Does anterior lumbar interbody fusion promote adjacent degeneration in degenerative disc disease? A finite element study

Tang, Shujie; Rebholz, Brandon J.

doi:10.1007/s00776-011-0037-3

Cited by 53 publications

(40 citation statements)

References 26 publications

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“…Five different models were considered in the current study, including one normal model, one mild degeneration model, one moderate degeneration model, and corresponding nucleotomy models. The normal model has been validated in previous studies (13). The two degenerative and corresponding nucleotomy models were developed according to the normal model.…”

Section: Methodsmentioning

confidence: 99%

“…Clinically, the disc space height decreases significantly after nucleotomy with time (5,8), and may decrease the lordosis of the lumbar spine and affect stress conduction (13), indicating aggravated degeneration of the lumbar segment. Consequently, nucleotomy may affect lumbar degeneration at the operated level adversely, but no articles have been published in English on the subject.…”

Section: Introductionmentioning

confidence: 99%

“…However, the finite element method is of high reproducibility and repeatability. The models can be adjusted to change the material properties, and imitate both normal and degenerative conditions (13). In the finite element study from Rohlmann (7), different grades of disc degeneration including mild, moderate and Dou H and Tang S: Nucleotomy Affects Lumbar Degeneration severe degeneration were simulated by varying disc height and bulk modulus of the nucleus pulposus, which cannot be performed in a clinical study or conventional experiment and demonstrates the advantages of finite element techniques.…”

Section: Introductionmentioning

confidence: 99%

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Analysis of the influence of nucleotomy on the lumbar degeneration of operated level using the finite element method

Dou¹,

Tang²

2012

Turkish Neurosurgery

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AIm:To determine whether nucleotomy may aggravate lumbar degeneration at the operated level. mATeRIAL and meTHods: A normal healthy finite element model, two degeneration models and corresponding nucleotomy models of the L4-5 segment were created. Combined with 800 N preloading, 10 Nm moment was applied on the L4 superior endplate to simulate extension, flexion, left axial rotation and lateral bending, respectively. The shear stress of annulus fibrosus, posterior annulus bulge along with the contact force of facet joint at L4-5 were investigated. ResuLTs:In all loading directions, the shear stress and contact force of the facet joint in two nucleotomy models were higher than those in mildly or moderately degenerative models, while the posterior annulus bulge was lower than those in mildly or moderately degenerative models.CoNCLusIoN: Nucleotomy may adversely aggravate lumbar degeneration at the operated level KeywoRds: Nucleotomy, Posterior annulus bulge, Contact force of facet joint, Shear stress, Finite element analysis ÖZ AmAÇ: Nükleotominin ameliyat edilen düzeyde lomber dejenerasyonu arttırıp, arttırmadığını belirlemek. yÖNTem ve GeReÇLeR: L4-5 segmenti için normal sağlıklı bir sonlu eleman modeli, iki dejenerasyon modeli ve karşılık gelen nükleotomi modelleri oluşturuldu. 800 N ön yükleme ile kombine edilerek L4 superior uç plakasına sırasıyla ekstansiyon, fleksiyon, sol aksiyal rotasyon ve lateral bükülmeyi simüle etmek üzere 10 Nm moment uygulandı. L4-5 üzerinde annulus fibrozus üzerine kırpma stresi, posterior annulus kabarması ve faset ekleminde temas gücü incelendi.BuLGuLAR: Tüm yükleme yönlerinde kırpma ve faset ekleminde temas gücü iki nükleotomi modelinde hafif veya orta derecede dejeneratif modellerden daha yüksekken posterior annulus kabarması hafif veya orta derecede dejeneratif modellerden daha düşüktü. soNuÇ: Nükleotomi, ameliyat edilen düzeyde lomber dejenerasyon üzerine olumsuz etki yapabilir ANAHTAR sÖZCÜKLeR: Nükleotomi, Posterior annulus kabarması, Faset eklemi temas gücü, Kayma gerilimi, Sonlu eleman analizi

