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Effects of lumbar arthrodesis on the adjacent segments : analysis by finite element model

Other Titles
 요추 추체간 골유합술의 인접마디에 대한 영향 -유한요소법에 따른 분석 
Authors
 김태엽 
Department
 Dept. of Neurosurgery (신경외과학교실) 
Issue Date
2011
Description
Dept. of Medicine/석사
Abstract
Augmentation with posterior rigid fixation combined with transpedicular screw insertion, which is one of the most popular techniques for lumbar arthrodesis, shows benefits in immediate stabilization and a higher fusion rate, but is reportedly correlated with higher stress on adjacent segments. The purpose of this study was to evaluate the differences between surgical techniques in terms of the effects of arthrodesis on adjacent segments using three-dimensional finite element analysis. A finite element model of the human lumbar spine was developed. Three spinal segments (L2-L5) were used to investigate. The intact spinal model was validated by comparing it with previously reported models. Then, four arthrodesis models were analyzed and compared: (1) Anterior lumbar interbody fusion model; (2) Posterior lumbar interbody fusion model; (3) Semi-rigid fixation model; and (4) Rigid fixation model. Among these four models, the rigid fixation model showed the most stress, with increased intervertebral disc pressure and contact force of the facet joints of both the upper and lower adjacent segments. The second highest stress levels were seen in the semi-rigid fixation model and the lowest were seen in the anterior lumbar interbody fusion model. From these result, it was found that the effects of lumbar arthrodesis on adjacent segments could vary according to the surgical technique used for arthrodesis. Semi-rigid fixation deserves careful consideration and further detailed study because it may cause less stress on the adjacent segments than rigid fixation, while maintaining the benefits of the latter procedure.
Files in This Item:
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 2. Thesis
Yonsei Authors
Kim, Tae Yup(김태엽)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/133962
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