J Korean Neurosurg Soc.  2016 Mar;59(2):91-97. 10.3340/jkns.2016.59.2.91.

Biomechanical Comparison of Spinal Fusion Methods Using Interspinous Process Compressor and Pedicle Screw Fixation System Based on Finite Element Method

• Choi J
• Kim S
• Shin DA

• KMID: 2192037
• DOI: http://doi.org/10.3340/jkns.2016.59.2.91

Abstract

OBJECTIVE
To investigate the biomechanical effects of a newly proposed Interspinous Process Compressor (IPC) and compare with pedicle screw fixation at surgical and adjacent levels of lumbar spine.
METHODS
A three dimensional finite element model of intact lumbar spine was constructed and two spinal fusion models using pedicle screw fixation system and a new type of interspinous devices, IPC, were developed. The biomechanical effects such as range of motion (ROM) and facet contact force were analyzed at surgical level (L3/4) and adjacent levels (L2/3, L4/5). In addition, the stress in adjacent intervertebral discs (D2, D4) was investigated.
RESULTS
The entire results show biomechanical parameters such as ROM, facet contact force, and stress in adjacent intervertebral discs were similar between PLIF and IPC models in all motions based on the assumption that the implants were perfectly fused with the spine.
CONCLUSION
The newly proposed fusion device, IPC, had similar fusion effect at surgical level, and biomechanical effects at adjacent levels were also similar with those of pedicle screw fixation system. However, for clinical applications, real fusion effect between spinous process and hooks, duration of fusion, and influence on spinous process need to be investigated through clinical study.

Keyword

Intervertebral disc degeneration; Pedicle screw; Interspinous device; Finite element analysis; Range of motion

MeSH Terms

Finite Element Analysis
Intervertebral Disc
Intervertebral Disc Degeneration
Methods*
Range of Motion, Articular
Spinal Fusion*
Spine

Figure

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  Fig. 1 Geometry of the proposed interspinous process compressor device, which consists of bone block, superior hook, screw, and inferior hook.

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  Fig. 2 Finite element models of lumbar spine with no implant (A), PEEK cage and pedicle screw implemented by posterior lumbar interbody fusion method (B) and PEEK cage and interspinous process compressor systems (C). PEEK : polyether ether ketone.

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  Fig. 3 Comparison of range of motion (ROM) between the present study and Yamamoto et al.'s28) study.

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  Fig. 4 ROM of the PLIF and IPC models at surgical level (L3/4) (A) and adjacent levels (L2/3, L4/5) (B) in extension, flexion, bending and torsion, compared to the intact model. ROM : range of motion, INT : intact transverse ligament, PLIF : posterior lumbar interbody fusion, IPC : Interspinous Process Compressor.

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  Fig. 5 Von Mises stress in the intervertebral disc of the PLIF and IPC models at adjacent levels (D2, D4) in extension, flexion, bending and torsion, compared to the intact model. INT : intact transverse ligament, PLIF : posterior lumbar interbody fusion, IPC : Interspinous Process Compressor.

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  Fig. 6 Facet contact force of PLIF and IPC models at adjacent levels (L2/3, L4/5) in extension, flexion, bending and torsion, compared to the intact model. INT : intact transverse ligament, PLIF : posterior lumbar interbody fusion, IPC : Interspinous Process Compressor.

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