Finite element analysis of a ball‐and‐socket artificial disc design to suppress excessive loading on facet joints: A comparative study with ProDisc

Choi, Jin-Tak; Shin, Dong Ah; Kim, Sohee

doi:10.1002/cnm.3214

Cited by 6 publications

(4 citation statements)

References 41 publications

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“…It can be related to the biomechanics of the prosthesis. 29,30 However, suboptimal positioning of the prosthesis was often associated with facet joint deterioration and decreased ROM (68%). The malposition modifies the center of rotation and segmental intervertebral ROM, which subsequently alters facet joint kinematics.…”

Section: Discussionmentioning

confidence: 99%

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Revision Surgery of Total Lumbar Disk Replacement

Schmitz

Collinet

Ntilikina

et al. 2021

Clinical Spine Surgery: A Spine Publication

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Objective: The objective of this study was to analyze failure mechanisms after total lumbar disk replacement (TDR) and surgical revision strategies in patients with recurrent low back pain (LBP).Summary and Background Data: Several reports indicate that TDR revision surgery carries a major risk and that it should not be recommended. The clinical results of posterior instrumented fusion using the prosthesis like an interbody cage have not been well analyzed.Materials and Methods: From 2003 to 2018, 48 patients with recurrent LBP after TDR underwent revision surgery. The average age was 39 years (24-61 y). The mean follow-up was 100.4 months (24.6-207.7 mo). Clinical data, self-assessment of patient satisfaction, and Oswestry Disability Index collected at each clinical control or by phone call for the older files and radiologic assessments were reviewed. The surgical revision strategy included posterior fusion in 41 patients (group A) and TDR removal and anterior fusion in 7 patients (group B), of which 6 patients had an additional posterior fixation.Results: Facet joint osteoarthritis was associated with TDR failure in 85%. In 68% the position of the prosthesis was suboptimal. Range of motion was preserved in 25%, limited in extension in 65%, and limited in flexion in 40%. Limited range of motion and facet joint osteoarthritis were significantly related (P = 0.0008). The complication rate in group B was 43% including iliac vein laceration. Preoperative and 2-year follow-up Oswestry Disability Index were 25.5 and 22.0, respectively, in group A versus 27.9 and 21.3 in group B.Conclusions: Posterior osteoarthritis was the principal cause of recurrent LBP in failed TDR. The anterior approach for revision carried a major vascular risk, whereas a simple posterior instrumented fusion leads to the same clinical results.

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Section: Discussionmentioning

confidence: 99%

“…Facet joint osteoarthritis represented the most important cause (85%) for revision surgery. It can be related to the biomechanics of the prosthesis 29,30. However, suboptimal positioning of the prosthesis was often associated with facet joint deterioration and decreased ROM (68%).…”

Section: Discussionmentioning

confidence: 99%

Revision Surgery of Total Lumbar Disk Replacement

Schmitz

Collinet

Ntilikina

et al. 2021

Clinical Spine Surgery: A Spine Publication

View full text Add to dashboard Cite

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“…All the ligaments were meshed by tension‐only truss elements. The contact between the facet joints was simulated by frictionless surface‐to‐surface contact 22‐24 . The intact model included 120,978 nodes and 555,063 elements.…”

Section: Methodsmentioning

confidence: 99%

“…The contact between the facet joints was simulated by frictionless surface‐to‐surface contact. 22 , 23 , 24 The intact model included 120,978 nodes and 555,063 elements. Finally, the L1‐5 lumbar spine model was imported into Abaqus (Simulia, Inc., Providence, RI, USA) to perform FE analysis.…”

Section: Methodsmentioning

confidence: 99%

Biomechanical Evaluation of Transforaminal Lumbar Interbody Fusion with Coflex‐F and Pedicle Screw Fixation: Finite Element Analysis of Static and Vibration Conditions

Zhu

Shen

Cui

et al. 2022

Orthopaedic Surgery

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Objective To investigate the biomechanics of transforaminal lumbar interbody fusion (TLIF) with interspinous process device (IPD) or pedicle screw fixation under both static and vibration conditions by the finite element (FE) method. Method A validated FE model of the L1‐5 lumbar spine was used in this study. This FE model derived from computed tomography images of a healthy female adult volunteer of appropriate age. Then the model was modified to simulate L3‐4 TLIF. Four conditions were compared: (i) intact; (ii) TLIF combined with bilateral pedicle screw fixation (BPSF); (iii) TLIF combined with U‐shaped IPD Coflex‐F (CF); and (iv) TLIF combined with unilateral pedicle screw fixation (UPSF). The intact and surgical FE models were analyzed under static and vibration loading conditions respectively. For static loading conditions, four motion modes (flexion, extension, lateral bending, and axial rotation) were simulated. For vibration loading conditions, the dynamic responses of lumbar spine under sinusoidal vertical load were simulated. Result Under static loading conditions, compared with intact case, BPSF decreased range of motion (ROM) by 92%, 95%, 89% and 92% in flexion, extension, lateral bending and axial rotation, respectively. While CF decreased ROM by 87%, 90%, 69% and 80%, and UPSF decreased ROM by 84%, 89%, 66% and 82%, respectively. Compared with CF, UPSF increased the endplate stress by 5%–8% in flexion, 7%–10% in extension, 2%–4% in lateral bending, and decreased the endplate stress by 16%–19% in axial rotation. Compared with CF, UPSF increased the cage stress by 9% in flexion, 10% in extension, and decreased the cage stress by 3% in lateral bending, and 13% in axial rotation. BPSF decreased the stress responses of endplates and cage compared with CF and UPSF. Compared BPSF, CF decreased the facet joint force (FJF) by 6%–13%, and UPSF decreased the FJF by 4%–12%. During vibration loading conditions, compared with BPSF, CF reduced maximum values of the FJF by 16%–32%, and vibration amplitudes by 22%–35%, while UPSF reduced maximum values by 20%–40%, and vibration amplitudes by 31%–45%. Conclusion Compared with other surgical models, BPSF increased the stability of lumbar spine, and also showed advantages in cage stress and endplate stress. CF showed advantages in IDP and FJF especially during vertical vibration, which may lead to lower risk of adjacent segment degeneration. CF may be an effective alternative to pedicle screw fixation in TLIF procedures.

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