Long-Term Effects of Segmental Lumbar Spinal Fusion on Adjacent Healthy Discs: A Finite Element Study

• Published in: Asian spine journal Vol. 10; no. 2; pp. 205 - 214
• Main Authors: Srinivas, Gunti Ranga, Deb, Anindya, Kumar, Malhar N, Kurnool, Goutham
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Society of Spine Surgery 01.04.2016; Korean Spine Society; 대한척추외과학회
• Subjects: Back surgery; Basic Study; Boundary conditions; Intervertebral disc; Intervertebral disc degeneration; Intervertebral discs; Ligaments; Long-term effects; Lumbar vertebrae; Skin & tissue grafts; Spinal fusion; Spine (lumbar); 정형외과학; Intervertebral disc degeneration; Lumbar vertebrae; Intervertebral disc; Spinal fusion
• ISSN: 1976-1902; 1976-7846
• DOI: 10.4184/asj.2016.10.2.205

Experimental study. The aim of the study was to develop a finite element (FE) model to study the long-term effects of various types of lumbar spinal interventions on the discs adjacent to the fused segment. Earlier FE studies have been limited to one particular type of fusion and comparative quantification of the adjacent disc stresses for different types of surgical interventions has not been reported. A computer aided engineering (CAE) based approach using implicit FE analysis assessed the stresses in the lumbar discs adjacent to the fused segment following anterior and posterior lumbar spine fusions at one, two and three levels (with and without instrumentation). It was found that instrumentation and length of fusion were the most significant factors in increasing adjacent level stresses in the lumbar discs. In the present study, a calibrated FE model that examined spinal interventions under similar loading and boundary conditions was used to provide quantitative data which would be useful for clinicians to understand the probable long-term effect of their choice of surgical intervention.