The effect of annulus fibrosus incision and foraminoplasty on lumbar biomechanics in percutaneous endoscopic lumbar discectomy: a finite element analysis.

IF 1.7 4区医学 Q3 COMPUTER SCIENCE, INTERDISCIPLINARY APPLICATIONS

Computer Methods in Biomechanics and Biomedical Engineering Pub Date : 2024-11-01 Epub Date: 2023-10-20 DOI:10.1080/10255842.2023.2271602

Kai-Hua Li, Hui Yang, Zhi-Guo Li, Xin-Long Ma

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引用次数: 0

Abstract

The objective of this study was to analyze the effects of annulus fibrosus incision and foraminoplasty on lumbar biomechanics during posterior lateral approach translaminar percutaneous endoscopic lumbar discectomy (PELD) using a lumbar 4/5 segment model and three-dimensional finite element analysis (FEA). We created a model of the L4 to L5 segment and performed simulated foraminoplasty, annulus fibrosus incision, and a combined operation. The models were tested under six working conditions, and we recorded the deformation and equivalent strain/stress of each group. Results showed that foraminoplasty can affect the stability and rotation axis of the segment during rotation without significantly impacting discal stress. Conversely, annulus fibrosus incision significantly increases discal stress except for when the patient is doing a forward flexion movement. We recommend that surgical maneuvers minimize the removal and destruction of the annulus fibrosus and that rotation movements are avoided during the short-term recovery period following PELD surgery.

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纤维环切开和椎间孔成形术对经皮内镜下腰椎间盘切除术中腰椎生物力学的影响：有限元分析。

本研究的目的是使用腰椎4/5节段模型和三维有限元分析（FEA），分析纤维环切开和椎间孔成形术在后外侧入路经皮内镜下腰椎间盘切除术（PELD）中对腰椎生物力学的影响。我们创建了L4至L5节段的模型，并进行了模拟椎间孔成形术、纤维环切开术和联合手术。模型在六种工作条件下进行了测试，我们记录了每组的变形和等效应变/应力。结果表明，椎间孔成形术在旋转过程中可以影响节段的稳定性和旋转轴，而不会显著影响椎间盘应力。相反，纤维环切口显著增加椎间盘应力，除非患者进行前屈运动。我们建议手术操作尽量减少纤维环的移除和破坏，并在PELD手术后的短期恢复期内避免旋转运动。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Computer Methods in Biomechanics and Biomedical Engineering 工程技术-工程：生物医学

CiteScore

4.10

自引率

6.20%

发文量

179

审稿时长

4-8 weeks

期刊介绍： The primary aims of Computer Methods in Biomechanics and Biomedical Engineering are to provide a means of communicating the advances being made in the areas of biomechanics and biomedical engineering and to stimulate interest in the continually emerging computer based technologies which are being applied in these multidisciplinary subjects. Computer Methods in Biomechanics and Biomedical Engineering will also provide a focus for the importance of integrating the disciplines of engineering with medical technology and clinical expertise. Such integration will have a major impact on health care in the future.