Comparison of patient-specific computational models vs. clinical follow-up, for adjacent segment disc degeneration and bone remodelling after spinal fusion.

Autor: Rijsbergen MV; Orthopaedic Biomechanics, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands., van Rietbergen B; Orthopaedic Biomechanics, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands., Barthelemy V; Orthopaedic Biomechanics, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands., Eltes P; National Center for Spinal Disorders, Buda Health Center, Budapest, Hungary., Lazáry Á; National Center for Spinal Disorders, Buda Health Center, Budapest, Hungary., Lacroix D; INSIGNEO Institute for in silico Medicine, Department of Mechanical Engineering, University of Sheffield, Sheffield, United Kingdom., Noailly J; BCN MedTech, Department of Information and Communication Technologies, Universitat Pompeu Fabra (UPF), Barcelona, Spain., Ho Ba Tho MC; University of Technology of Compiègne, Compiègne, France., Wilson W; Orthopaedic Biomechanics, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands., Ito K; Orthopaedic Biomechanics, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2018 Aug 30; Vol. 13 (8), pp. e0200899. Date of Electronic Publication: 2018 Aug 30 (Print Publication: 2018).
DOI: 10.1371/journal.pone.0200899
Abstrakt: Spinal fusion is a standard surgical treatment for patients suffering from low back pain attributed to disc degeneration. However, results are somewhat variable and unpredictable. With fusion the kinematic behaviour of the spine is altered. Fusion and/or stabilizing implants carrying considerable load and prevent rotation of the fused segments. Associated with these changes, a risk for accelerated disc degeneration at the adjacent levels to fusion has been demonstrated. However, there is yet no method to predict the effect of fusion surgery on the adjacent tissue levels, i.e. bone and disc. The aim of this study was to develop a coupled and patient-specific mechanoregulated model to predict disc generation and changes in bone density after spinal fusion and to validate the results relative to patient follow-up data. To do so, a multiscale disc mechanoregulation adaptation framework was developed and coupled with a previously developed bone remodelling algorithm. This made it possible to determine extra cellular matrix changes in the intervertebral disc and bone density changes simultaneously based on changes in loading due to fusion surgery. It was shown that for 10 cases the predicted change in bone density and degeneration grade conforms reasonable well to clinical follow-up data. This approach helps us to understand the effect of surgical intervention on the adjacent tissue remodelling. Thereby, providing the first insight for a spine surgeon as to which patient could potentially be treated successfully by spinal fusion and in which patient has a high risk for adjacent tissue changes.
Competing Interests: The authors have declared that no competing interests exist.
Databáze: MEDLINE
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