Clinical Biomechanics最新文献

{"title":"Comparison of the Hara, Harrington, and Davis hip joint center regression equations for gait analysis in children with cerebral palsy","authors":"Reiko Hara ,&nbsp;Tishya A.L. Wren","doi":"10.1016/j.clinbiomech.2025.106565","DOIUrl":"10.1016/j.clinbiomech.2025.106565","url":null,"abstract":"<div><h3>Background</h3><div>Regression equations have been widely accepted in defining the location of the hip joint center in clinical gait analysis. Equations by Hara et al. require a single anthropometric measurement of leg length, allowing easy implementation in a clinical setting. This study evaluated the regression equations by Hara et al. in comparison to common equations by Harrington et al. and Davis et al. for clinical gait analysis in children with cerebral palsy.</div></div><div><h3>Methods</h3><div>The location of the hip joint centers was defined by each of the aforementioned three models and compared for retrospective gait analysis data of 30 children with cerebral palsy (13 females, age 5–16 years). Gait kinematics at the hip and knee across those models were further compared.</div></div><div><h3>Findings</h3><div>The location of the Hara hip joint center was defined in between the other two models: ∼1 cm anterior and medial with almost the same height as Harrington's model. Gait kinematics reflected the location of the hip joint centers, placing the curves from the Hara model in between the others. The root mean square differences between the Hara and the other models were within 2.6 degrees in all planes of motion.</div></div><div><h3>Interpretation</h3><div>The regression equations by Hara et al. demonstrated similarity in the location of the hip joint center and gait kinematics to other common equations. The Hara model is simple, appears less susceptible to errors associated with soft tissue, and might be a good alternative option for clinical gait analysis in children with cerebral palsy.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"126 ","pages":"Article 106565"},"PeriodicalIF":1.4,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144131411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gait and health-related quality of life outcomes following proximal femoral tumor resection and reconstruction with tensioning of the abductor musculotendinous unit","authors":"Jennifer R. Kallini,&nbsp;Eileen G. Fowler,&nbsp;Lindsay Pietruszewski,&nbsp;Andy Vuong,&nbsp;Marcia B. Greenberg,&nbsp;Nicholas J. Jackson,&nbsp;Rachel Thompson,&nbsp;Nicholas Bernthal,&nbsp;Kristen Stearns-Reider","doi":"10.1016/j.clinbiomech.2025.106561","DOIUrl":"10.1016/j.clinbiomech.2025.106561","url":null,"abstract":"<div><h3>Background</h3><div>Although proximal femoral tumors are common, there is little information on outcomes following proximal femoral tumor resection and endoprosthetic reconstruction with reattachment of the hip abductors on tension. The objective of this study is to determine the effect of this surgery on gait and health-related quality of life.</div></div><div><h3>Methods</h3><div>Participants ≥18 years old and ≥ 2 years after proximal femoral resection with endoprosthetic reconstruction and reattachment of hip abductors on tension were compared to controls in this cross-sectional study. Three-dimensional instrumented gait data were collected at preferred- and fast-walking speeds. Health-related quality of life indices were obtained using the SF-36. Knee flexor and extensor maximal strength was quantified using an isokinetic dynamometer. Surgical versus control limbs were compared using Welch's <em>t-</em>tests, while operative participants' surgical versus non-surgical limbs were compared using paired t-tests (<em>p &lt;</em> 0.05).</div></div><div><h3>Findings</h3><div>Fourteen participants (7 operative, 7 control) were included. Surgical limbs exhibited decreased hip and knee flexion angles, hip abductor and knee extensor moments, and knee power generation compared to non-surgical limbs. Comparison of surgical and control limbs revealed a significant reduction in knee joint motion, knee extensor and abductor moments, and knee power generation, however no significant differences were observed for any variable at the hip. Mean health-related quality of life exceeded national averages.</div></div><div><h3>Interpretation</h3><div>Despite differences in hip and knee kinematics and kinetics, proximal femoral resection with tensioning of the abductor musculotendinous unit was associated with relatively normal health-related quality of life.