Hangkai Shen1, Guy R Fogel2, Jia Zhu3, Zhenhua Liao3, Weiqiang Liu4. 1. Department of Mechanical Engineering, Tsinghua University, Beijing, China; Biomechanics and Biotechnology Lab, Research Institute of Tsinghua University in Shenzhen, Shenzhen, China. 2. Spine Pain Begone Clinic, San Antonio, Texas, USA. 3. Biomechanics and Biotechnology Lab, Research Institute of Tsinghua University in Shenzhen, Shenzhen, China. 4. Department of Mechanical Engineering, Tsinghua University, Beijing, China; Biomechanics and Biotechnology Lab, Research Institute of Tsinghua University in Shenzhen, Shenzhen, China. Electronic address: weiqiangliu19@163.com.
Abstract
BACKGROUND: Recently, interspinous stabilization with the interspinous process device (IPD) has become an alternative to treat lumbar spinal stenosis. The biomechanical influence of different design features of IPDs on intradiscal pressure (IDP) and facet joint force (FJF) has not been fully understood. The aim of this study was to investigate the biomechanical performance of different IPDs using finite element (FE) method. METHODS: A FE model of the L1-5 segments was developed and validated. Four surgical FE models were constructed by inserting different implants at the L3-4 segment (Coflex-F, DIAM, Wallis, and pedicle screw system). The 4 motion modes were simulated. RESULTS: The IPDs decreased range of motion (ROM) at the surgical level substantially in flexion and extension, but little influence was found in lateral bending and torsion. Compared with the DIAM and Wallis devices, the Coflex-F device showed advantages in stabilizing the surgical level, especially in flexion and extension, while it increased FJF at adjacent levels by 26%-27% in extension. Among the 3 IPDs, the DIAM device exhibited the most comparable ROM, IDP, and FJF at adjacent levels compared with the intact lumbar spine. The influence of the Wallis device was between that of the Coflex-F and DIAM devices. CONCLUSIONS: Compared with rigid fixation, the IPDs demonstrated less compensation at adjacent levels in terms of ROM, IDP, and FJF, which may lower the incidence of adjacent segment degeneration in the long term.
BACKGROUND: Recently, interspinous stabilization with the interspinous process device (IPD) has become an alternative to treat lumbar spinal stenosis. The biomechanical influence of different design features of IPDs on intradiscal pressure (IDP) and facet joint force (FJF) has not been fully understood. The aim of this study was to investigate the biomechanical performance of different IPDs using finite element (FE) method. METHODS: A FE model of the L1-5 segments was developed and validated. Four surgical FE models were constructed by inserting different implants at the L3-4 segment (Coflex-F, DIAM, Wallis, and pedicle screw system). The 4 motion modes were simulated. RESULTS: The IPDs decreased range of motion (ROM) at the surgical level substantially in flexion and extension, but little influence was found in lateral bending and torsion. Compared with the DIAM and Wallis devices, the Coflex-F device showed advantages in stabilizing the surgical level, especially in flexion and extension, while it increased FJF at adjacent levels by 26%-27% in extension. Among the 3 IPDs, the DIAM device exhibited the most comparable ROM, IDP, and FJF at adjacent levels compared with the intact lumbar spine. The influence of the Wallis device was between that of the Coflex-F and DIAM devices. CONCLUSIONS: Compared with rigid fixation, the IPDs demonstrated less compensation at adjacent levels in terms of ROM, IDP, and FJF, which may lower the incidence of adjacent segment degeneration in the long term.
Authors: Zhiyuan Guo; Guangfei Liu; Lu Wang; Yuejiang Zhao; Ye Zhao; Shouliang Lu; Cai Cheng Journal: Am J Transl Res Date: 2022-07-15 Impact factor: 3.940