Comparison of patient-specific computational models vs. clinical follow-up, for adjacent segment disc degeneration and bone remodelling after spinal fusion
| Autor: | Aron Lazary, Peter Endre Eltes, Damien Lacroix, Marie-Christine Ho Ba Tho, Veronique Barthelemy, Bert van Rietbergen, Keita Ito, Marc van Rijsbergen, Jérôme Noailly, W Wouter Wilson |
|---|---|
| Přispěvatelé: | Biomedical Engineering, Orthopaedic Biomechanics |
| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Male Vertebrae Bone density medicine.medical_treatment lcsh:Medicine Degeneration (medical) Intervertebral Disc Degeneration Bone remodeling 0302 clinical medicine Precision Medicine lcsh:Science Intervertebral Disc Surgical and invasive medical procedures Fusion Multidisciplinary Lumbar Vertebrae Low back pain Adaptation Physiological Biomechanical Phenomena medicine.anatomical_structure Spinal fusion Female Radiology Bone Remodeling medicine.symptom Algorithms Adult medicine.medical_specialty Finite Element Analysis Models Biological 03 medical and health sciences Chondrocytes Imaging Three-Dimensional medicine Humans Computer Simulation business.industry lcsh:R Intervertebral disc Spine 030104 developmental biology Spinal Fusion Disc degeneration lcsh:Q sense organs business Collagens Low Back Pain 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | PLoS ONE, Vol 13, Iss 8, p e0200899 (2018) PLoS ONE, 13(8):e0200899. Public Library of Science |
| ISSN: | 1932-6203 |
| Popis: | 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. The research leading to these results has received funding from the European Union Seventh Framework Programme (FP7-ICT-2009-6) under grant agreement n° 269909 |
| Databáze: | OpenAIRE |
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