Biomechanical effects of semi‑constrained integrated artificial discs on zygapophysial joints of implanted lumbar segments

Zheng,Sheng‑Nai; Yao,Qing-Qiang; Wang,Li‑Ming; Hu,Wen‑Hao; Wei,Bo; Xu,Yan; Zhang,Dong‑Sheng

doi:10.3892/etm.2013.1313

Biomechanical effects of semi‑constrained integrated artificial discs on zygapophysial joints of implanted lumbar segments

Authors:
- Sheng‑Nai Zheng
- Qing-Qiang Yao
- Li‑Ming Wang
- Wen‑Hao Hu
- Bo Wei
- Yan Xu
- Dong‑Sheng Zhang
View Affiliations

Affiliations: Department of Orthopaedic Surgery, Nanjing Medical University Nanjing Hospital, Nanjing, Jiangsu 210029, P.R. China, Department of Orthopaedic Surgery, Nanjing Medical University Nanjing Hospital, Nanjing, Jiangsu 210029, P.R. China, Biomechanical Laboratory, Shanghai University, Shanghai 200444, P.R. China
Published online on: September 26, 2013 https://doi.org/10.3892/etm.2013.1313
Pages: 1423-1430

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

This study aimed to optimize the design and application of semi‑constrained integrated artificial discs (SIADs) using a finite element (FE) analysis following implantation, wherein the zygapophysial joints of the segment were biomechanically reconstructed. An FE model of the L4‑L5 segment was constructed. Variations in the stresses on the discs and zygapophysial joints were observed during 5˚ anteflexion, 5˚ extension and 5˚ rotation under the 400‑N applied axial load. Stresses and load translation analyses of the discs and zygapophysial joints were conducted during anteflexion, extension and rotation under the 400‑N applied axial load. Following implantation of the lumbar segments, the stresses on the SIAD zygapophysial joints were not significantly different from those of physiological discs during anteflexion, and these were both marginally greater compared with those of non-constrained artificial discs (NADs). During extension, the increase in the stress on the SIAD zygapophysial joints was less than that on NAD zygapophysial joints. Stresses on the NAD zygapophysial joints were higher than those on SIAD and physiological discs during rotation. The stress on the SIAD zygapophysial joints was not significantly different from that on physiological discs during rotation. For SIADs and NADs, the stresses on the zygapophysial joints and the displacements of the discs were greater compared with those of the physiological discs during extension. The SIADs affected the variations in the stresses on the implanted segment more than the NADs, and the SIADs protected the zygapophysial joints of the implanted segment to a higher degree than the NADs.

