk of IVD injury, and be unfavorable for the scoliotic lumbar spine. Relaxation of the concave ITL alone is not an effective way to treat scoliosis.