Biomechanical evaluation of a novel pedicle screw-based interspinous spacer: A finite element analysis

Chen, Hsin‐Chang; Wu, Julia; Huang, Shou Chieh; Zhong, Zheng Cheng; Chiu, Shiu Ling; Lai, Yu Shu; Cheng, Cheng‐Kung

doi:10.1016/j.medengphy.2017.05.004

Cited by 11 publications

(12 citation statements)

References 26 publications

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“…other motions were not significant [15]. In this study, the changes in the ROM of the double DIAM model were smaller than Coflex and M-PEEK models at all levels in extension.…”

Section: Plos Onecontrasting

confidence: 61%

“…The ROM of each vertebra and the facet joint forces at all segments was computed. Subsequently, 1000 N axial compressive force was acting on the top of L1 vertebra and the intradiscal pressures were calculated in comparing to published literatures [15][16][17][18][19][20]. The material properties are listed in Table 1 [16][17][18].…”

Section: Fems Of the Lumbar Spine And Implantmentioning

confidence: 99%

“…An "M" geometry rod with 5.5 mm diameter is attached to the base poles and the concave part is placed underneath the spinous process. The three FE implanted models were constructed according to the real implant dimension as well as material properties posted, and were validated in previous studies [15,19,20]. According to the surgical procedures, the Coflex and DIAM interspinous spacers were inserted between adjacent spinous processes of the lumbar spine to resist hyperextension of the lumbar spine.…”

Section: Fems Of the Lumbar Spine And Implantmentioning

confidence: 99%

“…The device materials vary from metals such as titanium (such as X-Stop, Coflex) to rigid polymers like polyetheretherketone (PEEK) (M-PEEK), or other elastomer compounds (DIAM, Silicone coated with Dacron). The fixation method for the device to the vertebral spinous processes may also be categorized as either static spacer, such as X-Stop (Medtronic, USA) and Wallis (Abbott Spine, France); or flexible implant such as Coflex (RTI Surgical, USA), DIAM (Medtronic Sofamor Danek, USA), and M-PEEK (a PPEK pedicle screw-based M shape interspinous spacer developed by Chen et al [15].…”

Section: Introductionmentioning

confidence: 99%

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Effect of different designs of interspinous process devices on the instrumented and adjacent levels after double-level lumbar decompression surgery: A finite element analysis

Chen

Kuo

et al. 2020

PLoS ONE

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Recently, various designs and material manufactured interspinous process devices (IPDs) are on the market in managing symptomatic lumbar spinal stenosis (LSS). However, atraumatic fracture of the intervening spinous process has been reported in patients, particularly, double or multiple level lumbar decompression surgery with IPDs. This study aimed to biomechanically investigate the effects of few commercial IPDs, namely DIAMTM, CoflexTM, and M-PEEK, which were implanted into the L2-3, L3-4 double-level lumbar spinal processes. A validated finite element model of musculoskeletal intact lumbar spinal column was modified to accommodate the numerical analysis of different implants. The range of motion (ROM) between each vertebra, stiffness of the implanted level, intra stress on the intervertebral discs and facet joints, and the contact forces on spinous processes were compared. Among the three implants, the Coflex system showed the largest ROM restriction in extension and caused the highest stress over the disc annulus at the adjacent levels, as well as the sandwich phenomenon on the spinous process at the instrumented levels. Further, the DIAM device provided a superior loading-sharing between the two bridge supports, and the M-PEEK system offered a superior load-sharing from the superior spinous process to the lower pedicle screw. The limited motion at the instrumented segments were compensated by the upper and lower adjacent functional units, however, this increasing ROM and stress would accelerate the degeneration of un-instrumented segments.

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“…other motions were not significant [15]. In this study, the changes in the ROM of the double DIAM model were smaller than Coflex and M-PEEK models at all levels in extension.…”

Section: Plos Onecontrasting

confidence: 61%

Section: Fems Of the Lumbar Spine And Implantmentioning

confidence: 99%

Section: Fems Of the Lumbar Spine And Implantmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Effect of different designs of interspinous process devices on the instrumented and adjacent levels after double-level lumbar decompression surgery: A finite element analysis

Chen

Kuo

et al. 2020

PLoS ONE

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show abstract

“…For the intact FE model, another 8 Nm was applied to L2 to simulate flexion, extension, bending, and axial rotation [ 30 ]. For validation of the intact L2–L5 FE model, the segmental ROMs (L2/3, L3/4, and L4/5) were compared with the outcomes of previous biomechanical and FE publications [ 7 , 30 , 31 ]. For the surgical models, a hybrid method was applied, in which specific moments were applied to produce the same total ROMs of the intact FE model [ 7 , 32 ].…”

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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Biomechanical analysis of a customized lumbar interspinous spacer based on transfacetopedicular screw fixation: A finite element study

Zhao

Wang²,

Liu³

et al. 2022

Medical Engineering & Physics

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Biomechanical evaluation of a novel pedicle screw-based interspinous spacer: A finite element analysis

Cited by 11 publications

References 26 publications

Effect of different designs of interspinous process devices on the instrumented and adjacent levels after double-level lumbar decompression surgery: A finite element analysis

Effect of different designs of interspinous process devices on the instrumented and adjacent levels after double-level lumbar decompression surgery: A finite element analysis

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

Biomechanical analysis of a customized lumbar interspinous spacer based on transfacetopedicular screw fixation: A finite element study

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