Minimally invasive decompression is generally employed for treating lumbar spinal stenosis; however, it results in weakened spinal stability. To augment spinal stability, a new interspinous process device (NIPD) was developed in this study. The biomechanical features of the NIPD were evaluated in this study. Three finite-element (FE) models of the entire lumbar spine were implemented to perform biomechanical analysis: the intact, defect (DEF), and NIPD models. The DEF model was considered for lumbar spines with bilateral laminotomies and partial discectomy at L3–L4. Range of motion (ROM), disc stress, and facet joint contact force were evaluated in flexion, extension, torsion, and lateral bending in the three FE models. The results indicated that ROM in the extension increased by 23% in the DEF model but decreased by 23% in the NIPD model. In the NIPD model, the cephalic adjacent disc stress in flexion and extension was within 5%, and negligible changes were noted in the facet joint contact force for torsion and lateral bending. Thus, the NIPD offers superior spinal stability and causes only a minor change in cephalic adjacent disc stress in flexion and extension during the bilateral laminotomy and partial discectomy of the lumbar spine. However, the NIPD has a minor influence on the ROM and facet joint force for lateral bending and torsion.

Introduction: There are various surgical interventions to manage osteoporotic vertebral compression fracture. Modular spine block (MSB) is a novel intravertebral fixator that can be assembled. This study aimed to quantitatively investigate the force distribution in vertebrae with the various structural designs and implantation methods by finite element analysis (FEA).Methods: A three-dimensional nonlinear FEA of the L3 implanted with MSB was constructed. Different structural designs (solid vs. hollow) and implantation methods (three-layered vs. six-layered and unilateral vs. bilateral) were studied. The model was preloaded to 150 N-m before the effects of flexion, extension, torsion, and lateral bending were analyzed at the controlled ranges of motion of 20°, 15°, 8°, and 20°, respectively. The resultant intervertebral range of motion (ROM) and disk stress as well as intravertebral force distribution were analyzed at the adjacent segments.Results: The different layers of MSB provided similar stability at the adjacent segments regarding the intervertebral ROM and disk stress. Under stress tests, the force of the solid MSB was shown to be evenly distributed within the vertebrae. The maximum stress value of the unilaterally three-layered hollow MSB was generally lower than that of the bilaterally six-layered solid MSB. Conclusions:The MSB has little stress shielding effect on the intervertebral ROM and creates no additional loading to the adjacent disks. The surgeon can choose the appropriate numbers of MSB to fix vertebrae without worrying about poly (methyl methacrylate) extravasation, implant failure, or adjacent segment disease.

Background The spinal hybrid elastic (SHE) rod dynamic stabilization system can provide sufficient spine support and less adjacent segment stress. This study aimed to investigate the biomechanical effects after the internal fracture of SHE rods using finite element analysis. Methods A three-dimensional nonlinear finite element model was developed. The SHE rod comprises an inner nitinol stick (NS) and an outer polycarbonate urethane (PCU) shell (PS). The fracture was set at the caudal third portion of the NS, where the maximum stress occurred. The resultant intervertebral range of motion (ROM), intervertebral disc stress, facet joint contact force, screw stress, NS stress, and PCU stress were analyzed. Results When compared with the intact spine model, the overall trend was that the ROM, intervertebral disc stress, and facet joint force decreased in the implanted level and increased in the adjacent level. When compared with the Ns-I, the trend in the Ns-F decreased and remained nearly half effect. Except for torsion, the PS stress of the Ns-F increased because of the sharing of NS stress after the NS fracture. Conclusions The study concluded the biomechanical effects still afford nearly sufficient spine support and gentle adjacent segment stress after rod fracture in a worst-case scenario of the thinnest PS of the SHE rod system.

The spinal hybrid elastic (SHE) rod is a semi-rigid pedicle screw-based rod for spinal dynamic stabilization. This study investigated the biomechanical effects of different ratios of SHE rod using finite element analysis (FEA). A three-dimensional nonlinear FEA of an intact lumbar spine model (INT) was constructed. The SHE rod was composed of an inner nitinol stick (NS) and an outer polycarbonate urethane shell (PS). Four groups implanted at L3–L4 had the same outer diameter (5.5 mm) but different NS diameter/PS thickness ratios: Nt45, Nt35, Nt25, and Nt15. The resultant intervertebral range of motion (ROM), disc stress, facet joint contact force, screw stress, NS stress, and PCU stress were analyzed. The results indicated that ROM, disc stress, and facet force decreased moderately in the implanted L3–L4 levels and increased slightly in the adjacent L2–L3 levels. The NS stress and NS diameter trended towards inverse proportionality. Changing the ratio did not markedly influence screw or PS stress. The SHE rod system with elastic NS and insulated PS has a 5.5 mm diameter for universal pedicle screws. The SHE rod system provides sufficient spinal support and increases gentle adjacent segment stress. Considering the durability, the optimal NS diameter/PS thickness ratio of the SHE rod system is 3.5/2.0 mm.