Coogan Jessica S, Francis W Loren, Eliason Travis D, Bredbenner Todd L, Stemper Brian D, Yoganandan Narayan, Pintar Frank A, Nicolella Daniel P
Southwest Research Institute , San Antonio, TX , USA.
Spinal Stabilization Technologies , San Antonio, TX , USA.
Front Bioeng Biotechnol. 2016 Dec 1;4:93. doi: 10.3389/fbioe.2016.00093. eCollection 2016.
Nucleus replacement technologies are a minimally invasive alternative to spinal fusion and total disc replacement that have the potential to reduce pain and restore motion for patients with degenerative disc disease. Finite element modeling can be used to determine the biomechanics associated with nucleus replacement technologies. The current study focuses on a new nucleus replacement device designed as a conforming silicone implant with an internal void. A validated finite element model of the human lumbar L3-L4 motion segment was developed and used to investigate the influence of the nucleus replacement device on spine biomechanics. In addition, the effect of device design changes on biomechanics was determined. A 3D, L3-L4 finite element model was constructed from medical imaging data. Models were created with the normal intact nucleus, the nucleus replacement device, and a solid silicone implant. Probabilistic analysis was performed on the normal model to provide quantitative validation metrics. Sensitivity analysis was performed on the silicone Shore A durometer of the device. Models were loaded under axial compression followed by flexion/extension, lateral bending, or axial rotation. Compressive displacement, endplate stresses, reaction moment, and annulus stresses were determined and compared between the different models. The novel nucleus replacement device resulted in similar compressive displacement, endplate stress, and annulus stress and slightly higher reaction moment compared with the normal nucleus. The solid implant resulted in decreased displacement, increased endplate stress, decreased annulus stress, and decreased reaction moment compared with the novel device. With increasing silicone durometer, compressive displacement decreased, endplate stress increased, reaction moment increased, and annulus stress decreased. Finite element analysis was used to show that the novel nucleus replacement device results in similar biomechanics compared with the normal intact nucleus.
核置换技术是一种微创替代脊柱融合和全椎间盘置换的方法,有可能减轻退行性椎间盘疾病患者的疼痛并恢复其活动能力。有限元建模可用于确定与核置换技术相关的生物力学。当前的研究聚焦于一种新型核置换装置,其设计为带有内部空隙的贴合式硅胶植入物。开发了一个经过验证的人体腰椎L3-L4运动节段的有限元模型,并用于研究核置换装置对脊柱生物力学的影响。此外,还确定了装置设计变化对生物力学的影响。根据医学成像数据构建了一个三维的L3-L4有限元模型。创建了包含正常完整椎间盘、核置换装置和实心硅胶植入物的模型。对正常模型进行概率分析以提供定量验证指标。对装置的硅胶邵氏A硬度进行了敏感性分析。模型在轴向压缩后进行屈曲/伸展、侧弯或轴向旋转加载。确定并比较了不同模型之间的压缩位移、终板应力、反作用力矩和纤维环应力。与正常椎间盘相比,新型核置换装置产生了相似的压缩位移、终板应力和纤维环应力,且反作用力矩略高。与新型装置相比,实心植入物导致位移减小、终板应力增加、纤维环应力减小和反作用力矩减小。随着硅胶硬度的增加,压缩位移减小,终板应力增加,反作用力矩增加,纤维环应力减小。有限元分析表明,与正常完整椎间盘相比,新型核置换装置产生了相似的生物力学特性。