Biomechanical comparative analysis of effects of dynamic and rigid fusion on lumbar motion with different sagittal parameters: An in vitro study
Background: Although the management of the lumbar disease is highly dependent on the severity of the patient’s condition, optimal surgical techniques to reduce the risk of adjacent degeneration disease (ADS) remain elusive. Based on in vitro biomechanical tests of the cadaver spine, this study aimed...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2022-08-01
|
| Series: | Frontiers in Bioengineering and Biotechnology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fbioe.2022.943092/full |
| _version_ | 1798037656978849792 |
|---|---|
| author | Wei Wang Wei Wang Chao Kong Chao Kong Fumin Pan Fumin Pan Yu Wang Yu Wang Xueqing Wu Baoqing Pei Shibao Lu Shibao Lu |
| author_facet | Wei Wang Wei Wang Chao Kong Chao Kong Fumin Pan Fumin Pan Yu Wang Yu Wang Xueqing Wu Baoqing Pei Shibao Lu Shibao Lu |
| author_sort | Wei Wang |
| collection | DOAJ |
| description | Background: Although the management of the lumbar disease is highly dependent on the severity of the patient’s condition, optimal surgical techniques to reduce the risk of adjacent degeneration disease (ADS) remain elusive. Based on in vitro biomechanical tests of the cadaver spine, this study aimed to comparatively analyze the kinematic responses of the spine with dynamic and rigid fixations (i.e., Coflex fixation and posterolateral fusion) after single-or double-level lumbar fusion in daily activities.Methods: Six human lumbar specimens (L1-S1) were selected for this experiment, and the sagittal parameters of each lumbar specimen were measured in the 3D model. The specimens were successively reconstructed into five groups of models: intact model, single-level L4-5 Coflex fixation model, single-level L4-5 Fusion (posterior pedicle screw fixation) model, double-level L4-5 Coflex + L5-S1 Fusion model; and double-level L4-5 Fusion + L5-S1 Fusion model. The pure moment was applied to the specimen model to simulate physiological activities in daily life through a custom-built robot testing device with an optical tracking system.Results: For single-level lumbar fusion, compared to the traditional Fusion fixation, the Coflex dynamic fixation mainly restricted the extension of L4-L5, partially retained the range of motion (ROM) of the L4-L5 segment, and reduced the motion compensation of the upper adjacent segment. For the double-level lumbar fixation, the ROM of adjacent segments in the Coflex + Fusion was significantly decreased compared to the Fusion + Fusion fixation, but there was no significant difference. In addition, PT was the only sagittal parameter of the preoperative lumbar associated with the ROM under extension loading. The Coflex fixation had little effect on the original sagittal alignment of the lumbar spine.Conclusion: The Coflex was an effective lumbar surgical technique with a less altering kinematic motion of the lumbar both at the index segment and adjacent segments. However, when the Coflex was combined with the fusion fixation, this ability to protect adjacent segments remained elusive in slowing the accelerated degradation of adjacent segments. |
| first_indexed | 2024-04-11T21:29:31Z |
| format | Article |
| id | doaj.art-7620c3d58c2145ccb91bbf484dcf9a88 |
| institution | Directory Open Access Journal |
| issn | 2296-4185 |
| language | English |
| last_indexed | 2024-04-11T21:29:31Z |
| publishDate | 2022-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Bioengineering and Biotechnology |
| spelling | doaj.art-7620c3d58c2145ccb91bbf484dcf9a882022-12-22T04:02:15ZengFrontiers Media S.A.Frontiers in Bioengineering and Biotechnology2296-41852022-08-011010.3389/fbioe.2022.943092943092Biomechanical comparative analysis of effects of dynamic and rigid fusion on lumbar motion with different sagittal parameters: An in vitro studyWei Wang0Wei Wang1Chao Kong2Chao Kong3Fumin Pan4Fumin Pan5Yu Wang6Yu Wang7Xueqing Wu8Baoqing Pei9Shibao Lu10Shibao Lu11Department of Orthopedics, Xuanwu Hospital, Capital Medical University, Beijing, ChinaNational Clinical Research Center for Geriatric Diseases, Beijing, ChinaDepartment of Orthopedics, Xuanwu Hospital, Capital Medical University, Beijing, ChinaNational Clinical Research Center for Geriatric Diseases, Beijing, ChinaDepartment of Orthopedics, Xuanwu Hospital, Capital Medical University, Beijing, ChinaNational Clinical Research Center for Geriatric Diseases, Beijing, ChinaDepartment of Orthopedics, Xuanwu Hospital, Capital Medical University, Beijing, ChinaNational Clinical Research Center for Geriatric Diseases, Beijing, ChinaBeijing Key Laboratory for Design and Evaluation Technology of Advanced Implantable and Interventional Medical Devices, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, ChinaBeijing Key Laboratory for Design and Evaluation Technology of Advanced Implantable and Interventional Medical Devices, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, ChinaDepartment of Orthopedics, Xuanwu Hospital, Capital Medical University, Beijing, ChinaNational Clinical Research Center for Geriatric Diseases, Beijing, ChinaBackground: Although the management of the lumbar disease is highly dependent on the severity of the patient’s condition, optimal surgical techniques to reduce the risk of adjacent degeneration disease (ADS) remain elusive. Based on