A Validated Finite Element Analysis of Facet Joint Stress in Degenerative Lumbar Scoliosis

Wang, Liang; Zhang, Bangke; Chen, Shuo; Lü, Xiaoying; Li, Zhiyong; Guo, Qunfeng

doi:10.1016/j.wneu.2016.07.106

Cited by 33 publications

(17 citation statements)

References 28 publications

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“…These observations are in accordance with recent studies that found the higher loading on facet joints in degenerative lumbar scoliosis is dependent on the curve intensity, the position of the apex, and spinal movements, which do not always correlate with the concavity of the curvature. 28 For these reasons, the scoliotic facet joints in this study were all considered as abnormally loaded, and they were compared to the cadaveric nonscoliotic facet joints which we deemed being exposed to physiological and balanced loading. An in-depth 3-dimensional analysis is needed to decipher the link between biomechanical forces and tissue deterioration.…”

Section: Discussionmentioning

confidence: 99%

Facet joint degeneration in adolescent idiopathic scoliosis

et al. 2018

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Adolescent idiopathic scoliosis (AIS) is a poorly understood deformity of the thoracolumbar spine which affects the intervertebral discs (IVDs) and the articular facet joints. The knowledge concerning facet joints in this context is very limited, although facet joint degeneration is a known contributor of back pain. In this study, a comprehensive investigation was performed to characterize the facet joint chondrocytes and extracellular matrix within the scoliotic spine. Surgically removed articular facet joint tissues were collected from patients undergoing spinal corrective surgery for AIS deformities, while non‐scoliotic articular facet joint tissues were obtained from cadaveric organ donors. Alterations in cartilage tissue structure were evaluated histologically with safranin‐O fast green and a modified OARSI grading scale. Pro‐inflammatory cytokines, matrix‐degrading proteases, and fragmented matrix molecules associated with cartilage degradation were analyzed by immunohistochemistry and western blotting. Safranin‐O fast green staining revealed that young scoliotic facet joints show clear signs of degeneration with substantial proteoglycan loss, similar to osteoarthritis (OA). The proteoglycan levels were significantly lower than in healthy asymptomatic non‐scoliotic control individuals. In comparison to controls, scoliotic articular facets showed increased cell density, increased expression of the proliferation marker Ki‐67, and higher expression of MMP‐3, MMP‐13, and IL‐1β. Expression and fragmentation of the small leucine‐rich proteins (SLRPs) chondroadherin, decorin, biglycan, lumican, and fibromodulin were analyzed with western blot. Chondroadherin and decorin were fragmented in cartilage from patients with a curve greater than 70°, whereas biglycan and fibromodulin did not show curve‐related fragmentation. AIS facet joint cartilage shows hallmarks of OA including proteoglycan loss, overexpression of pro‐inflammatory mediators, increased synthesis of matrix‐degrading proteases and fragmentation of SLRPs. As with patients with age‐related OA, the premature joint degeneration seen in scoliotic patients is likely to contribute to the pain perceived in some individuals.

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Section: Discussionmentioning

confidence: 99%

Facet joint degeneration in adolescent idiopathic scoliosis

et al. 2018

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“…The ligaments constructed in the FE model were defined as truss elements that respond nonlinearly in tension only [ 27 , 28 ]. Frictionless soft-contact between the articular processes was applied to mimic articular cartilage [ 29 ]. The bony tissues, nucleus pulposus, and the implants were modeled as elastic elements.…”

Section: Methodsmentioning

confidence: 99%

Interlaminar stabilization offers greater biomechanical advantage compared to interspinous stabilization after lumbar decompression: a finite element analysis

Teng

2020

J Orthop Surg Res

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Background Interlaminar stabilization and interspinous stabilization are two newer minimally invasive methods for lumbar spine stabilization, used frequently in conjunction with lumbar decompression to treat lumbar stenosis. The two methods share certain similarities, therefore, frequently being categorized together. However, the two methods offer distinct biomechanical properties, which affect their respective effectiveness and surgical success. Objective To compare the biomechanical characteristics of interlaminar stabilization after lumbar decompression (ILS) and interspinous stabilization after lumbar decompression (ISS). For comparison, lumbar decompression alone (DA) and decompression with instrumented fusion (DF) were also included in the biomechanical analysis. Methods Four finite element models were constructed, i.e., DA, DF, ISS, and ILS. To minimize device influence and focus on the biomechanical properties of different methods, Coflex device as a model system was placed at different position for the comparison of ISS and ILS. The range of motion (ROM) and disc stress peak at the surgical and adjacent levels were compared among the four surgical constructs. The stress peak of the spinous process, whole device, and device wing was compared between ISS and ILS. Results Compared with DA, the ROM and disc stress at the surgical level in ILS or ISS were much lower in extension. The ROM and disc stress at the surgical level in ILS were 1.27° and 0.36 MPa, respectively, and in ISS 1.51°and 0.55 MPa, respectively in extension. This is compared with 4.71° and 1.44 MPa, respectively in DA. ILS (2.06–4.85° and 0.37–0.98 MPa, respectively) or ISS (2.07–4.78° and 0.37–0.98 MPa, respectively) also induced much lower ROM and disc stress at the adjacent levels compared with DF (2.50–7.20° and 0.37–1.20 MPa, respectively). ILS further reduced the ROM and disc stress at the surgical level by 8% and 25%, respectively, compared to ISS. The stress peak of the spinous process in ILS was significantly lower than that in ISS (13.93–101 MPa vs. 31.08–172.5 MPa). In rotation, ILS yielded a much lower stress peak in the instrumentation wing than ISS (128.7 MPa vs. 222.1 MPa). Conclusion ILS and ISS partly address the issues of segmental instability in DA and hypermobility and overload at the adjacent levels in DF. ILS achieves greater segmental stability and results in a lower disc stress, compared to ISS. In addition, ILS reduces the risk of spinous process fracture and device failure.

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“… 87 Scoliotic severity also affected the FJF; under compression and a bending moment higher FJFs were predicted on the convex and concave side when the Cobb angle was above and below 20°. 92 …”

Section: Methodsmentioning

confidence: 99%

Computational modelling of the scoliotic spine: A literature review

Gould¹,

Cristofolini

Davico³

et al. 2021

Numer Methods Biomed Eng

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Scoliosis is a deformity of the spine that in severe cases requires surgical treatment. There is still disagreement among clinicians as to what the aim of such treatment is as well as the optimal surgical technique. Numerical models can aid clinical decision‐making by estimating the outcome of a given surgical intervention. This paper provided some background information on the modelling of the healthy spine and a review of the literature on scoliotic spine models, their validation, and their application. An overview of the methods and techniques used to construct scoliotic finite element and multibody models was given as well as the boundary conditions used in the simulations. The current limitations of the models were discussed as well as how such limitations are addressed in non‐scoliotic spine models. Finally, future directions for the numerical modelling of scoliosis were addressed.

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A Validated Finite Element Analysis of Facet Joint Stress in Degenerative Lumbar Scoliosis

Cited by 33 publications

References 28 publications

Facet joint degeneration in adolescent idiopathic scoliosis

Facet joint degeneration in adolescent idiopathic scoliosis

Interlaminar stabilization offers greater biomechanical advantage compared to interspinous stabilization after lumbar decompression: a finite element analysis

Computational modelling of the scoliotic spine: A literature review

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