Temple University College of Engineering, Philadelphia, PA 19104, USA.
Med Eng Phys. 2013 Mar;35(3):357-64. doi: 10.1016/j.medengphy.2012.05.013. Epub 2012 Jun 27.
The current study aimed to compare the biomechanics of the L3-S1 spine segment treated either by fusion or total disc replacement (TDR) using the TRIUMPH(®) Lumbar Disc (Globus Medical, Audubon, PA). A validated three-dimensional, nonlinear finite element model (FEM) of L3-S1 was altered at L4/L5 by fusion and implantation of the TRIUMPH(®) Lumbar Disc. Under a hybrid testing protocol, the resultant range of motion (ROM), nucleus pressure at the adjacent levels, facet joint force, and anterior longitudinal ligament (ALL) force were analyzed. FEM predicted several changes in biomechanics when compared to the intact segment. The analyses suggest that posterolateral lumbar disc arthroplasty with the TRIUMPH(®) Lumbar Disc can preserve the mobility of the surgical level while not allowing excessive ROM and reducing segmental motion at the adjacent levels when compared to fusion. The current finite element model could be valuable for engineers and surgeons seeking to optimize TDR designs.
本研究旨在比较 L3-S1 脊柱节段在融合或全椎间盘置换（TDR）治疗下的生物力学特性，使用 TRIUMPH®腰椎间盘（Globus Medical，Audubon，PA）。通过融合和植入 TRIUMPH®腰椎间盘，改变了 L3-S1 的经过验证的三维非线性有限元模型（FEM）。在混合测试协议下，分析了运动范围（ROM）、相邻节段核压力、小关节力和前纵韧带（ALL）力。与完整节段相比，FEM 预测了几个生物力学变化。分析表明，与融合相比，使用 TRIUMPH®腰椎间盘进行后路腰椎间盘置换术可以在保留手术节段活动度的同时，不允许过度的 ROM，并减少相邻节段的节段运动。目前的有限元模型对于寻求优化 TDR 设计的工程师和外科医生可能具有重要价值。