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"126 ","pages":"Article 106561"},"PeriodicalIF":1.4,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144147000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rod persuading reduces primary construct stability in lumbar interbody fusion in the osteoporotic spine – A biomechanical in-vitro study","authors":"Vincent J. Heck ,&nbsp;Tobias Prasse ,&nbsp;Juan Manuel Vinas-Rios ,&nbsp;Andreas Prescher ,&nbsp;Lajos Basten ,&nbsp;Maximilian Weber ,&nbsp;Peer Eysel ,&nbsp;Nikolaus Kernich","doi":"10.1016/j.clinbiomech.2025.106563","DOIUrl":"10.1016/j.clinbiomech.2025.106563","url":null,"abstract":"<div><h3>Background</h3><div>With the introduction of the pedicle screw-rod system and intervertebral cages, posterior spinal fusion has increasingly become a standard procedure in the treatment of degenerative spinal conditions.</div><div>The aim of this study is to investigate the influence of rod persuading in lumbar spinal fusion constructs on the pullout strength of pedicle screws, considering different bone qualities.</div></div><div><h3>Methods</h3><div>Ten fresh-frozen lumbar spines (L1–5) from 10 cadaveric donors were initially included. All specimens were examined at the beginning of the study both macroscopically and by computed tomography scans (HR-CT, Siemens) to ensure specimen integrity, and the mineral bone density by using Hounsfield units. One specimen had to be excluded prior to biomechanical testing due to a vertebral fracture extending into the pedicle, leaving a total of 9 specimens available for the study.</div></div><div><h3>Findings</h3><div>The displacement of the screws during the pullout test was significantly greater in the osteoporotic specimens after rod persuader use (Group 2), compared to the non-osteoporotic specimens (3.7 ± 0.7 mm vs. 5.5 ± 0.4 mm, <em>p</em> = 0.0486). This difference was not observed in the non-rod persuader group. Overall, rod persuading decreased the displacement distance until tensile load to screw failure by 29 %.</div></div><div><h3>Interpretation</h3><div>The use of the rod persuader reduces the pedicle screw pullout strength, thereby compromising the construct stability. This reduction is particularly significant in osteoporotic vertebral bodies, highlighting the need for careful consideration of rod persuader use in this patient population.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"126 ","pages":"Article 106563"},"PeriodicalIF":1.4,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144108020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continued mid-term stability of a novel cementless femoral stem design: A radiostereometric analysis study","authors":"Stuart A. Callary ,&nbsp;Deepti K. Sharma ,&nbsp;Simon P. Coffey ,&nbsp;Rami M. Sorial","doi":"10.1016/j.clinbiomech.2025.106560","DOIUrl":"10.1016/j.clinbiomech.2025.106560","url":null,"abstract":"<div><h3>Background</h3><div>Measuring early micromotion using radiostereometric analysis is the gold standard to evaluate new implant performance. The aim of this study was to assess the continued stability of a new cementless Paragon stem at 5 years. Secondary aims were to assess patient reported outcomes and compare the continued stability between 2 and 5 year to an existing gold standard, the Corail stem.</div></div><div><h3>Methods</h3><div>This is a brief follow-up report of a radiostereometric analysis study. Of the original 46 patients in the 2 year study, four patients were lost to follow-up, three had died, five relocated interstate and seven withdrew from the study. We prospectively reviewed 27 primary <u>total hip arthroplasty</u> patients who underwent radiographic examinations at 5 years for beaded radiostereometric analysis measurements of stem translational and rotation migration.</div></div><div><h3>Findings</h3><div>Median subsidence of the Paragon stem at 5 years was −0.428 mm (range − 0.107 to −1.092) and the median stem subsidence between 2 and 5 years was −0.010 mm (0.115 to −0.269). When compared to the historical Corail stem stability between two and six years, the Paragon stem demonstrated <u>similar subsidence (<em>p</em> = 0.09); and</u> significantly less medial translation (<em>p</em> = 0.0033), anterior translation (<em>p</em> &lt; 0.0001), anterior tilt (<em>p</em> = 0.0004) and anteversion (<em>p</em> = 0.015) between 2 and 5 years. The mean Oxford Hip Score improved <u>substantially</u> within the first year and did not decrease between 2 (44.7, SD 5.9) and 5 years (44.0, SD 8).</div></div><div><h3>Interpretation</h3><div>The Paragon stem showed continued stability up to 5 years follow-up which is encouraging for the further clinical use of this new design.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"126 ","pages":"Article 106560"},"PeriodicalIF":1.