Biomechanical Evaluation of Spinal Column after Percutaneous Cement Discoplasty: A Finite Element Analysis

Objective To compare the biomechanical properties of percutaneous cement discoplasty (PCD) in the spinal column between different implant‐endplate friction. Methods A validated L3‐Scarumfinite element (FE) model was modified for simulation. In the PCD model, the L4/5 level was modified based on mode...

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Main Authors: Shuang Li, Baoshan Xu, Yancheng Liu, Jingyu Zhang, Guijun Xu, Pengfei Shao, Xiaoye Li, Yongcheng Hu, Xinlong Ma
Format: Article
Language:English
Published: Wiley 2022-08-01
Series:Orthopaedic Surgery
Subjects:
Online Access:https://doi.org/10.1111/os.13314
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author Shuang Li
Baoshan Xu
Yancheng Liu
Jingyu Zhang
Guijun Xu
Pengfei Shao
Xiaoye Li
Yongcheng Hu
Xinlong Ma
author_facet Shuang Li
Baoshan Xu
Yancheng Liu
Jingyu Zhang
Guijun Xu
Pengfei Shao
Xiaoye Li
Yongcheng Hu
Xinlong Ma
author_sort Shuang Li
collection DOAJ
description Objective To compare the biomechanical properties of percutaneous cement discoplasty (PCD) in the spinal column between different implant‐endplate friction. Methods A validated L3‐Scarumfinite element (FE) model was modified for simulation. In the PCD model, the L4/5 level was modified based on model 1 (M1) and model 2 (M2). In M1, the interaction between bone cement and endplate was defined as face‐to‐face contact with a friction coefficient of 0.3; in M2, the contact was defined as a Tie constraint. 7.5 N m moments of four physiological motions and axial load of 15, 100 and 400 N preload were imposed at the top of L3. The range of motion (ROM) and interface stress analysis of endplates, annulus fibrosus and bone cement of the operated level were calculated for comparisons among the three models. Results The ROM of M1 and M2 increased when compared with the intact model during flexion (FL) (17.5% vs 10.0%), extension (EX) (8.8% vs −8.8%), left bending (LB) (19.0% vs −17.2%) and left axial rotation (LR) (34.6% vs −3.8%). The stress of annulus fibrosus in M1 and M2 decreased in FL (−48.4% vs −57.5%), EX (−25.7% vs −14.7%), LB (−47.5% vs −52.4%), LR (−61.4% vs −68.7%) and axis loading of 100 N (−41.5% vs −15.3%), and 400 N (−27.9% vs −27.3%). The stress of upper endplate of M1 and M2 increased in FL (24.6% vs 24.7%), LB (82.2% vs 89.5%), LR (119% vs 62.4%) and axis loading of 100 N (64.6% vs 45.5%), and 400 N (58.2% vs 24.3%), but was similar in EX (2.9% vs 0.3%). The stress of lower endplate of M1 and M2 increased in FL (170.9% vs 175.0%), EX (180.8% vs 207.7%), LB (302.6% vs 274.7%), LR (332.4% vs 132.8%) and axis loading of 100 N (350.7% vs 168.6%), and 400 N (165.2% vs 106.7%). Conclusion Percutaneous cement discoplasty procedure could make effect on the mobility or stiffness. The fusion of bone cement and endplate might have more biomechanical advantages, including of the decreasing rate of implant subsidence and dislocation, and the increase spine stability.