View Figures

View References

1	Swanson KE, Lindsey DP, Hsu KY, Zucherman JF and Yerby SA: The effects of an interspinous implant on intervertebral disc pressures. Spine (Phila Pa 1976). 28:26–32. 2003. View Article : Google Scholar : PubMed/NCBI
2	Sengupta DK: Dynamic stabilization devices in the treatment of low back pain. Neurol India. 53:466–474. 2005. View Article : Google Scholar : PubMed/NCBI
3	Shono Y, Kaneda K, Abumi K, McAfee PC and Cunningham BW: Stability of posterior spinal instrumentation and its effects on adjacent motion segments in the lumbosacral spine. Spine (Phila Pa 1976). 23:1550–1558. 1998. View Article : Google Scholar : PubMed/NCBI
4	Meyers KN, Campbell DA, Lipman JD, et al: Dynamics of an intervertebral disc prosthesis in human cadaveric spines. HSS J. 3:164–168. 2007. View Article : Google Scholar : PubMed/NCBI
5	Ha SK, Kim SH, Kim DH, Park JY, Lim DJ and Lee SK: Biomechanical study of lumbar spinal arthroplasty with a semi-constrained artificial disc (Activ L) in the human cadaveric spine. J Korean Neurosurg Soc. 45:169–175. 2009. View Article : Google Scholar : PubMed/NCBI
6	Austen S, Punt IM, Cleutjens JP, et al: Clinical, radiological, histological and retrieval findings of Activ-L and Mobidisc total disc replacements: a study of two patients. Eur Spine J. 4:S513–S520. 2012. View Article : Google Scholar : PubMed/NCBI
7	Rohlmann A, Mann A, Zander T and Bergmann G: Effect of an artificial disc on lumbar spine biomechanics: a probabilistic finite element study. Eur Spine J. 18:89–97. 2009. View Article : Google Scholar : PubMed/NCBI
8	Kim KT, Lee SH, Suk KS, Lee JH and Jeong BO: Biomechanical changes of the lumbar segment after total disc replacement: Charite^®, Prodisc^® and Maverick^® using finite element model study. J Korean Neurosurg Soc. 47:446–453. 2010. View Article : Google Scholar : PubMed/NCBI
9	Yao QQ, Wang LM, Gui JC, et al: Three dimension finite element model of the earlier-period degeneration lumbar motion segments reconstructed from CT images. Acta Universitatis Medicinalis Nanjing. 27:1084–1087. 2007.(In Chinese).
10	Goto K, Tajima N, Chosa E, et al: Effects of lumbar spinal fusion on the other lumbar intervertebral levels (three-dimensional finite element analysis). J Orthop Sci. 8:577–584. 2003. View Article : Google Scholar : PubMed/NCBI
11	Yamamoto I, Panjabi MM, Crisco T and Oxland T: Three-dimensional movements of the whole lumbar spine and lumbosacral joint. Spine (Phila Pa 1976). 14:1256–1260. 1989. View Article : Google Scholar : PubMed/NCBI
12	Fujiwara A, Lim TH, An HS, et al: The effect of disc degeneration and facet joint osteoarthritis on the segmental flexibility of the lumbar spine. Spine (Phila Pa 1976). 25:3036–3044. 2000. View Article : Google Scholar : PubMed/NCBI
13	Aghayev E, Röder C, Zweig T, Etter C and Schwarzenbach O: Benchmarking in the SWISSspine registry: results of 52 Dynardi lumbar total disc replacements compared with the data pool of 431 other lumbar disc prostheses. Eur Spine J. 19:2190–2199. 2010. View Article : Google Scholar : PubMed/NCBI
14	Chou WY, Hsu CJ, Chang WN and Wong CY: Adjacent segment degeneration after lumbar spinal posterolateral fusion with instrumentation in elderly patients. Arch Orthop Trauma Surg. 122:39–43. 2002. View Article : Google Scholar : PubMed/NCBI
15	McMillan DW, McNally DS, Garbutt G and Adams MA: Stress distributions inside intervertebral discs: the validity of experimental ‘stress profilometry’. Proc Inst Mech Eng. 210:81–87. 1996.PubMed/NCBI
16	Simpson EK, Parkinson IH, Manthey B and Fazzalari NL: Intervertebral disc disorganization is related to trabecular bone architecture in the lumbar spine. J Bone Miner Res. 16:681–687. 2001. View Article : Google Scholar : PubMed/NCBI
17	Whitecloud TS 3rd, Castro FP Jr, Brinker MR, Hartzog CW Jr, Ricciardi JE and Hill C: Degenerative conditions of the lumbar spine treated with intervertebral titanium cages and posterior instrumentation for circumferential fusion. J Spinal Disord. 11:479–486. 1998.
