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研究生:LE MINH THAI
研究生(外文):LE MINH THAI
論文名稱:Treatment of Lumbar Degenerative Disc Disease Using Different Spinal Fixation Systems Based on Finite Element Method
論文名稱(外文):Treatment of Lumbar Degenerative Disc Disease Using Different Spinal Fixation Systems Based on Finite Element Method
指導教授:徐慶琪
指導教授(外文):Ching-Chi Hsu
口試委員:趙振綱釋高上徐慶琪
口試委員(外文):Ching-Kong ChaoKao-Shang ShihChing-Chi Hsu
口試日期:2017-06-13
學位類別:碩士
校院名稱:國立臺灣科技大學
系所名稱:應用科技研究所
學門:自然科學學門
學類:其他自然科學學類
論文種類:學術論文
論文出版年:2017
畢業學年度:105
語文別:英文
論文頁數:67
中文關鍵詞:Finite element analysesPedicle screw and rodTranslaminar facet screwTransfacet pedicle screwCoflex device
外文關鍵詞:Finite element analysesPedicle screw and rodTranslaminar facet screwTransfacet pedicle screwCoflex device
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Fusion has been the gold standard treatment for treating lumbar degenerative disc disease. Many clinical studies have demonstrated that adjacent segment degeneration was observed in patients over time. Various instrumentations of stabilization systems have been investigated using numerical approaches. However, numerical models developed in the past were simplified to reduce computational time or compare a few different stabilization systems. The aim of this study was to evaluate and to compare the biomechanical performance of different spinal fixation systems as pedicle screw and rod system, translaminar facet screw system, transfacet pedicle screw system, and Coflex system using a more realistic numerical model. Three-dimensional nonlinear finite element models of the T10-S1 multilevel spine with various posterior instrumentations were developed. The intersegmental rotation, the maximum disc stress, and the maximum implant stress were calculated. The results indicated that pedicle screw and rod system had the greatest stability but also a greater risk of adjacent segment failure. The biomechanical performance of Coflex system was closer to that of the intact spine model compared with pedicle screw and rod system, translaminar facet screw system, and transfacet pedicle screw system. The results of this study could help surgeons understand the biomechanical characteristics of different posterior instrumentations for the treatment of lumbar degenerative disc diseases
Fusion has been the gold standard treatment for treating lumbar degenerative disc disease. Many clinical studies have demonstrated that adjacent segment degeneration was observed in patients over time. Various instrumentations of stabilization systems have been investigated using numerical approaches. However, numerical models developed in the past were simplified to reduce computational time or compare a few different stabilization systems. The aim of this study was to evaluate and to compare the biomechanical performance of different spinal fixation systems as pedicle screw and rod system, translaminar facet screw system, transfacet pedicle screw system, and Coflex system using a more realistic numerical model. Three-dimensional nonlinear finite element models of the T10-S1 multilevel spine with various posterior instrumentations were developed. The intersegmental rotation, the maximum disc stress, and the maximum implant stress were calculated. The results indicated that pedicle screw and rod system had the greatest stability but also a greater risk of adjacent segment failure. The biomechanical performance of Coflex system was closer to that of the intact spine model compared with pedicle screw and rod system, translaminar facet screw system, and transfacet pedicle screw system. The results of this study could help surgeons understand the biomechanical characteristics of different posterior instrumentations for the treatment of lumbar degenerative disc diseases
ABSTRACT
ACKNOWLEGEMENT
TABLE CONTENTS
LIST OF FIGURES
LIST OF TABLES
CHAPTER 1: INTRODUCTION
1.1 Research Background and Study Purpose
1.2 Anatomy of Spine
1.2.1 Vertebral Column
1.2.2 Each vertebral bone and Intervertebral disc
1.2.3 Lumbar degenerative disease
1.3 Literatures Review
1.4 Structure of Thesis
CHAPTER 2: MATERIALS AND METHODS
2.1 Overview of Study Methodology
2.2 Stabilization Systems
2.2.1 Pedicle screw-rod System (PSR)
2.2.2 Translaminar facet screw System (TLFS) & Transfacet pedicle screw System (TFPS)
2.3 Finite Element Analysis
2.3.1 T10-S1 Multilevel Spine Models
2.3.2 Finite Element Models
2.4 Biomechanical Performances of Different Instrumentations
CHAPTER 3: RESULTS
3.1 Finite Element Analyses and Validation
3.2 Evaluation of Adjacent Segment Degeneration
3.3 Failure Risk of Intervertebral Discs
3.4 Failure Risk of the Stabilization Systems
CHAPTER 4: DISCUSSION
CHAPTER 5: CONCLUSION
REFERENCES
[1] S. Agazzi, A. Reverdin, and D. May, "Posterior lumbar interbody fusion with cages: an independent review of 71 cases," J Neurosurg, vol. 91, no. 2 Suppl, pp. 186-92, Oct 1999.
[2] P. Enker and A. D. Steffee, "Interbody fusion and instrumentation," Clin Orthop Relat Res, vol. 300, no. 300, pp. 90-101, Mar 1994.
[3] T. M.-D. Hsieh M-S, Yeh Y-D, Jou S-B, "Automatic spinal fracture diagnosis and surgical management based on 3D image analysis and reconstruction of CT transverse sections," Biomed Eng-App Bas C vol. 14, p. 204, 2002.
[4] X.-W. Zhao et al., "Interspinous process devices(IPD) alone versus decompression surgery for lumbar spinal stenosis(LSS): A systematic review and meta-analysis of randomized controlled trials," International Journal of Surgery, vol. 39, pp. 57-64, 3// 2017.