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spelling doaj.art-98f187ba95de48228117b4006e32dba72022-12-22T02:52:01ZengWileyOrthopaedic Surgery1757-78531757-78612022-08-011481853186310.1111/os.13314Biomechanical Evaluation of Spinal Column after Percutaneous Cement Discoplasty: A Finite Element AnalysisShuang Li0Baoshan Xu1Yancheng Liu2Jingyu Zhang3Guijun Xu4Pengfei Shao5Xiaoye Li6Yongcheng Hu7Xinlong Ma8College of Orthopaedics Tianjin Medical University Tianjin ChinaDepartment of Minimally Invasive Spine Surgery Tianjin Hospital, Tianjin University Tianjin ChinaDepartment of Bone and Tissue Oncology Tianjin Hospital, Tianjin University Tianjin ChinaDepartment of Bone and Tissue Oncology Tianjin Hospital, Tianjin University Tianjin ChinaDepartment of Bone and Tissue Oncology Tianjin Hospital, Tianjin University Tianjin ChinaDepartment of Neurosurgery Shijingshan Hospital Beijing ChinaThe Third Central Hospital of Tianjin Tianjin ChinaDepartment of Bone and Tissue Oncology Tianjin Hospital, Tianjin University Tianjin ChinaDepartment of Bone and Tissue Oncology Tianjin Hospital, Tianjin University Tianjin ChinaObjective To compare the biomechanical properties of percutaneous cement discoplasty (PCD) in the spinal column between different implant‐endplate friction. Methods A validated L3‐Scarumfinite element (FE) model was modified for simulation. In the PCD model, the L4/5 level was modified based on model 1 (M1) and model 2 (M2). In M1, the interaction between bone cement and endplate was defined as face‐to‐face contact with a friction coefficient of 0.3; in M2, the contact was defined as a Tie constraint. 7.5 N m moments of four physiological motions and axial load of 15, 100 and 400 N preload were imposed at the top of L3. The range of motion (ROM) and interface stress analysis of endplates, annulus fibrosus and bone cement of the operated level were calculated for comparisons among the three models. Results The ROM of M1 and M2 increased when compared with the intact model during flexion (FL) (17.5% vs 10.0%), extension (EX) (8.8% vs −8.8%), left bending (LB) (19.0% vs −17.2%) and left axial rotation (LR) (34.6% vs −3.8%). The stress of annulus fibrosus in M1 and M2 decreased in FL (−48.4% vs −57.5%), EX (−25.7% vs −14.7%), LB (−47.5% vs −52.4%), LR (−61.4% vs −68.7%) and axis loading of 100 N (−41.5% vs −15.3%), and 400 N (−27.9% vs −27.3%). The stress of upper endplate of M1 and M2 increased in FL (24.6% vs 24.7%), LB (82.2% vs 89.5%), LR (119% vs 62.4%) and axis loading of 100 N (64.6% vs 45.5%), and 400 N (58.2% vs 24.3%), but was similar in EX (2.9% vs 0.3%). The stress of lower endplate of M1 and M2 increased in FL (170.9% vs 175.0%), EX (180.8% vs 207.7%), LB (302.6% vs 274.7%), LR (332.4% vs 132.8%) and axis loading of 100 N (350.7% vs 168.6%), and 400 N (165.2% vs 106.7%). Conclusion Percutaneous cement discoplasty procedure could make effect on the mobility or stiffness. The fusion of bone cement and endplate might have more biomechanical advantages, including of the decreasing rate of implant subsidence and dislocation, and the increase spine stability.https://doi.org/10.1111/os.13314BiomechanicalBone cementFinite element analysisLumbar spinal stenosisPercutaneous cement discoplastyPMMA
spellingShingle Shuang Li
Baoshan Xu
Yancheng Liu
Jingyu Zhang
Guijun Xu
Pengfei Shao
Xiaoye Li
Yongcheng Hu
Xinlong Ma
Biomechanical Evaluation of Spinal Column after Percutaneous Cement Discoplasty: A Finite Element Analysis
Orthopaedic Surgery
Biomechanical
Bone cement
Finite element analysis
Lumbar spinal stenosis
Percutaneous cement discoplasty
PMMA
title Biomechanical Evaluation of Spinal Column after Percutaneous Cement Discoplasty: A Finite Element Analysis
title_full Biomechanical Evaluation of Spinal Column after Percutaneous Cement Discoplasty: A Finite Element Analysis
title_fullStr Biomechanical Evaluation of Spinal Column after Percutaneous Cement Discoplasty: A Finite Element Analysis
title_full_unstemmed Biomechanical Evaluation of Spinal Column after Percutaneous Cement Discoplasty: A Finite Element Analysis
title_short Biomechanical Evaluation of Spinal Column after Percutaneous Cement Discoplasty: A Finite Element Analysis
title_sort biomechanical evaluation of spinal column after percutaneous cement discoplasty a finite element analysis
topic Biomechanical
Bone cement
Finite element analysis
Lumbar spinal stenosis
Percutaneous cement discoplasty
PMMA
url https://doi.org/10.1111/os.13314
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