18	Schmidt R, Obertacke U, Nothwang J, et al: The impact of implantation technique on frontal and sagittal alignment in total lumbar disc replacement: a comparison of anterior versus oblique implantation. Eur Spine J. 19:1534–1539. 2010. View Article : Google Scholar : PubMed/NCBI
19	Katsimihas M, Bailey CS, Issa K, et al: Prospective clinical and radiographic results of CHARITÉ III artificial total disc arthroplasty at 2- to 7-year follow-up: a Canadian experience. Can J Surg. 53:408–4145. 2010.
20	Vicars R, Hyde PJ, Brown TD, et al: The effect of anterior-posterior shear load on the wear of ProDisc-L TDR. Eur Spine J. 19:1356–1362. 2010. View Article : Google Scholar : PubMed/NCBI
21	Schmidt H, Midderhoff S, Adkins K and Wilke HJ: The effect of different design concepts in lumbar total disc arthroplasty on the range of motion, facet joint forces and instantaneous center of rotation of a L4–5 segment. Eur Spine J. 18:1695–1705. 2009.PubMed/NCBI
22	Robinson Y and Sandén B: Spine imaging after lumbar disc replacement: pitfalls and current recommendations. Patient Saf Surg. 3:152009. View Article : Google Scholar : PubMed/NCBI
23	Berg S, Tullberg T, Branth B, Olerud C and Tropp H: Total disc replacement compared to lumbar fusion: a randomised controlled trial with 2-year follow-up. Eur Spine J. 18:1512–1519. 2009.PubMed/NCBI
24	Sasso RC, Foulk DM and Hahn M: Prospective, randomized trial of metal-on-metal artificial lumbar disc replacement: initial results for treatment of discogenic pain. Spine (Phila Pa 1976). 33:123–131. 2008. View Article : Google Scholar
25	Nie WZ, Zhang XA and Wang CT: Biomechanics Research on Artificial Disk of Maverick. Beijing Biomedical Engineering. 28:4–7. 2009.(In Chinese).
26	Valdevit A and Errico TJ: Design and evaluation of the FlexiCore metal-on-metal intervertebral disc prosthesis. Spine J. 4:276S–288S. 2004. View Article : Google Scholar : PubMed/NCBI
27	Yue JJ, Bertagnoli R, McAfee PC and An HS: Motion Preservation Surgery of the Spine. 1st edition. Elsevier; Philadelphia, PA: pp. 25–28. 2008
28	Nie L, Hou Y and Cheng L: Spinal motor function reconstruction surgery-spinal non-fusion theory and surgical techniques. Shandong Science and Technology Press; Jinan: pp. 91–95. 2008, (In Chinese).
29	Nie L, Hou Y and Cheng L: Spinal motor function reconstruction surgery-spinal non-fusion theory and surgical techniques. Shandong Science and Technology Press; Jinan: pp. 84–91. 2008, (In Chinese).
30	McNally D, Naylor J and Johnson S: An in vitro biomechanical comparison of Cadisc™-L with natural lumbar discs in axial compression and sagittal flexion. Eur Spine J. 21(Suppl 5): S612–S617. 2012.PubMed/NCBI
31	Yue JJ, Bertagnoli R, McAfee PC and An HS: Chapter 3. Motion Preservation Surgery of the Spine. 1st edition. Elsevier; Philadelphia, PA: pp. 29–31. 2008
32	Moumene M and Geisler FH: Comparison of biomechanical function at ideal and varied surgical placement for two lumbar artificial disc implant designs: mobile-core versus fixed-core. Spine (Phila Pa 1976). 32:1840–1851. 2007. View Article : Google Scholar : PubMed/NCBI
33	Rohlmann A, Mann A, Zander T and Bergmann G: Effect of an artificial disc on lumbar spine biomechanics: a probabilistic finite element study. Eur Spine J. 18:89–97. 2009. View Article : Google Scholar : PubMed/NCBI
34	Zhong ZC, Wei SH, Wang JP, Feng CK, Chen CS and Yu CH: Finite element analysis of the lumbar spine with a new cage using a topology optimization method. Med Eng Phys. 28:90–98. 2006. View Article : Google Scholar : PubMed/NCBI
35	Zhong ZC, Wei SH, Wang JP, Feng CK, Chen CS and Yu CH: Finite element analysis of the lumbar spine with a new cage using a topology optimization method. Med Eng Phys. 28:90–98. 2006. View Article : Google Scholar : PubMed/NCBI