Risk factor analysis of disc and facet joint degeneration after intersegmental pedicle screw fixation for lumbar spondylolysis

Meng, Hui; Gao, Yuan; Lu, Peng; Guang-min, Zhao; Zhi-cheng, Zhang; Sun, Tiansheng; Li, Fang

doi:10.1186/s13018-022-03082-9

Cited by 5 publications

(3 citation statements)

References 39 publications

(40 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The isthmus was recognized as a weak area in the lumbar spine [ 37 ]. Spondylolysis is believed to result from repetitive mechanical stress on the lower lumbar vertebrae [ 51 ]. Excessive activity and stimulation of the fractured isthmus can lead to symptoms such as pain.…”

Section: Discussionmentioning

confidence: 99%

Biomechanical response of decompression alone in lower grade lumbar degenerative spondylolisthesis--A finite element analysis

Liu,

He,

et al. 2024

J Orthop Surg Res

View full text Add to dashboard Cite

Background Previous studies have demonstrated the clinical efficacy of decompression alone in lower-grade spondylolisthesis. A higher rate of surgical revision and a lower rate of back pain relief was also observed. However, there is a lack of relevant biomechanical evidence after decompression alone for lower-grade spondylolisthesis. Purpose Evaluating the biomechanical characteristics of total laminectomy, hemilaminectomy, and facetectomy for lower-grade spondylolisthesis by analyzing the range of motion (ROM), intradiscal pressure (IDP), annulus fibrosus stress (AFS), facet joints contact force (FJCF), and isthmus stress (IS). Methods Firstly, we utilized finite element tools to develop a normal lumbar model and subsequently constructed a spondylolisthesis model based on the normal model. We then performed total laminectomy, hemilaminectomy, and one-third facetectomy in the normal model and spondylolisthesis model, respectively. Finally, we analyzed parameters, such as ROM, IDP, AFS, FJCF, and IS, for all the models under the same concentrate force and moment. Results The intact spondylolisthesis model showed a significant increase in the relative parameters, including ROM, AFS, FJCF, and IS, compared to the intact normal lumbar model. Hemilaminectomy and one-third facetectomy in both spondylolisthesis and normal lumbar models did not result in an obvious change in ROM, IDP, AFS, FJCF, and IS compared to the pre-operative state. Moreover, there was no significant difference in the degree of parameter changes between the spondylolisthesis and normal lumbar models after undergoing the same surgical procedures. However, total laminectomy significantly increased ROM, AFS, and IS and decreased the FJCF in both normal lumbar models and spondylolisthesis models. Conclusion Hemilaminectomy and one-third facetectomy did not have a significant impact on the segment stability of lower-grade spondylolisthesis; however, patients with LDS undergoing hemilaminectomy and one-third facetectomy may experience higher isthmus stress on the surgical side during rotation. In addition, total laminectomy changes the biomechanics in both normal lumbar models and spondylolisthesis models.

show abstract

Section: Discussionmentioning

confidence: 99%

Biomechanical response of decompression alone in lower grade lumbar degenerative spondylolisthesis--A finite element analysis

Liu,

He,

et al. 2024

J Orthop Surg Res

View full text Add to dashboard Cite

show abstract

“…A recent study investigating the risk factors affecting the incidence of facet joint degeneration found that fixation time is a risk factor. They found that the earlier bony union occurs, and internal fixation was removed, the incidence of facet joint degeneration was lowered ( 30 ). Further studies are required to clarify the effect of intersegmental pedicle screw fixation and to evaluate various risk factors that may predict the possibility of degeneration of the intervertebral disc and facet joints.…”

Section: Discussionmentioning

confidence: 99%

Oblique lateral interbody fusion in heterogenous lumbar diseases: Anterolateral screw fixation vs. posterior percutaneous pedicle screw fixation – A single center experience

Chung²,

Chen³

et al. 2022

Front. Surg.

