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Investigate the Spinal Fusion and Internal Fixation of Degenerative Lumbar Unsteadiness Inducing the Degeneration of the Adjacent Segments by Means of Finite Element Method

Author: WangWenKai
Tutor: HanDeZuo
School: Fujian Medical
Course: Surgery
Keywords: Lumbar instability Internal fixation Adjacent segment Finite Element
CLC: R681.53
Type: Master's thesis
Year: 2008
Downloads: 89
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Abstract


[Objective] To explore the degenerative lumbar spinal instability underwent posterior fusion and internal fixation of its adjacent segment degeneration process , thereby guide clinical lumbar instability choice of treatment and provide a theoretical basis , provide the basis for the focus of clinical surgery and surgical fusion of the choice of the fixed segment ; the load segment all directions , postoperative functional exercise guidance . 【Method】 Using finite element analysis software Super-SapV the lumbar CT image of the volunteers completed the normal lumbar motion segment (L2-S1) finite element model , by changing the relevant biological parameters , based on the normal model degeneration The lumbar model and fixed within the model (L4-5). Then were loaded on the degeneration and within a fixed model including vertical flexion , extension , lateral bending , and left and right to reverse the direction of the load seven calculate their respective adjacent segment stress change , and compared with each other . 【Results】 1 L4-5 back renegade segment Posterior lumbar interbody fusion fixation , adjacent segment disc (L3-4, L5-S1) in all directions of load each node Von Mises stress values ??compared with surgery before the increase (P lt; 0.01). 2 L4-5 back renegade segment Posterior lumbar interbody fusion fixation in flexion, lateral bending , and left and right torsional load L3-4 disc each node increase in the value of the Von Mises stress is more obvious than the L5-S1 segment increased (P lt; 0.01). 3 retire renegade segment line interbody fusion fixation, or so twisted reproduced upload neighboring L3 - 4 and L5 - S1 segment the intervertebral node Von Mises stress values ??increased most significantly ( P lt; 0.01 ) . Conclusion 1 degenerative lumbar instability line Posterior lumbar interbody fusion and internal fixation , adjacent segments intervertebral stress load increases speed up the process of degeneration ; and increase in the intervertebral stress load on proximal adjacent segment than the remote more obvious that proximal adjacent segment degeneration speed up more than remote . 2 degenerative lumbar instability line Posterior lumbar interbody fusion fixation or so torsional load the intervertebral stress load of the adjacent segment increased most significantly , that is most vulnerable to accelerate its adjacent segment degeneration .

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CLC: > Medicine, health > Surgery > Orthopaedic Surgery ( movement system diseases,orthopedic surgery ) > Bone diseases > Spine and back disorders > Spinal joint disease
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