Posterior Ligamentum Complex Preservation Alleviate ASD‐Related Biomechanical Deterioration in Lumbar Interbody Fusion Models: A Finite Element Analysis
ABSTRACT Background There are differences in the extent of excision of articular processes, spinal processes and posterior ligamentum complexes (PLC) for posterior approach lumbar interbody fusion. Given that the biomechanical significance of these structures has been verified and that deterioration...
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Wiley
2025-03-01
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| Online Access: | https://doi.org/10.1002/jsp2.70030 |
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| author | Lipeng He Tingchen Zhu Weiye Cai Wenhao Yang Zan Chen Jingchi Li |
| author_facet | Lipeng He Tingchen Zhu Weiye Cai Wenhao Yang Zan Chen Jingchi Li |
| author_sort | Lipeng He |
| collection | DOAJ |
| description | ABSTRACT Background There are differences in the extent of excision of articular processes, spinal processes and posterior ligamentum complexes (PLC) for posterior approach lumbar interbody fusion. Given that the biomechanical significance of these structures has been verified and that deterioration of the biomechanical environment is the main trigger for complications in both fused and adjacent motion segments, changes in decompression ranges may affect the potential risk of adjacent segmental disease (ASD) biomechanically; however, this topic has yet to be identified. Methods Posterior lumbar interbody fusion (PLIF) with different decompression strategies was simulated in a well‐validated lumbosacral model. The excision and preservation of the cranial motion of the segmental PLC and the lateral articular process in the fusion segment were simulated in this model. The stress distribution in the cranial motion segment was computed under different loading conditions to determine the potential risk of ASD. Results Compared to complete bilateral articular process excision, preservation of the lateral two‐thirds of the articular process did not alleviate stress concentration on the cranial motion segment both in PLC preserved and excised models. In contrast, preservation of the cranial segmental PLC can obviously alleviate the stress concentration tendency of the cranial intervertebral disc under flexion loading conditions. Conclusion Preservation of the lateral parts of the articular process cannot optimize the biomechanical environment, in contrast, PLC preservation can effectively alleviate ASD related biomechanical deterioration of the cranium segment. |
| format | Article |
| id | doaj-art-62caf9f0f1024b2590e0a8204a2cf70a |
| institution | DOAJ |
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| language | English |
| publishDate | 2025-03-01 |
| publisher | Wiley |
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| series | JOR Spine |
| spelling | doaj-art-62caf9f0f1024b2590e0a8204a2cf70a2025-08-20T03:11:04ZengWileyJOR Spine2572-11432025-03-0181n/an/a10.1002/jsp2.70030Posterior Ligamentum Complex Preservation Alleviate ASD‐Related Biomechanical Deterioration in Lumbar Interbody Fusion Models: A Finite Element AnalysisLipeng He0Tingchen Zhu1Weiye Cai2Wenhao Yang3Zan Chen4Jingchi Li5Department of Orthopaedics Jiangsu CM Clinical Innovation Center of Degenerative Bone & Joint Disease, Wuxi TCM Hospital Affiliated to Nanjing University of chinese Medicine Wuxi Jiangsu Province People's Republic of ChinaDepartment of Orthopaedics Jiangsu CM Clinical Innovation Center of Degenerative Bone & Joint Disease, Wuxi TCM Hospital Affiliated to Nanjing University of chinese Medicine Wuxi Jiangsu Province People's Republic of ChinaDepartment of Orthopedics, Luzhou Key Laboratory of Orthopedic Disorders, The Affiliated Traditional Chinese Medicine Hospital Southwest Medical University Luzhou Sichuan Province People's Republic of ChinaDepartment of Orthopedics, Luzhou Key Laboratory of Orthopedic Disorders, The Affiliated Traditional Chinese Medicine Hospital Southwest Medical University Luzhou Sichuan Province People's Republic of ChinaDepartment of Orthopedic, The Affiliated Hospital Southwest Medical University Luzhou Sichuan Province People's Republic of ChinaDepartment of Orthopedics, Luzhou Key Laboratory of Orthopedic Disorders, The Affiliated Traditional Chinese Medicine Hospital Southwest Medical University Luzhou Sichuan Province People's Republic of ChinaABSTRACT Background There are differences in the extent of excision of articular processes, spinal processes and posterior ligamentum complexes (PLC) for posterior approach lumbar interbody fusion. Given that the biomechanical significance of these structures has been verified and that deterioration of the biomechanical environment is the main trigger for complications in both fused and adjacent motion segments, changes in decompression ranges may affect the potential risk of adjacent segmental disease (ASD) biomechanically; however, this topic has yet to be identified. Methods Posterior lumbar interbody fusion (PLIF) with different decompression strategies was simulated in a well‐validated lumbosacral model. The excision and preservation of the cranial motion of the segmental PLC and the lateral articular process in the fusion segment were simulated in this model. The stress distribution in the cranial motion segment was computed under different loading conditions to determine the potential risk of ASD. Results Compared to complete bilateral articular process excision, preservation of the lateral two‐thirds of the articular process did not alleviate stress concentration on the cranial motion segment both in PLC preserved and excised models. In contrast, preservation of the cranial segmental PLC can obviously alleviate the stress concentration tendency of the cranial intervertebral disc under flexion loading conditions. Conclusion Preservation of the lateral parts of the articular process cannot optimize the biomechanical environment, in contrast, PLC preservation can effectively alleviate ASD related biomechanical deterioration of the cranium segment.https://doi.org/10.1002/jsp2.70030biomechanical deteriorationcapsuleiatrogenic capsule injurymotion segmentposterior lumbar interbody fusion |
| spellingShingle | Lipeng He Tingchen Zhu Weiye Cai Wenhao Yang Zan Chen Jingchi Li Posterior Ligamentum Complex Preservation Alleviate ASD‐Related Biomechanical Deterioration in Lumbar Interbody Fusion Models: A Finite Element Analysis JOR Spine biomechanical deterioration capsule iatrogenic capsule injury motion segment posterior lumbar interbody fusion |
| title | Posterior Ligamentum Complex Preservation Alleviate ASD‐Related Biomechanical Deterioration in Lumbar Interbody Fusion Models: A Finite Element Analysis |
| title_full | Posterior Ligamentum Complex Preservation Alleviate ASD‐Related Biomechanical Deterioration in Lumbar Interbody Fusion Models: A Finite Element Analysis |
| title_fullStr | Posterior Ligamentum Complex Preservation Alleviate ASD‐Related Biomechanical Deterioration in Lumbar Interbody Fusion Models: A Finite Element Analysis |
| title_full_unstemmed | Posterior Ligamentum Complex Preservation Alleviate ASD‐Related Biomechanical Deterioration in Lumbar Interbody Fusion Models: A Finite Element Analysis |
| title_short | Posterior Ligamentum Complex Preservation Alleviate ASD‐Related Biomechanical Deterioration in Lumbar Interbody Fusion Models: A Finite Element Analysis |
| title_sort | posterior ligamentum complex preservation alleviate asd related biomechanical deterioration in lumbar interbody fusion models a finite element analysis |
| topic | biomechanical deterioration capsule iatrogenic capsule injury motion segment posterior lumbar interbody fusion |
| url | https://doi.org/10.1002/jsp2.70030 |
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