Instantaneous center of rotation behavior of the lumbar spine with ligament failure

Alapan, Yunus; Demir, Cihan; Kaner, Tuncay; Güçlü, Rahmi; İnceoğlu, Serkan

doi:10.3171/2013.3.spine12923

Cited by 21 publications

(20 citation statements)

References 43 publications

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“…Though, this relationship was quite muted for the lateral bending direction. Previous studies have investigated the role of ligament failure on a single L4-L5 spinal unit and similarly reported an increase in motion with loss of surrounding stabilizing structures 12,13 . Each of these studies observed a larger response in the lateral bending direction than reported herein.…”

Section: Discussionmentioning

confidence: 99%

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Comparative role of disc degeneration and ligament failure on functional mechanics of the lumbar spine

Ellingson

Shaw

Giambini

et al. 2015

Computer Methods in Biomechanics and Biomedical Engineering

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Understanding spinal kinematics is essential for distinguishing between pathological conditions of spine disorders, which ultimately lead to low back pain. It’s of high importance to understand how changes in mechanical properties affect the response of the lumbar spine, specifically in an effort to differentiate those associated with disc degeneration from ligamentous changes, allowing for more precise treatment strategies. To do this the goals of this study were twofold: 1) develop and validate a finite element (FE) model of the lumbar spine and 2) systematically alter the properties of the intervertebral disc and ligaments to define respective roles in functional mechanics. A three-dimensional non-linear FE model of the lumbar spine (L3-Sacrum) was developed and validated for pure moment bending. Disc degeneration and sequential ligament failure was modeled. Intersegmental range of motion (ROM) and bending stiffness was measured. The prediction of the FE model to moment loading in all three planes of bending showed very good agreement, where global and intersegmental ROM and bending stiffness of the model fell within one standard deviation of the in vitro results. Degeneration decreased ROM for all directions. Stiffness increased for all directions except axial rotation, where it initially increased then decreased for moderate and severe degeneration, respectively. Incremental ligament failure produced increased ROM and decreased stiffness. This effect was much more pronounced for all directions except lateral bending, which is minimally impacted by ligaments. These results indicate that lateral bending may be more apt to detect the subtle changes associated with degeneration, without being masked by associated changes of surrounding stabilizing structures.

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Section: Discussionmentioning

confidence: 99%

“…Disc degeneration has been the subject of many lumbar FE models 9–11 , however very few studies have investigated the role of ligamentous pathology or failure 12,13 . Moreover, these studies only included a single spinal unit, rather than a longer spinal segment.…”

Section: Introductionmentioning

confidence: 99%

Comparative role of disc degeneration and ligament failure on functional mechanics of the lumbar spine

Ellingson

Shaw

Giambini

et al. 2015

Computer Methods in Biomechanics and Biomedical Engineering

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“…However, bone strength varies greatly between individuals as a result of the effect of osteoporosis, and this has been difficult to reproduce. Almost all previous studies have used a two-layer model of bone material consisting of cortical bone and medulla with consistent mechanical properties for analysis [10,12,13]. In this study, we created a patient-specific FE model using bone densities derived from CT images of an individual patient, for which we determined element-specific Young's modulus and carried out damage analysis.…”

Section: Discussionmentioning

confidence: 99%

“…In this study, we created a patient-specific FE model using bone densities derived from CT images of an individual patient, for which we determined element-specific Young's modulus and carried out damage analysis. Although most researchers have found it difficult to establish a model for the ligaments around the vertebral bodies, modeling them only as spring elements exerting tension only in one dimension [13,23], we modeled and analyzed the ligaments around the vertebral bodies as three-dimensional finite elements in this study. To the best of our knowledge, we are the first to successfully reproduce the tension and deformation behavior around the cages used in PLIF in a simulation using the osteoporotic vertebral bodies of an old person, allowing us to predict the mechanism by which cage subsidence occurs.…”

Section: Discussionmentioning

confidence: 99%

“…Finite element analysis (FEA) is one technique that can be used for in vitro biomechanical and biomaterial studies. FEA is an indispensable biomechanical evaluation tool for supplementing in vitro biomechanical studies of the spine [9][10][11][12][13]. Most previous studies of PLIF using FEA have not taken into account the strength of osteoporotic bone in the elderly, and FEA analysis of PLIF in a model simulating vertebral bodies of normal bone strength for young people found almost no fractures [14], with the damage elements localized at the part of the bone around the cage.…”

Section: Introductionmentioning

confidence: 99%

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Use of Nonlinear Finite Element Analysis of Bone Density to Investigate the Biomechanical Effect in the Bone around Intervertebral Cages in Posterior Lumbar Interbody Fusion

Sato¹,

Yonezawa²,

Todo³

et al. 2017

JBiSE

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Preventing subsidence of intervertebral cages in posterior lumbar interbody fusion (PLIF) requires understanding its mechanism, which is yet to be done. We aimed to describe the mechanism of intervertebral cage subsidence by using finite element analysis through simulation of the osteoporotic vertebral bodies of an elderly woman. The data from computed tomography scans of L2-L5 vertebrae in a 72-year-old woman with osteoporosis were used to create 2 FE models: one not simulating implant placement (LS-INT) and one simulating L3/4 PLIF using polyetheretherketone (PEEK) cages (LS-PEEK). Loads and moments simulating the living body were applied to these models, and the following analyses were performed: 1) Drucker-Prager equivalent stress distribution at the cage contact surfaces; 2) the distribution of damage elements in L2-L5 during incremental loading; and 3) the distribution of equivalent plastic strain at the cage contact surfaces. In analysis 1, the Drucker-Prager equivalent stress on the L3 and L4 vertebral endplates was greater for LS-PEEK than for LS-INT under all loading conditions and tended to be particularly concentrated at the contact surfaces. In analysis 2, compared with LS-INT, LS-PEEK showed more damage elements along the bone around the cages in the L3 vertebral body posterior to the cage contact surfaces, followed by the area of the L4 vertebral body posterior to the cage contact surfaces. In analysis 3, in the L3 inferior surface in LS-PEEK the distribution of equivalent plastic strain was visualized as gradually expanding along the cages from the area posterior to the cages to the area anterior to them with increased loading. These analyses suggested that in PLIF for

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The radiologic assessment of posterior ligamentous complex injury in patients with thoracolumbar fracture

Chen

Goswami

et al. 2016

Eur Spine J

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Instantaneous center of rotation behavior of the lumbar spine with ligament failure

Cited by 21 publications

References 43 publications

Comparative role of disc degeneration and ligament failure on functional mechanics of the lumbar spine

Comparative role of disc degeneration and ligament failure on functional mechanics of the lumbar spine

Use of Nonlinear Finite Element Analysis of Bone Density to Investigate the Biomechanical Effect in the Bone around Intervertebral Cages in Posterior Lumbar Interbody Fusion

The radiologic assessment of posterior ligamentous complex injury in patients with thoracolumbar fracture

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