A new lumbar fixation device alternative to pedicle-based stabilization for lumbar spine: <i>In vitro</i> cadaver investigation

Gömleksiz, Cengiz; Erbulut, Deniz Ufuk; Can, Halil; Kodigudla, Manoj; Kelkar, Amey; Kasapoglu, Eser; Özer, Ali Fahir; Goel, Vijay K.

doi:10.1080/10790268.2018.1495932

Cited by 3 publications

(13 citation statements)

References 21 publications

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“…In general, it can be stated that the ROMs of the L4-L5 segment in these intact and implanted models were compatible with the ROMs of previous in vitro studies. 35,36 In addition, the implanted model with contoured rods gave results similar to those of the implanted model with straight rods, as shown in Figure 5(b).…”

Section: Resultssupporting

confidence: 61%

“…The ROM values of the L4-L5 segment in both intact and implanted models were compared with those obtained in the in vitro studies of Gomleksiz et al 35 and Oktenoglu et al 36 In the work of Gomleksiz et al, 35 L2-S1 cadaver specimens with implantation at the L4-L5 level were used and one analysis included PSs without transforaminal lumbar interbody fusion cages. Those results were considered for comparison with the present study.…”

Section: Resultsmentioning

confidence: 99%

“…To validate the intact model, ROM values obtained for the L4-L5 lumbar spine segment with related moment loads were compared with the values obtained in previous in vitro studies. [32][33][34][35][36] The results obtained with moment load of 10 Nm were used for the comparison of PPSI and vertebral stress values.…”

Section: C3d8r-c3d10 (Hexahedral Elementsquadrilateral Elements)mentioning

confidence: 99%

“…40 In vitro studies were used to assess model behavior while identifying trends in various loading conditions. [32][33][34][35][36] Literature data were utilized regarding the selection of mesh quality, considering element types and characteristics. 41 Linear hexahedral elements with average element side length of 1 mm were used for the whole model.…”

Section: Mesh Convergence and Validationmentioning

confidence: 99%

“…The FE model of the intact L4-L5 lumbar spine was validated in light of previous in vitro studies. [32][33][34][35][36] Pure bending moment load of up to 10 Nm was then applied to the FE model in flexion, extension, lateral bending, and axial rotation directions. ROMs for the L4-L5 lumbar segment were obtained for a comparison with the results of studies in the literature.…”

Section: Model Validationmentioning

confidence: 99%

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The effects of pre-stressed rods contoured by different bending techniques on posterior instrumentation of L4-L5 lumbar spine segment: A finite element study

Sengul

Özmen

Demir

2022

Proc Inst Mech Eng H

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Posterior pedicle screw instrumentation (PPSI) is a well-known method in lumbar spine surgery. Understanding how PPSI affects the biomechanics of the lumbar spine is an important issue. In particular, during PPSI operations, surgeons bend rods according to the patients’ spinal curvatures based on their own experiences. As a result, residual stresses develop on the rods due to this bending. Although many finite element-based biomechanical studies have been performed for PPSI, studies comparing the effects of residual stresses arising from rod contouring on the construct stresses are lacking. Thus, this study aimed to investigate the effects of residual stress in PPSI using rods contoured with a French bender and an in-situ bender, as well as comparing the differences in stress increment with straight and contoured rods for different physiological motions. Accordingly, a finite element (FE) model of the L4-L5 lumbar spine segment was developed for PPSI and the effects of residual stresses on rods were investigated by using different bending methods. In the simulations, it was found that rods contoured with a French bender with residual stress resulted in significantly more increased stress in PPSI compared to those contoured with an in-situ bender. The results of this study emphasize that increased stress in PPSI due to the residual stresses for different physiological motions may increase the risk of PPSI failures. Additionally, the finite element modeling approach employed here could be used as a fundamental tool for further investigations of topics such as PPSI fatigue life and failure studies.

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Section: Resultssupporting

confidence: 61%

Section: Resultsmentioning

confidence: 99%

Section: C3d8r-c3d10 (Hexahedral Elementsquadrilateral Elements)mentioning

confidence: 99%

Section: Mesh Convergence and Validationmentioning

confidence: 99%

Section: Model Validationmentioning

confidence: 99%

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The effects of pre-stressed rods contoured by different bending techniques on posterior instrumentation of L4-L5 lumbar spine segment: A finite element study

Sengul

Özmen

Demir

2022

Proc Inst Mech Eng H

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Role of intra-lamellar collagen and hyaluronan nanostructures in annulus fibrosus on lumbar spine biomechanics: insights from molecular mechanics-finite element–based multiscale analyses

Bhattacharya,

Dubey

2024

Med Biol Eng Comput

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Influence of posterior pedicle screw fixation at L4–L5 level on biomechanics of the lumbar spine with and without fusion: a finite element method

et al. 2021

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Background Posterior pedicle screw (PS) fixation, a common treatment method for widespread low-back pain problems, has many uncertain aspects including stress concentration levels, effects on adjacent segments, and relationships with physiological motions. A better understanding of how posterior PS fixation affects the biomechanics of the lumbar spine is needed. For this purpose, a finite element (FE) model of a lumbar spine with posterior PS fixation at the L4–L5 segment level was developed by partially removing facet joints (FJs) to imitate an actual surgical procedure. This FE study aimed to investigate the influence of the posterior PS fixation system on the biomechanics of the lumbar spine before and after fusion by determining which physiological motions have the most increase in posterior instrumentation (PI) stresses and FJ loading. Results It was determined that posterior PS fixation increased FJ loading by approximately 35% and 23% at the L3–L4 adjacent level with extension and lateral bending motion, respectively. This increase in FJ loading at the adjacent level could point to the possibility that adjacent segment disease has developed or progressed after posterior lumbar interbody fusion. Furthermore, analyses of peak von Mises stresses on PI showed that the maximum PI stresses of 272.1 MPa and 263.7 MPa occurred in lateral bending and flexion motion before fusion, respectively. Conclusions The effects of a posterior PS fixation system on the biomechanics of the lumbar spine before and after fusion were investigated for all physiological motions. This model could be used as a fundamental tool for further studies, providing a better understanding of the effects of posterior PS fixation by clearing up uncertain aspects.

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A new lumbar fixation device alternative to pedicle-based stabilization for lumbar spine: In vitro cadaver investigation

Cited by 3 publications

References 21 publications

The effects of pre-stressed rods contoured by different bending techniques on posterior instrumentation of L4-L5 lumbar spine segment: A finite element study

The effects of pre-stressed rods contoured by different bending techniques on posterior instrumentation of L4-L5 lumbar spine segment: A finite element study

Role of intra-lamellar collagen and hyaluronan nanostructures in annulus fibrosus on lumbar spine biomechanics: insights from molecular mechanics-finite element–based multiscale analyses

Influence of posterior pedicle screw fixation at L4–L5 level on biomechanics of the lumbar spine with and without fusion: a finite element method

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