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144134107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomechanical and clinical assessments of activities of daily living following unicompartmental knee arthroplasty: A scoping review","authors":"Haithem M'barki ,&nbsp;Ahmed Yacine Lardjane ,&nbsp;Laura Wallard ,&nbsp;Martine Gagnon ,&nbsp;Etienne L. Belzile ,&nbsp;Katia Turcot","doi":"10.1016/j.clinbiomech.2025.106564","DOIUrl":"10.1016/j.clinbiomech.2025.106564","url":null,"abstract":"<div><h3>Background</h3><div>Unicompartmental knee arthroplasty is an effective treatment for isolated medial or lateral knee osteoarthritis. Evaluating knee joint loading during activities of daily living postoperatively can offer valuable insights about the compensatory mechanisms in unicompartmental knee arthroplasty patients. The aim of this scoping review was to summarize and to synthesize the existing literature on the most performed activities of daily living and their associated biomechanical outcomes following unicompartmental knee arthroplasty.</div></div><div><h3>Methods</h3><div>Five databases, including Medline, Embase, CINAHL, Web of Science, and Ergonomics Abstracts were searched based on 3 main concepts: unicompartmental knee arthroplasty, activities of daily living and biomechanical outcomes. Studies were screened based on titles and abstracts, followed by a full text reading conducted by two authors following inclusion and exclusion criteria.</div></div><div><h3>Findings</h3><div>This scoping review included 17 studies that met the inclusion criteria and focusing on activities of daily living. These activities were categorized into three main subgroups 1) Stair negotiation, 2) Higher degree of knee flexion activities (including squat, lunge and sit-to-stand) and 3) other activities of daily living (including balance, incline and decline walking).</div></div><div><h3>Interpretation</h3><div>Stair negotiation was the most evaluated task followed by squatting with a main focus on reporting knee joint kinematics and kinetics. The majority of studies did not report the use of Patient Reported Outcome Measures combined with motion analysis outcomes. Furthermore, most studies focused primarily on medial knee arthroplasty with a fixed-bearing design in short-term follow-up which warrants caution when generalizing these findings to all types of unicompartmental knee arthroplasty.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"126 ","pages":"Article 106564"},"PeriodicalIF":1.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144090278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-speed x-ray characterizes fracture incidence and bone-implant motion during a fall from standing","authors":"Emily K. Bliven ,&nbsp;Pierre Guy ,&nbsp;Alexander Baker ,&nbsp;Anita Fung ,&nbsp;Benedikt Helgason ,&nbsp;Peter A. Cripton","doi":"10.1016/j.clinbiomech.2025.106556","DOIUrl":"10.1016/j.clinbiomech.2025.106556","url":null,"abstract":"<div><h3>Background</h3><div>Fall-related traumas like hip fracture are a common yet devastating injury with poor outcomes. Characterizing fracture biomechanics and bone-implant kinematics is essential to increase our understanding of these events to inform treatment and prevention strategies.</div></div><div><h3>Methods</h3><div>This study developed a bilateral high-speed x-ray methodology for the real-time capture of fracture and kinematic data near the hip during fall impacts. High speed x-ray was applied to capture fall impacts of seven cadaveric pelvis-femur specimens encased in a soft tissue surrogate, using a previously developed method. In these specimens, the intact proximal femur had been prophylactically reinforced with an intramedullary nailing system intended to prevent fragility fractures. The feasibility of extracting 3D kinematic data from x-ray data was investigated.</div></div><div><h3>Findings</h3><div>The HSXR system demonstrated visual clarity and sufficient resolution for capturing skeletal fracture and kinematics. The data in this study revealed fracture and newly-seen deformations of the pelvis, highlighting the ability of the x-ray system to document real-time fracture and kinematic events. Kinematic data in 3D was extracted with sufficient accuracy for one specimen.</div></div><div><h3>Interpretation</h3><div>These results demonstrate the merit of high-speed x-ray for studying periprosthetic fracture, which is of increasing relevance due to increasing populations with orthopedic hardware. Application of this method advances our understanding of impact-related biomechanics and fracture mechanics during a clinically-relevant fall from standing.