Negative biomechanical effects of large grade nuclectomy in the transforaminal endoscopic discectomy increased the risk of adjacent segment diseases: A finite element study

Cao, Rui; He, Yanwei; Qian, Chengmei; Ma, Lin; Li, Jingchi; Xi, Zhaodong; Chen, Cheng

doi:10.1016/j.jocn.2021.09.014

Cited by 2 publications

(2 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 6 , 26 , 27 Moreover, previous studies have shown that disc removal may also affect the stability of the TJC of the adjacent levels. 28 However, the studies on the effect of discectomy on spinal biomechanics are mostly finite element analyses. In contrast, our study investigated the long-term morphological changes in the TJC, and the results indicated aggravated disc degeneration, reduced disc height, and preserved the facet joints.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Radiographic and Clinical Outcomes in Patients Undergoing Transforaminal Endoscopic Lumbar Discectomy: A Propensity Score Matching Study

Mu,

Yue,

Sun

2023

JPR

View full text Add to dashboard Cite

Background Our study aims to investigate the long-term clinical and radiographic effects of transforaminal endoscopic lumbar discectomy (TELD) on lumbar disc herniation. Patients and Methods Radiographic and clinical data of patients undergoing TELD in our institution from January 2015 to January 2019 were retrospectively collected. LDH outpatients who had not received surgical treatment during the same period were 1:1 matched by propensity score matching as the conservative group. The radiographic parameters of the two groups at baseline and at the last follow-up (≥24 months) were analyzed. Results The study included 47 patients in the TELD group, matched with 47 patients in the conservative group. The disc height of the TELD group at the last follow-up was lower than that at the baseline (P < 0.001), and lower than that of the conservative group at the last follow-up (P < 0.05). The disc degeneration grade of the TELD group at the last follow-up was greater than that at the baseline, and greater than that of the conservative group at the last follow-up. There was no significant difference in the facet joint degeneration in the TELD group between the baseline and the last follow-up, and between the TELD group and the conservative group at the last follow-up (P > 0.05). The pain intensity and disability score in the TELD group at 3-month follow-up and at the last follow-up were significantly lower than those at the baseline (P < 0.001). Six patients in the TELD group required additional surgery during the follow-up period. Conclusion Our long-term follow-up data shows that the disc height of the operated level was significantly reduced and the disc degeneration was significantly aggravated in TELD-treated patients; in contrast, the facet joint degeneration did not show significant aggravation.

show abstract

Section: Discussionmentioning

confidence: 99%

Long-Term Radiographic and Clinical Outcomes in Patients Undergoing Transforaminal Endoscopic Lumbar Discectomy: A Propensity Score Matching Study

Mu,

Yue,

Sun

2023

JPR

View full text Add to dashboard Cite

show abstract

“…Zhang et al [ 17 ] analyzed the effects of different levels of foraminotomy and arthroplasty annular defects on lumbar biomechanics in the L5–S1 segments using a finite element method. Cao et al [ 18 ] aimed to investigate the changes in the biomechanical environment after in-out PTED with intact articular synapse with large-level nucleosome and out-in PTED with limited laminoplasty with small-level nucleosome. Li et al [ 19 ] investigated the changes in the prevalence of adjacent segment disease in patients with PTED without osteoporosis and with osteoporosis using finite elements.…”

Section: Introductionmentioning

confidence: 99%

Biomechanical Evaluation of 2 Endoscopic Spine Surgery Methods for Treating Lumbar Disc Herniation: A Finite Element Study

Zou,

Ji,

Yang

et al. 2024

Neurospine

View full text Add to dashboard Cite

Objective: This study aimed to evaluate the effects of 2 endoscopic spine surgeries on the biomechanical properties of normal and osteoporotic spines.Methods: Based on computed tomography images of a healthy adult volunteer, 6 finite element models were created. After validating the normal intact model, a concentrated force of 400 N and a moment of 7.5 Nm were exerted on the upper surface of L3 to simulate 6 physiological activities of the spine. Five types of indices were used to assess the biomechanical properties of the 6 models, range of motion (ROM), maximum displacement value, intervertebral disc stress, maximum stress value, and articular protrusion stress, and by combining them with finite element stress cloud.Results: In normal and osteoporotic spines, there was no meaningful change in ROM or disc stress in the 2 surgical models for the 6 motion states. Model N1 (osteoporotic percutaneous transforaminal endoscopic discectomy model) showed a decrease in maximum displacement value of 20.28% in right lateral bending. Model M2 (unilateral biportal endoscopic model) increased maximum displacement values of 16.88% and 17.82% during left and right lateral bending, respectively. The maximum stress value of L4–5 increased by 11.72% for model M2 during left rotation. In addition, using the same surgical approach, ROM, maximum displacement values, disc stress, and maximum stress values were more significant in the osteoporotic model than in the normal model.Conclusion: In both normal and osteoporotic spines, both surgical approaches were less disruptive to the physiologic structure of the spine. Furthermore, using the same endoscopic spine surgery, normal spine biomechanical properties are superior to osteoporotic spines.

show abstract

Negative biomechanical effects of large grade nuclectomy in the transforaminal endoscopic discectomy increased the risk of adjacent segment diseases: A finite element study

Cited by 2 publications

References 33 publications

Long-Term Radiographic and Clinical Outcomes in Patients Undergoing Transforaminal Endoscopic Lumbar Discectomy: A Propensity Score Matching Study

Long-Term Radiographic and Clinical Outcomes in Patients Undergoing Transforaminal Endoscopic Lumbar Discectomy: A Propensity Score Matching Study

Biomechanical Evaluation of 2 Endoscopic Spine Surgery Methods for Treating Lumbar Disc Herniation: A Finite Element Study

Contact Info

Product

Resources

About