View full text Add to dashboard Cite

BackgroundOblique lateral interbody fusion (OLIF) is a type of minimally invasive lateral lumbar interbody fusion technique used for treating lumbar degenerative diseases. This study aimed to analyze the clinical and radiographic efficacy of OLIF with anterolateral screw fixation alone and OLIF requiring fixation with conventional posterior percutaneous pedicle screws for lumbar diseases.MethodsMedical records of consecutive patients admitted to Cheng-Hsin Hospital who received OLIF between January 2019 and December 2020 were retrospectively reviewed. Patients were divided into two groups by screw fixation: patients who received anterolateral screw fixation alone were defined as one-stage OLIF (n = 9) and patients who received fixation with conventional posterior percutaneous pedicle screw were defined as two-stage OLIF (n = 16). Patient clinical characteristics, medical history, intraoperative blood loss, length of hospital stay, peri-operative, and post-operative complications were evaluated in all patients.ResultsDuring the study period, a total of 25 patients were successfully treated with OLIF (n = 9 one-stage; n = 16 two-stage). Two-stage OLIF was associated with longer operation times, longer hospital stays, shorter bed-rest time, and a greater likelihood of having a blood transfusion compared with the one-stage OLIF group. A higher proportion of grade I subsidence was observed at 6 months and 1 year after surgery in the two-stage group compared with the one-stage group. Post-operative complications included ileus, dystonia, and dystonia were higher in the two-stage OLIF group. Improvements in radiographic parameters were demonstrated after OLIF, and the improvements were comparable between one-stage and two-stage OLIF.ConclusionsOne-stage OLIF is a feasible and efficacious treatment method for single- and multiple-level degenerative lumbar diseases. Additional clinical follow-up is necessary to confirm long-term outcomes.

show abstract

“…At the same time, the intersegmental fixation device can be removed surgically as early as possible. ROM of the lumbosacral region can be restored through early functional exercise (Meng et al, 2022). Certainly, the hybrid fixation is recently proposed as a new technology combining intrasegmental fixation and intersegment fixation technology, and the material application cost is slightly higher compared with the other two technologies.…”

Section: Figurementioning

confidence: 99%

Biomechanical evaluation of lumbar spondylolysis repair with various fixation options: A finite element analysis

Jin²,

Yang³

et al. 2022

Front. Bioeng. Biotechnol.

View full text Add to dashboard Cite

Objective: This study was designed to compare the biomechanical properties of lumbar spondylolysis repairs using different fixation methods by using three-dimensional finite element analysis.Methods: Five finite element models (A, B, C, D, and E) of L4-S1 vertebral body were reconstructed by CT images of a male patient (A: intact model; B: spondylolysis model; C: spondylolysis model with intrasegmental direct fixation by Buck screw; D: spondylolysis model with intersegmental indirect fixation by pedicle screw system; E: spondylolysis model with hybrid internal fixation). L5-S1 level was defined as the operative level. After the intact model was verified, six physiological motion states were simulated by applying 500 N concentrated force and 10 Nm torque on the upper surface of L4. The biomechanical properties of the three different internal fixation methods were evaluated by comparing the range of motion (ROM), maximum stress, and maximum displacement.Results: Compared with Model B, the ROM and maximum displacement of Model C, D, and E decreased. The maximum stress on L5/S1 disc in models A, B, and C was much higher than that in Model D and E under extension and lateral bending conditions. Under axial rotation and lateral bending conditions, the maximum stress of interarticular muscle and internal fixation system in Model B and Model C was significantly higher than that in Model D and Model E. In contrast to Model D, the stress in Model E was distributed in two internal fixation systems.Conclusion: In several mechanical comparisons, hybrid fixation had better biomechanical properties than other fixation methods. The experimental results show that hybrid fixation can stabilize the isthmus and reduce intervertebral disc stress, which making it the preferred treatment for lumbar spondylolysis.

show abstract

Risk factor analysis of disc and facet joint degeneration after intersegmental pedicle screw fixation for lumbar spondylolysis

Cited by 5 publications

References 39 publications

Biomechanical response of decompression alone in lower grade lumbar degenerative spondylolisthesis--A finite element analysis

Biomechanical response of decompression alone in lower grade lumbar degenerative spondylolisthesis--A finite element analysis

Oblique lateral interbody fusion in heterogenous lumbar diseases: Anterolateral screw fixation vs. posterior percutaneous pedicle screw fixation – A single center experience

Biomechanical evaluation of lumbar spondylolysis repair with various fixation options: A finite element analysis

Contact Info

Product

Resources

About