OBJECT The authors evaluated the biomechanical effects of an interspinous process (ISP) device on kinematics and load sharing at the implanted and adjacent segments. METHODS A 3D finite-element (FE) model of the lumbar spine (L1–5) was developed and validated through comparison with published in vitro study data. Specifically, validation was achieved by a flexible (load-control) approach in 3 main planes under a pure moment of 10 Nm and a compressive follower load of 400 N. The ISP device was inserted between the L-3 and L-4 processes. Intact and implanted cases were simulated using the hybrid protocol in all motion directions. The resultant motion, facet load, and intradiscal pressure after implantation were investigated at the index and adjacent levels. In addition, stress at the bone-implant interface was predicted. RESULTS The hybrid approach, shown to be appropriate for adjacent-level investigations, predicted that the ISP device would decrease the range of motion, facet load, and intradiscal pressure at the index level relative to the corresponding values for the intact spine in extension. Specifically, the intradiscal pressure induced after implantation at adjacent segments increased by 39.7% and by 6.6% at L2–3 and L4–5, respectively. Similarly, facet loads at adjacent segments after implantation increased up to 60% relative to the loads in the intact case. Further, the stress at the bone-implant interface increased significantly. The influence of the ISP device on load sharing parameters in motion directions other than extension was negligible. CONCLUSIONS Although ISP devices apply a distraction force on the processes and prevent further extension of the index segment, their implantation may cause changes in biomechanical parameters such as facet load, intradiscal pressure, and range of motion at adjacent levels in extension.

The finite element model has been used as an effective tool in human spine biomechanics. Biomechanical finite element models have provided basic insights into the workings of the cervical spine system. Advancements in numerical methods during the last decade have enabled researchers to propose more accurate models of the cervical spine. The new finite element model of the cervical spine considers the accurate representation of each tissue regarding the geometry and material. The aim of this paper is to address the new advancements in the finite element model of the human cervical spine. The procedures for creating a finite element model are introduced, including geometric construction, material-property assignment, boundary conditions and validation. The most recent and published finite element models of the cervical spine are reviewed. KEywoRds: Finite element modelling, Cervical spine, Numerical method ÖZSonlu eleman yöntemi efektif bir araç olarak omurga biyomekaniğinde yaygın kullanılmaktadır. Servikal omurga içerisinde meydana gelebilecek biyomekanik değişimlerin incelenmesine fırsat verebilmektedir. Geçtiğimiz on yıl içerisinde, geliştirilmiş olan nümerik metodlar sayesinde, daha gerçekçi omurga modellerinin çıkarılması sağlanmıştır. Günümüzde, servikal omurga modellerinde kullanılan geometri ve malzeme özellikleri olabildiğince gerçeğe yakın oluşturulabilmektedir. Bu makalenin amacı, sonlu eleman yöntemi kullanılarak insan servikal modellinin oluşturulmasını örneklerle açıklamaktır. Servikal omurga modelinin sonlu eleman yöntemi ile oluşturulmasının her bir adımı detaylı ele alınmıştır. Literatürde en son yayınlanan servikal omurga sonlu eleman modelleri incelenmiş ve karşılaştırılmıştır.

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Spinal rigid instrumentations have been used to fuse and stabilize spinal segments as a surgical treatment for various spinal disorders to date. This technology provides immediate stability after surgery until the natural fusion mass develops. At present, rigid fixation is the current gold standard in surgical treatment of chronic back pain spinal disorders. However, such systems have several drawbacks such as higher mechanical stress on the adjacent segment, leading to long-term degenerative changes and hypermobility that often necessitate additional fusion surgery. Dynamic stabilization systems have been suggested to address adjacent segment degeneration, which is considered to be a fusion-associated phenomenon. Dynamic stabilization systems are designed to preserve segmental stability, to keep the treated segment mobile, and to reduce or eliminate degenerative effects on adjacent segments. This paper aimed to describe the biomechanical aspect of dynamic stabilization systems as an alternative treatment to fusion for certain patients.

In some finite element analysis studies of models of sections of the spine, the three-dimensional solid model is built by assuming symmetry about the mid-sagittal plane of the section, whereas in other studies, the model is built from the exact geometry of the section. The influence of the method used to build the solid model on model parameters, in the case of the cervical spine, has not been reported in the literature. This issue is the subject of this study, with the section being C2-C7, the applied loadings being extension, flexion, left lateral bending, and right axial rotation (each of magnitude 1 Nm), and the model parameters determined being rotation, intradiskal pressure, and facet load at each of the segments. When all the parameter results were considered, it was found that, by and large, the influence of solid model construction method used (exact geometry vs assumption of symmetry about the mid-sagittal plane of the section) was marginal. As construction of a symmetric finite element model requires less time and effort, construction of an asymmetric model may be justified in special cases only.