[5] J. Kuchta and P. J. Simons, "P137. Results of Interspinous Spacer Implantation (XStop, Wallis, Diam, Coflex) in a Single Center Study," The Spine Journal, vol. 8, no. 5, p. 167S, 2008/09/01/ 2008.
[6] A. A. Ghasemi, "Adjacent-segment degeneration after posterior lumbar fusion: An analysis of possible risk factors," Clinical Neurology and Neurosurgery, vol. 143, pp. 15-18, 4// 2016.
[7] A. Rohlmann, N. K. Burra, T. Zander, and G. Bergmann, "Comparison of the effects of bilateral posterior dynamic and rigid fixation devices on the loads in the lumbar spine: a finite element analysis," European Spine Journal, Journal article vol. 16, no. 8, pp. 1223-1231, 2007.
[8] T. A. Jahng, Y. E. Kim, and K. Y. Moon, "Comparison of the biomechanical effect of pedicle-based dynamic stabilization: a study using finite element analysis," The Spine Journal, vol. 13, no. 1, pp. 85-94, 2013/01/01/ 2013.
[9] "The Structure and Function of a Healthy Spine," https://my.clevelandclinic.org, 2017.
[10] "Anatomy of the Human Spine," https://www.mayfieldclinic.com, 2017.
[11] "Lumbar Spine Anatomy," http://emedicine.medscape.com, 2017.
[12] "Vertebral column," https://en.wikipedia.org, 2017.
[13] C. Y. Fan, C. C. Hsu, C. K. Chao, S. C. Lin, and K. H. Chao, "Biomechanical Comparisons of different posterior instrumentation constructs after two-level ALIF: a finite element study," Med Eng Phys, vol. 32, no. 2, pp. 203-11, Mar 2010.
[14] K.-S. Shih, C.-C. Hsu, S.-Y. Zhou, and S.-M. Hou, "Biomechanical Investigation of Pedicle Screw-Based Posterior Stabilization Systems for the Treatment of Lumbar Degenerative Disc Disease Using Finite Element Analyses," Biomedical Engineering: Applications, Basis and Communications, vol. 27, no. 06, p. 1550060, 2015.
[15] M. Lisa A. Ferrara, Jessica L.Secor, BS, Byung-ho Jin, MD, Andrew Wakefield, MD, Serkan Inceoglu, MS, and Edward C. Benzel, MD, "A Biomechanical Comparison of facet screw fixation and pedicle screw fixation," Spine, vol. 28, pp. 1226-1234, 2003.
[16] M. Dieter Adelt, Jacques Samani, MD, Woo-Kyung Kim, MD, PhD , Marcus Eif, MD , and M. Gary L. Lowery, PhD and Robert J. Chomiak, MS, "coflex Interspinous Stabilization: Clinical and Radiographic Results from an International Multicenter Retrospective Study," Paradigm Spine 2007.
[17] O. T. Panjabi MM, Yamamoto I, Crisco JJ, "Mechanical behavior of the human lumbar and lumbosacral spine as shown by three-dimensional load-displacement curves," J Bone Joint Surg Am, vol. 76, p. 413, 1994.
[18] L. S. Chen SH, Tsai WC, Wang CW, Chao SH, "Biomechanical comparison of unilateral and bilateral pedicle screw fixation for transforaminal lumbar interbody fusion after decompressive surgery - A finite element analysis," BMC Musculoskel Disord, vol. 13, p. 72, 2012.
[19] N. S. Rohlmann A, Claes L, Bergmann G, Wilke HJ, "Influence of a follower load on intradiscal pressure and intersegmental rotation of the lumbar spine," Spine, vol. 26, p. E557, 2001.
[20] P. M. Yamamoto I, Crisco T, Oxland T, "Threedimensional movements of the whole lumbar spine and lumbosacral joint," Spine, vol. 14, p. 1256, 1989.
[21] A. Faizan, V. K. Goel, A. Biyani, S. R. Garfin, and C. M. Bono, "Adjacent level effects of bi-level disc replacement, bi-level fusion and disc replacement plus fusion in cervical spine- a finite element based study," Clinical Biomechanics, vol. 27, no. 3, pp. 226-233, 3// 2012.
[22] Z. T. Rohlmann A, Schmidt H, Wilke HJ, Bergmann Garfin, Steven R., "Analysis of the influence of disc degeneration on the mechanical behavior of a lumbar motion segment using the finite element method," J Biomech, vol. 39, p. 1287, 2006.
[23] W. R. Jones AC, "Finite element analysis of the spine: Towards a framework of verification, validation and sensitivity analysis," Med Eng Phys, vol. 30, p. 1287, 2006.
[24] I. H, "Three-dimensional architecture of lumbar intervertebral discs," Spine, vol. 6, p. 139, 1981.
[25] H. Schmidt, A. Kettler, A. Rohlmann, L. Claes, and H.-J. Wilke, "The risk of disc prolapses with complex loading in different degrees of disc degeneration – A finite element analysis," Clinical Biomechanics, vol. 22, no. 9, pp. 988-998, 11// 2007.
[26] S. J. Cunningham BW, Shono Y, McAfee PC, "Static and cyclical biomechanical analysis of pedicle screw spinal constructs," Spine, vol. 25, p. 1S, 2000.
[27] C. K. Chao, C. C. Hsu, J. L. Wang, and J. Lin, "Increasing bending strength and pullout strength in conical pedicle screws: biomechanical tests and finite element analyses," J Spinal Disord Tech, vol. 21, no. 2, pp. 130-8, Apr 2008.
[28] C. K. Chao, J. Lin, S. T. Putra, and C. C. Hsu, "A neurogenetic approach to a multiobjective design optimization of spinal pedicle screws," J Biomech Eng, vol. 132, no. 9, p. 091006, Sep 2010.
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