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"126 ","pages":"Article 106556"},"PeriodicalIF":1.4,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144071875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Type II coronoid fracture in a terrible triad elbow: An experimental study of the elbow kinematics using dynamic radiostereometric analysis","authors":"Johanne Frost Teilmann ,&nbsp;Josephine Olsen Kipp ,&nbsp;Emil Toft Petersen ,&nbsp;Chalotte Krabbe Hemmingsen ,&nbsp;Maiken Stilling ,&nbsp;Theis Muncholm Thillemann","doi":"10.1016/j.clinbiomech.2025.106557","DOIUrl":"10.1016/j.clinbiomech.2025.106557","url":null,"abstract":"<div><h3>Background</h3><div>The aim of this study was to evaluate the elbow kinematics with and without a Regan-Morrey type II coronoid fracture in an experimental setting of terrible triad injury with intact collateral ligaments and radial head arthroplasty.</div></div><div><h3>Methods</h3><div>Eight human donor arms were examined following radial head arthroplasty with and without a 1/3 coronoid fracture by CT and dynamic radiostereometry during elbow flexion with the forearm in unloaded neutral position, and in supinated- and pronated position without and with 10 N either varus or valgus load, respectively. The elbow kinematics were described using anatomical coordinate systems.</div></div><div><h3>Findings</h3><div>The coronoid fracture changed the elbow kinematics. In the valgus loaded pronated forearm position, the radius shifted mean 1.7 mm (95 %CI 0.2; 3.2) posterior, and the ulna shifted mean 0.6 mm (95 %CI 0.0; 1.2) in the radial direction. In the unloaded supinated position, the radius shifted 0.8 mm (95 %CI 0.0; 1.5) posterior and 1.0 mm (95 %CI 0.4; 1.6) in the ulnar direction, while the ulna shifted 0.7 mm (95 %CI 0.1; 1.4) posterior. In the varus loaded supinated position, the radius shifted 1.4 mm (95 %CI 0.2; 2.6) in the ulnar direction.</div></div><div><h3>Interpretation</h3><div>The Regan-Morrey type II coronoid fracture imposed slight kinematic changes to the elbow joint, which may not be clinically relevant. This indicates that a type II coronoid fracture may not need fixation in the setting of optimal radial head arthroplasty with intact collateral ligaments. However, elbow stability should be evaluated intraoperatively in every terrible triad case.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"126 ","pages":"Article 106557"},"PeriodicalIF":1.4,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144070819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knee biomechanics during rehabilitation exercise in individuals with and without anterior cruciate ligament reconstruction: A systematic review","authors":"Zhané N. Murrell-Smith ,&nbsp;Meernah Mohammed Alabdullah ,&nbsp;Fengtao Zhang ,&nbsp;Louise M. Jennings ,&nbsp;Sarah L. Astill ,&nbsp;Aiqin Liu","doi":"10.1016/j.clinbiomech.2025.106559","DOIUrl":"10.1016/j.clinbiomech.2025.106559","url":null,"abstract":"<div><h3>Background</h3><div>Post-traumatic osteoarthritis rates are similar in individuals with anterior cruciate ligament injury who receive surgical reconstruction and those who opt for non-surgical management, indicating continuing changes in knee biomechanics post-surgery. There is no gold standard rehabilitation strategy for the post-reconstruction patient, however investigating the biomechanics of the knee during rehabilitation exercises will drive the development of more efficacious rehabilitation paradigms. This systematic review aimed to synthesise biomechanical data from healthy participants and participants with anterior cruciate ligament reconstruction during rehabilitation exercises to provide insights into knee biomechanical changes induced by injury and surgery.</div></div><div><h3>Methods</h3><div>A systematic literature search was conducted in Web of Science, MEDLINE, EMBASE, PubMed, CINAHL and Scopus, using key terms relating to anterior cruciate ligament reconstruction, lower limb rehabilitation exercises, and knee biomechanics. 34 articles matching the inclusion criteria were identified following abstract and full text screening.</div></div><div><h3>Findings</h3><div>The included studies reported data on 607 healthy participants and 175 participants with an anterior cruciate ligament reconstruction across five different exercises. Peak knee flexion angle was the most reported variable, whereas tibial anterior translation and adduction biomechanics were reported infrequently, despite their relevance to the ligament injury status.</div></div><div><h3>Interpretation</h3><div>There is limited biomechanical data of rehabilitation exercise in the knee, with the exception of knee flexion angles. Furthermore, variations in data collection and reporting methods across studies cause difficulties in systematic analysis of results and demonstrate inconsistent kinematic results between articles.