The biomechanical effects of graded upper articular process arthroplasty on lumbar spine: A finite element study |
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| Institution: | 1. Ningbo University School of Medicine, Ningbo, China;2. Department of Orthopaedics, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, China;1. Keio University School of Medicine, Department of Orthopaedic Surgery, Tokyo, Japan;2. Kobe Medical Center, Department of Orthopaedic Surgery, Kobe, Japan;3. Kanazawa University, Department of Orthopaedic Surgery, Kanazawa, Japan;4. Meijo Hospital, Department of Orthopaedic Surgery, Nagoya, Japan;5. Tokyo Shinjuku Medical Center, Department of Spine Surgery, Tokyo, Japan;6. Toyota Kosei Hospital, Department of Orthopaedic Surgery, Toyota, Japan;7. Japan Spinal Deformity Institute, Nagoya, Japan;1. Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan;2. Division of Rehabilitation Medicine, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan;3. Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, 7-10-2, Tomogaoka, Suma-ku, Kobe, 654-0142, Japan;1. Department of Orthopaedic Surgery, Hospital for Special Surgery, 535 E 70th Street, New York, NY, 10021, USA;2. Department of Orthopaedic Surgery, University of Alabama at Birmingham School of Medicine, 1313 13th Street South, Birmingham, Al, 35205, USA;3. Department of Orthopaedics and Rehabilitation, Yale School of Medicine, 800 Howard Avenue, New Haven, CT, 06510, USA |
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| Abstract: | BackgroundSuperior articular process arthroplasty is important for intervertebral foramen microscopy but may lead to spinal instability. Currently, there has been no relevant study in relation to the biomechanical analysis of superior articular process arthroplasty. Hence, this study is intended to verify biomechanical effects after unilateral S1 superior articular process arthroplasty.MethodsEight finite element (FE) models of lumbosacral vertebrae (L4-S) were constructed, and the superior articular process formation was simulated with the help of Geomagic studio. Then, the models were imported into Nastran software after optimization. Normal load and appropriate torque were applied to simulate forward flexion, back extension, lateral flexion and lateral rotation. In the end, changes of lumbar range of motion (ROM) and structural stress were compared with those of normal model.ResultsCompared with the normal model, formed from ventral to dorsal (Longitudinal), the larger motion of lumbar spine and the greater larger stress of articular process showed statistical significance (P < 0.05) in most of directions when the forming range was greater than 3/5. Formed from the apex to the base (transverse), the larger motion of lumbar spine and the greater stress of articular process showed statistical significance (P < 0.05) in most of directions when the forming range was great than 1/5.ConclusionWhen conducting unilateral S1 articular process arthroplasty from ventral to dorsal, the forming range is recommended to be less than 3/5 of the superior articular process. Notably, it is not advisable to form from the apex to the base. |
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