School of Mechanical Engineering and Automation, Northeastern University, No. 3-11, Wenhua Road, Heping District, Shenyang, 110819, China.
Med Biol Eng Comput. 2019 Jan;57(1):89-98. doi: 10.1007/s11517-018-1838-8. Epub 2018 Jul 7.
Recently, interspinous stabilization with Coflex-F implant has become an alternative to treat lumbar spinal stenosis (LSS). However, little attention focused on modifying the structure of the device to obtain the better clinic application. The purpose of this study was to design a new interspinous implant using topology optimization methods and evaluate its biomechanical performance. The finite element models of healthy lumbar spine and surgical lumbar spine with Coflex-F and Coflex-NEW (the new designed implant) were constructed. Finite element analysis was applied to each of the three models. The interspinous implant structure after topology optimization was remodeled at an 8% reduced volume compared with the Coflex-F device, and they can both provide stability in all motion at the surgical segment. Additionally, the advantage of Coflex-NEW was that it can decrease the von Mises stress of the implant structure in flexion, extension, torsion, and the spinous process in flexion, extension, and bending. The stress in spinous process with Coflex-NEW was well-distributed. Graphical abstract ᅟ.
最近，Coflex-F 植入物的棘突间稳定术已成为治疗腰椎管狭窄症（LSS）的一种替代方法。然而，很少有人关注对器械结构进行改进以获得更好的临床应用。本研究旨在使用拓扑优化方法设计一种新型的棘突间植入物，并评估其生物力学性能。构建了健康腰椎和手术腰椎的有限元模型，其中包含 Coflex-F 和 Coflex-NEW（新设计的植入物）。对这三个模型分别进行有限元分析。与 Coflex-F 器械相比，经过拓扑优化的棘突间植入物结构的体积缩小了 8%，并且在手术节段的所有运动中都能保持稳定性。此外，Coflex-NEW 的优势在于它可以降低器械结构在屈伸、扭转和屈伸时的棘突处的 von Mises 应力。Coflex-NEW 的棘突处的应力分布均匀。
