Yangzhi Rehabilitation Hospital, Sunshine Rehabilitation Centre, Tongji University School of Medicine, Shanghai 201619, China; Biomechanics Laboratory, Tongji University School of Medicine, Shanghai 200092, China.
Biomechanics Laboratory, Tongji University School of Medicine, Shanghai 200092, China.
Spine J. 2018 Dec;18(12):2288-2296. doi: 10.1016/j.spinee.2018.07.001. Epub 2018 Jul 7.
BACKGROUND CONTEXT: Anterior vertebral body osteophytes are common with degeneration but their biomechanical influence on the whole lumbar spine remains unclear. PURPOSE: To investigate the biomechanical influence of anterior vertebral body osteophytes on the whole lumbar spine. STUDY DESIGN/SETTING: This is a study using finite element analysis. OUTCOME MEASURES: Intersegmental rotation, maximum Mises stress, and intradiscal pressure on the intervertebral discs of different lumbar levels were calculated. METHODS: A finite element model of an intact lumbar spine was constructed and validated against in vitro studies. The modified models, which had different degrees of anterior vertebral body osteophyte formation (OF) in combination with disc space narrowing, were applied with physiological loadings. RESULTS: The lumbar levels with various degrees of OF altered the kinematics of these levels, which also affected the whole lumbar spine. In flexion and lateral bending, the segment that was one level inferior to the vertebra with OF showed a trend towards increased range of motion. On the intervertebral discs that were one level inferior to the OF level, a trend towards increase in the maximum von Mises stress was found on the annulus. CONCLUSIONS: Segments adjacent to levels with anterior vertebral body osteophytes showed increased intersegmental rotation and maximum stress. Further clinical observation should be performed to verify the results in vivo.
背景:前椎体骨赘在退变中很常见,但它们对整个腰椎的生物力学影响尚不清楚。
目的:研究前椎体骨赘对整个腰椎的生物力学影响。
研究设计/设置:这是一项使用有限元分析的研究。
测量指标:计算不同腰椎节段的节段间旋转、最大米塞斯应力和椎间盘内压。
方法:构建完整腰椎的有限元模型,并与体外研究进行验证。应用生理负荷对具有不同程度前椎体骨赘形成(OF)的改良模型进行了模拟,同时还模拟了椎间盘间隙变窄的情况。
结果:具有不同程度 OF 的腰椎节段改变了这些节段的运动学,也影响了整个腰椎。在前椎体骨赘水平以下的一个节段,在屈伸和侧屈时,运动范围有增加的趋势。在前椎体骨赘水平以下的椎间盘上,发现环的最大 von Mises 应力有增加的趋势。
结论:与前椎体骨赘相邻的节段表现出较大的节段间旋转和最大应力。应进行进一步的临床观察,以验证体内的结果。
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