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"126 ","pages":"Article 106559"},"PeriodicalIF":1.4,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144090277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Degradable poly-lactic-co-glycolic acid and non-degradable polymer implants result in similar fracture healing at early timepoints","authors":"Anna N. Smith ,&nbsp;Kathryn S. Strand ,&nbsp;Trent J. Levy ,&nbsp;Joseph B. Ulsh ,&nbsp;Stephen Ching ,&nbsp;Edgardo J. Arroyo ,&nbsp;Robert L. Mauck ,&nbsp;Michael W. Hast","doi":"10.1016/j.clinbiomech.2025.106545","DOIUrl":"10.1016/j.clinbiomech.2025.106545","url":null,"abstract":"<div><h3>Background</h3><div>Although rigid interfragmentary fixation is required for fracture repair, overly stiff implants are known to cause stress shielding which ultimately inhibits healing. While gradual dynamization of the fracture site both accelerates and improves osteogenesis, this approach requires external fixators or secondary surgeries. This study leverages biodegradable implants as mechanisms of gradual, passive dynamization during fracture healing.</div></div><div><h3>Methods</h3><div>Using a rat femoral osteotomy model, additively manufactured poly-lactic-co-glycolic acid implants were compared to geometrically matched non-degradable biocompatible resin devices. Bone healing was assessed at 3 and 6 weeks via micro-computed tomography, histology, and mechanical testing. Implant degradation kinetics were assessed through testing of plates that were used in the rat model and with an unloaded in vitro degradation model.</div></div><div><h3>Findings</h3><div>Quantitative bone measures made with micro-computed tomography, histology, and mechanical testing of the healing femora revealed no differences between degradable and non-degradable implants at 3 or 6 weeks. Degradable implants caused significant increases in bone volume to total volume mean density (<em>p</em> &lt; 0.0001) and callus to cortical volume (<em>p</em> &lt; 0.05) ratios between 3 and 6 weeks. Poly-lactic-co-glycolic acid devices were significantly stiffer than resin at week 0, but the two groups were equivalent by week 6 due to in vivo degradation. In vivo ambulatory loading caused significant losses of degradable implant stiffness at both 3 (p &lt; 0.05) and 6 (<em>p</em> &lt; 0.01) weeks, but this was not observed in the unloaded in vitro model.</div></div><div><h3>Interpretation</h3><div>The results from this early timepoint study demonstrate the feasibility of passive, internal fracture dynamization driven by implant material mechanics.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"126 ","pages":"Article 106545"},"PeriodicalIF":1.4,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143935362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomechanical effects of cement neck and interspinous process device on locking lumbar interbody cementation","authors":"Shang-Chih Lin ,&nbsp;Yu-Kun Xu ,&nbsp;Che-Wei Liu ,&nbsp;Kung Chia Li","doi":"10.1016/j.clinbiomech.2025.106554","DOIUrl":"10.1016/j.clinbiomech.2025.106554","url":null,"abstract":"<div><h3>Background</h3><div>Locking lumbar interbody cementation is a surgical option in patients with osteoporosis and low mobility. It can quickly stabilize the spine construct and prevent cage subsidence. However, establishing a stable bridging neck cement between the vertebrae and disc is a key procedure.</div></div><div><h3>Methods</h3><div>The validated lumbosacral model analyzed the stress cracking risks for five cement neck diameters under flexion, extension, bending, and twisting. The key indices included disc mobility and neck stress. The biomechanical impact of the interspinous process device was evaluated in high-stress fracture-prone necks.</div></div><div><h3>Findings</h3><div>The neck diameter has a significant impact on neck stress, especially extension. The maximum neck stress with a 4-mm diameter was very close to the ultimate tensile strength (25.4 MPa) of cement, inducing a high risk of neck fracture. Generally, neck fractures have little effect on disc mobility during flexion, bending, and twisting. However, after the fracture, neck failure led to a 17.1 % increase in disc mobility during extension. If the neck diameter was less than 5 mm on intraoperative radiography, the interspinous process device effectively reduced neck stress by 51.1 % during extension and 31.7 % during bending.</div></div><div><h3>Interpretation</h3><div>To improve neck strength, the neck diameter should be increased to at least 5 mm during the surgery. If the strength is inadequate, an interspinous process device can be considered to further minimize the risk of fractures, particularly during extension and bending movements.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"126 ","pages":"Article 106554"},"PeriodicalIF":1.4,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143935345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}