in vitro biomechanical tests of the cadaver spine, this study aimed to comparatively analyze the kinematic responses of the spine with dynamic and rigid fixations (i.e., Coflex fixation and posterolateral fusion) after single-or double-level lumbar fusion in daily activities.Methods: Six human lumbar specimens (L1-S1) were selected for this experiment, and the sagittal parameters of each lumbar specimen were measured in the 3D model. The specimens were successively reconstructed into five groups of models: intact model, single-level L4-5 Coflex fixation model, single-level L4-5 Fusion (posterior pedicle screw fixation) model, double-level L4-5 Coflex + L5-S1 Fusion model; and double-level L4-5 Fusion + L5-S1 Fusion model. The pure moment was applied to the specimen model to simulate physiological activities in daily life through a custom-built robot testing device with an optical tracking system.Results: For single-level lumbar fusion, compared to the traditional Fusion fixation, the Coflex dynamic fixation mainly restricted the extension of L4-L5, partially retained the range of motion (ROM) of the L4-L5 segment, and reduced the motion compensation of the upper adjacent segment. For the double-level lumbar fixation, the ROM of adjacent segments in the Coflex + Fusion was significantly decreased compared to the Fusion + Fusion fixation, but there was no significant difference. In addition, PT was the only sagittal parameter of the preoperative lumbar associated with the ROM under extension loading. The Coflex fixation had little effect on the original sagittal alignment of the lumbar spine.Conclusion: The Coflex was an effective lumbar surgical technique with a less altering kinematic motion of the lumbar both at the index segment and adjacent segments. However, when the Coflex was combined with the fusion fixation, this ability to protect adjacent segments remained elusive in slowing the accelerated degradation of adjacent segments.https://www.frontiersin.org/articles/10.3389/fbioe.2022.943092/fullCoflex interspinous stabilizationlumbar fusionrange of motionsagittal parameteradjacent segment degeneration |
| spellingShingle | Wei Wang Wei Wang Chao Kong Chao Kong Fumin Pan Fumin Pan Yu Wang Yu Wang Xueqing Wu Baoqing Pei Shibao Lu Shibao Lu Biomechanical comparative analysis of effects of dynamic and rigid fusion on lumbar motion with different sagittal parameters: An in vitro study Frontiers in Bioengineering and Biotechnology Coflex interspinous stabilization lumbar fusion range of motion sagittal parameter adjacent segment degeneration |
| title | Biomechanical comparative analysis of effects of dynamic and rigid fusion on lumbar motion with different sagittal parameters: An in vitro study |
| title_full | Biomechanical comparative analysis of effects of dynamic and rigid fusion on lumbar motion with different sagittal parameters: An in vitro study |
| title_fullStr | Biomechanical comparative analysis of effects of dynamic and rigid fusion on lumbar motion with different sagittal parameters: An in vitro study |
| title_full_unstemmed | Biomechanical comparative analysis of effects of dynamic and rigid fusion on lumbar motion with different sagittal parameters: An in vitro study |
| title_short | Biomechanical comparative analysis of effects of dynamic and rigid fusion on lumbar motion with different sagittal parameters: An in vitro study |
| title_sort | biomechanical comparative analysis of effects of dynamic and rigid fusion on lumbar motion with different sagittal parameters an in vitro study |
| topic | Coflex interspinous stabilization lumbar fusion range of motion sagittal parameter adjacent segment degeneration |
| url | https://www.frontiersin.org/articles/10.3389/fbioe.2022.943092/full |
| work_keys_str_mv | AT weiwang biomechanicalcomparativeanalysisofeffectsofdynamicandrigidfusiononlumbarmotionwithdifferentsagittalparametersaninvitrostudy AT weiwang biomechanicalcomparativeanalysisofeffectsofdynamicandrigidfusiononlumbarmotionwithdifferentsagittalparametersaninvitrostudy AT chaokong biomechanicalcomparativeanalysisofeffectsofdynamicandrigidfusiononlumbarmotionwithdifferentsagittalparametersaninvitrostudy AT chaokong biomechanicalcomparativeanalysisofeffectsofdynamicandrigidfusiononlumbarmotionwithdifferentsagittalparametersaninvitrostudy AT fuminpan biomechanicalcomparativeanalysisofeffectsofdynamicandrigidfusiononlumbarmotionwithdifferentsagittalparametersaninvitrostudy AT fuminpan biomechanicalcomparativeanalysisofeffectsofdynamicandrigidfusiononlumbarmotionwithdifferentsagittalparametersaninvitrostudy AT yuwang biomechanicalcomparativeanalysisofeffectsofdynamicandrigidfusiononlumbarmotionwithdifferentsagittalparametersaninvitrostudy AT yuwang biomechanicalcomparativeanalysisofeffectsofdynamicandrigidfusiononlumbarmotionwithdifferentsagittalparametersaninvitrostudy AT xueqingwu biomechanicalcomparativeanalysisofeffectsofdynamicandrigidfusiononlumbarmotionwithdifferentsagittalparametersaninvitrostudy AT baoqingpei biomechanicalcomparativeanalysisofeffectsofdynamicandrigidfusiononlumbarmotionwithdifferentsagittalparametersaninvitrostudy AT shibaolu biomechanicalcomparativeanalysisofeffectsofdynamicandrigidfusiononlumbarmotionwithdifferentsagittalparametersaninvitrostudy AT shibaolu biomechanicalcomparativeanalysisofeffectsofdynamicandrigidfusiononlumbarmotionwithdifferentsagittalparametersaninvitrostudy |