Influence of single-level lumbar degenerative disc disease on the behavior of the adjacent segments—A finite element model study

Fusion has been the gold standard treatment for treating lumbar degenerative disc disease. Many clinical studies have demonstrated that adjacent segment degeneration was observed in patients over time. Various instrumentations of pedicle screw-based stabilization systems have been investigated using numerical approaches. However, numerical models developed in the past were simplified to reduce computational time. The aim of this study was to evaluate and to compare the biomechanical performance of rigid, semi-rigid, and dynamic posterior instrumentations using a more realistic numerical model. Three-dimensional nonlinear finite element models of the T11-S1 multilevel spine with various posterior instrumentations were developed. The intersegmental rotation, the maximum disc stress, and the maximum implant stress were calculated. The results indicated that the rigid instrumentation resulted in greater fixation stability but also a greater risk of adjacent segment degeneration and implant failure. The biomechanical performance of the dynamic instrumentation was closer to that of the intact spine model compared with the rigid and semi-rigid instrumentations. The results of this study could help surgeons understand the biomechanical characteristics of different posterior instrumentations for the treatment of lumbar degenerative disc diseases.

Download Full-text

Novel Minimally Invasive Approaches to Lumbar Degenerative Disc Disease: Direct Lateral Approach to the Lumbar Spine

Journal of Neurological Surgery Part A Central European Neurosurgery ◽

10.1055/s-0034-1382191 ◽

2014 ◽

Vol 75 (S 01) ◽

Author(s):

J. Boddu ◽

J. Rostron ◽

A. Danison ◽

J. Hamilton

Keyword(s):

Lumbar Spine ◽

Minimally Invasive ◽

Degenerative Disc Disease ◽

Lateral Approach ◽

Disc Disease ◽

Lumbar Degenerative Disc Disease ◽

Degenerative Disc ◽

Direct Lateral Approach

Download Full-text

Titanium-interlayer mediated hydroxyapatite coating on polyetheretherketone: a prospective study in patients with single-level cervical degenerative disc disease

Journal of Translational Medicine ◽

10.1186/s12967-020-02688-z ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Ce Zhu ◽

Miaomiao He ◽

Lili Mao ◽

Tao Li ◽

Li Zhang ◽

...

Keyword(s):

Degenerative Disc Disease ◽

Fusion Rate ◽

Peek Cage ◽

Disc Disease ◽

Degenerative Disc ◽

Single Level ◽

Cervical Degenerative Disc Disease ◽

Post Operation

Abstract Background Currently, there are limited reports regarding investigation of the biological properties of polyetheretherketone (PEEK) coated with titanium (Ti) and hydroxyapatite (HA) in human. The objective of this study is to evaluate the in vivo response of the PEEK cages coated with Ti and HA versus uncoated PEEK cages after anterior cervical discectomy and fusion (ACDF) in patients with single-level cervical degenerative disc disease (CDDD). Methods Twenty-four patients with PEEK cages coated with Ti and HA (PEEK/Ti/HA group) were matched one-to-one with patients with uncoated PEEK cages (PEEK group) based on age, gender, and operative segment. All patients had been followed up for more than 2 years. Radiological assessments included intervertebral height (IH), C2-7 angle (C2-7a), segmental alignment (SA), and fusion rate. Clinical parameters included Visual Analogue Scale (VAS) and Japanese Orthopedic Association (JOA) scores. Results There was no statistical difference in SA, IH, and C2-7a between the two groups before and after surgery and all these parameters were restored postoperatively. The fusion rate of PEEK/Ti/HA group was significantly higher than PEEK group at 3-month post-operation (87.5% vs. 62.5%). At the last follow-up, the fusion rate of the both groups achieved 100%. The VAS and JOA scores were comparable between two groups and improved postoperatively. Conclusions In patients with single-level ACDF, PEEK cage coated with Ti and HA provided a higher fusion rate than uncoated PEEK cage at 3-month post-operation, while both two cages could achieve solid osseous fusion at the last follow up. Compared with the uncoated PEEK cage, PEEK/Ti/HA cage yielded similar favorable segmental and overall cervical lordosis, IH, and clinical outcomes after the surgery.

Download Full-text