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Analysis of the influence of nucleotomy on the lumbar degeneration of operated level using the finite element method

Dou¹,

Tang²

2012

Turkish Neurosurgery

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“…Specimens for cases and controls are difficult to obtain and standardize, and subsequent repetitive testing under various loads can result in significant sample variability (10). In contrast, the finite element modeling technique mitigates these problems.…”

Section: Tang S: Does Tlif Aggravate Adjacent Segmental Degeneration mentioning

confidence: 99%

“…Adjustments can be made to the models to affect the material properties, simulate different situations of spine either in normal or fusion conditions, show stress distribution under different loading modes, or reflect any structural change. Compared with other experimental methods, the finite element method has many advantages, facilitating a comparative study among different models (10).…”

Section: Tang S: Does Tlif Aggravate Adjacent Segmental Degeneration mentioning

confidence: 99%

Does tlif aggravate adjacent segmental degeneration more adversely than alif? a finite element study

Tang

2011

Turkish Neurosurgery

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AIm: To determine whether transforaminal lumbar interbody fusion aggravate adjacent segmental degeneration more adversely than anterior lumbar interbody fusion. mAteRIAl and methods:A normal finite element model, an anterior lumbar interbody fusion model and a transforaminal lumbar interbody fusion model of L3-5 were developed. 800 N compressive loading plus 10 Nm moments simulating flexion, extension, lateral bending and axial rotation were imposed on L3 superior endplate. The intradiscal pressure, intersegmental rotation and tresca stress in L3-4 were investigated.Results: Under all loading directions, the values of three parameters in transforaminal lumbar interbody fusion model were the highest and those in normal model were the lowest, and the values in the ALIF model were higher than the normal model while lower than the TLIF model. In the ALIF and normal models, the values of the three parameters on left lateral bending and axial rotation were equal to those on right lateral bending and axial rotation. However, in the TILF model, the values on right lateral bending and axial rotation were larger than those on left lateral bending and axial rotation. ConClusIon:Transforaminal lumbar interbody fusion aggravates adjacent segmental degeneration more adversely than anterior lumbar interbody fusion.

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The shear modulus of the nucleus pulposus measured using magnetic resonance elastography: A potential biomarker for intervertebral disc degeneration

et al. 2013

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Summary Purpose This study aims to: 1) measure the shear modulus of nucleus pulposus (NP) in intact human vertebra-disc-vertebra segments using a magnetic resonance elastography (MRE) setup for a 7T whole-body scanner, 2)quantify the effect of disc degeneration on the NP shear modulus measured using MRE, and 3) compare the NP shear modulus to other MR-based biomarkers of disc degeneration. Methods Thirty intact human discs segments were classified as normal, mild, or severely degenerated. The NP shear modulus was measured using a custom-made setup that included a novel inverse method less sensitive to noisy displacements. T2 relaxation time was measured at 7T. The accuracy of these parameters to classify different degrees of degeneration was evaluated using ROC curves. Results The MRE measure of shear modulus in the NP was able to differentiate between normal, mild degeneration, and severe degeneration. The T2 relaxation time was able to differentiate between normal and mild degeneration, but it could not distinguish between mild and severe degeneration. Conclusion This study shows that the NP shear modulus measured using MRE is sensitive to disc degeneration and has the potential of being used as a clinical tool to quantify the mechanical integrity of the intervertebral disc.

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Does anterior lumbar interbody fusion promote adjacent degeneration in degenerative disc disease? A finite element study

Cited by 53 publications

References 26 publications

Analysis of the influence of nucleotomy on the lumbar degeneration of operated level using the finite element method

Analysis of the influence of nucleotomy on the lumbar degeneration of operated level using the finite element method

Does tlif aggravate adjacent segmental degeneration more adversely than alif? a finite element study

The shear modulus of the nucleus pulposus measured using magnetic resonance elastography: A potential biomarker for intervertebral disc degeneration

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