Differences in 3D vs. 2D analysis in lumbar spinal fusion simulations
Autor: | Maxim Bashkuev, Matthias Pumberger, Hung-Wei Hsu, Hendrik Schmidt |
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Rok vydání: | 2017 |
Předmět: |
Materials science
Bridging (networking) Finite Element Analysis Biomedical Engineering Biophysics Models Biological 03 medical and health sciences 0302 clinical medicine Lumbar Osteogenesis medicine Humans Orthopedics and Sports Medicine Bone formation 030222 orthopedics Fusion Lumbar Vertebrae Rehabilitation Stiffness Finite element method 2d analysis Biomechanical Phenomena Spinal Fusion Lordosis medicine.symptom 030217 neurology & neurosurgery Lumbar spinal fusion Algorithms Biomedical engineering |
Zdroj: | Journal of biomechanics. 72 |
ISSN: | 1873-2380 |
Popis: | Lumbar interbody fusion is currently the gold standard in treating patients with disc degeneration or segmental instability. Despite it having been used for several decades, the non-union rate remains high. A failed fusion is frequently attributed to an inadequate mechanical environment after instrumentation. Finite element (FE) models can provide insights into the mechanics of the fusion process. Previous fusion simulations using FE models showed that the geometries and material of the cage can greatly influence the fusion outcome. However, these studies used axisymmetric models which lacked realistic spinal geometries. Therefore, different modeling approaches were evaluated to understand the bone-formation process. Three FE models of the lumbar motion segment (L4–L5) were developed: 2D, Sym-3D and Nonsym-3D. The fusion process based on existing mechano-regulation algorithms using the FE simulations to evaluate the mechanical environment was then integrated into these models. In addition, the influence of different lordotic angles (5, 10 and 15°) was investigated. The volume of newly formed bone, the axial stiffness of the whole segment and bone distribution inside and surrounding the cage were evaluated. In contrast to the Nonsym-3D, the 2D and Sym-3D models predicted excessive bone formation prior to bridging (peak values with 36 and 9% higher than in equilibrium, respectively). The 3D models predicted a more uniform bone distribution compared to the 2D model. The current results demonstrate the crucial role of the realistic 3D geometry of the lumbar motion segment in predicting bone formation after lumbar spinal fusion. |
Databáze: | OpenAIRE |
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