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. 2021 Mar-Apr;37(2):403-408.
doi: 10.12669/pjms.37.2.3223.

Biomechanical effects of osteoporosis on adjacent segments after posterior lumbar interbody fusion: A finite element study

Chenchen Zhang  1 , Minmin Chang  2 , Renwen Zhang  3 , Shujie Tang  4
Affiliations

Biomechanical effects of osteoporosis on adjacent segments after posterior lumbar interbody fusion: A finite element study

Chenchen Zhang et al. Pak J Med Sci. 2021 Mar-Apr.

Abstract

Objective: To investigate the biomechanical effects of osteoporosis on adjacent segments after posterior lumbar interbody fusion (PLIF).

Methods: This study was designed and conducted in the Traumatology and Orthopedics Laboratory, School of Chinese Medicine, Jinan University, Guangzhou, China, between December 2019 and February 2020. A healthy finite element model of L3-S1 was developed along with one PLIF model and one PLIF with osteoporosis model. Based on a hybrid test method, the inferior surface of S1 was entirely fixed, and a preload of 400N combined with an adjusted moment was imposed on the superior surface of L3 in each model to simulate flexion, extension, lateral bending and axial rotation. The intradiscal pressure (IDP), shear stress on annulus fibrosus, and the range of motion (ROM) of L3-L4 and L5-S1 were calculated and compared.

Results: In each direction, the highest value of IDP and shear stress on annulus fibrosus at L3-L4 and L5-S1 was found in the PLIF model, and the lowest value in the healthy model. The largest ROM at L4-L5 appeared in the healthy model, and the smallest value in the PLIF model in each direction. At L3-L4 and L5-S1, the highest ROM in most directions was found in the PLIF model, followed by the PLIF with osteoporosis model, and the lowest value in the healthy model.

Conclusions: Osteoporosis can decrease IDP, shear stress on annulus fibrosus, and ROM at adjacent levels, and slow down the development of ASD after PLIF.

Keywords: Adjacent segmental degeneration (ASD); Finite element study; Osteoporosis; Posterior lumbar interbody fusion (PLIF).

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Figures

Fig.1
Fig.1
The finite element models in the current study (A: healthy model, B: posterior lumbar interbody fusion model).
Fig.2
Fig.2
The distribution of intradiscal pressure.
Fig.3
Fig.3
The intradiscal pressure nephogram of the models in flexion and extension.
Fig.4
Fig.4
The distribution of shear stress on annulus fibrosus.
Fig.5
Fig.5
The distribution of range of motion.
See this image and copyright information in PMC

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