Clinical Biomechanics最新文献

{"title":"The effect of carbon fiber custom dynamic orthosis use and design on center of pressure progression and perceived smoothness in individuals with lower limb trauma","authors":"Sapna Sharma ,&nbsp;Kirsten M. Anderson ,&nbsp;Molly S. Pacha ,&nbsp;Kierra J. Falbo ,&nbsp;Clare Severe ,&nbsp;Andrew H. Hansen ,&nbsp;Brad D. Hendershot ,&nbsp;Jason M. Wilken ,&nbsp;CARBon Fiber Orthosis Research Network (CARBON)","doi":"10.1016/j.clinbiomech.2024.106284","DOIUrl":"https://doi.org/10.1016/j.clinbiomech.2024.106284","url":null,"abstract":"<div><h3>Background</h3><p>Carbon-fiber custom dynamic orthoses are used to improve gait and limb function following lower limb trauma in specialty centers. However, the effects of commercially available orthoses on center of pressure progression and patient perception of orthosis smoothness during walking are poorly understood.</p></div><div><h3>Methods</h3><p>In total, 16 participants with a unilateral lower extremity traumatic injury underwent gait analysis when walking without an orthosis, and while wearing monolithic and modular devices, in a randomized order. Device alignment, stiffness, participant rating of perceived device smoothness, center of pressure velocity, and ankle zero moment crossing were assessed.</p></div><div><h3>Findings</h3><p>The modular device was approximately twice as stiff as the monolithic device. Alignment, smoothness ratings, peak magnitude of center of pressure velocity, and zero moment crossing were not different between study devices. The time to peak center of pressure velocity occurred significantly later for the modular device compared to the monolithic and no orthosis conditions, with large effect sizes observed.</p></div><div><h3>Interpretation</h3><p>Commercially available orthoses commonly used to treat limb trauma affect the timing of center of pressure progression relative to walking without an orthosis. Despite multiple design differences, monolithic and modular orthoses included in this study did not differ with respect to other measures of center of pressure progression. Perceived smoothness ratings were approximately 40% greater with the study orthoses as compared to previous studies in specialty centers, which may be due to a more gradual center of pressure progression, as indicted by lower peak magnitude of center of pressure velocity with both study orthoses.</p></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141314230","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":"Elevated proinflammatory cytokines in response to mechanical stimulus are associated with reduced knee loading 2 years after anterior cruciate ligament reconstruction","authors":"Arielle G. Fischer ,&nbsp;Matthew R. Titchenal ,&nbsp;Eleonora Migliore ,&nbsp;Jessica L. Asay ,&nbsp;Jennifer C. Erhart-Hledik ,&nbsp;Thomas P. Andriacchi","doi":"10.1016/j.clinbiomech.2024.106286","DOIUrl":"https://doi.org/10.1016/j.clinbiomech.2024.106286","url":null,"abstract":"<div><h3>Background</h3><p>The aim of this study was to test the hypothesis that proinflammatory cytokines correlate with knee loading mechanics during gait following a mechanical walking stimulus in subjects 2 years after anterior cruciate ligament reconstruction. Elevated systemic levels of proinflammatory cytokines can be sustained for years after injury. Considering roughly 50% of these patients progress to Osteoarthritis 10–15 years after injury, a better understanding of the role of proinflammatory cytokines such as tumor necrosis factor-α and Interleukin-1β on Osteoarthritis risk is needed.</p></div><div><h3>Methods</h3><p>Serum proinflammatory cytokines concentrations were measured in 21 subjects 2 years after unilateral ACLR from blood drawn at rest and 3.5 h after 30 min of walking. An optoelectronic system and a force plate measured subjects' knee kinetics. Correlations were tested between inflammatory marker response and knee extension and knee adduction moments.</p></div><div><h3>Findings</h3><p>Changes in proinflammatory cytokines due to mechanical stimulus were correlated (<em>R</em> = 0.86) and showed substantial variation between subjects in both cytokines at 3.5 h post-walk. Knee loading correlated with 3.5-h changes in tumor necrosis factor-α concentration (Knee extension moment: R = -0.5, Knee adduction moment: R = -0.5) and Interleukin-1β concentration (Knee extension moment: R = -0.44). However, no significant changes in concentrations were observed in tumor necrosis factor-α and Interleukin-1β when comparing baseline and post walking stimulus conditions.</p></div><div><h3>Interpretation</h3><p>The significant associations between changes in serum proinflammatory markers following a mechanical stimulus and gait metrics in subjects at risk for developing Osteoarthritis underscore the importance of investigating the interaction between biomarkers and biomechanical factors in Osteoarthritis development.</p></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141291622","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":"Structural modification and biomechanical analysis of lumbar disc prosthesis: A finite element study","authors":"Haibo Ke ,&nbsp;Yuan Guo ,&nbsp;Xushu Zhang ,&nbsp;Long Yin ,&nbsp;Wenbin Nie ,&nbsp;Yibo Zhao ,&nbsp;Bin Zhao ,&nbsp;Kai Zhang ,&nbsp;Yunpeng Wen ,&nbsp;Binping Ji ,&nbsp;Ming Zhang","doi":"10.1016/j.clinbiomech.2024.106266","DOIUrl":"10.1016/j.clinbiomech.2024.106266","url":null,"abstract":"<div><h3>Background</h3><p>Most ball-in-socket artificial lumbar disc implanted in the spine result in increased hypermobility of the operative level and overloading of the facet joint.</p></div><div><h3>Methods</h3><p>A finite element model was established and validated for the lumbar spine (L1-L5). The structure of the Mobidisc prosthesis was modified, resulting in the development of two new intervertebral disc prostheses, Movcore and Mcopro. The prostheses were implanted into the L3/L4 level to simulate total disc replacement, and the biomechanical properties of the lumbar spine model were analyzed after the operation.</p></div><div><h3>Findings</h3><p>Following the implantation of the prostheses, the mobility of operative level, peak stress of lumbar spine models, and peak stress of facet joint increased. The performance of mobility was found to be more similar between Movcore and Mobidisc. The mobility and facet joint peak stress of the Mcopro model decreased progressively with an increase in the Young's modulus of the artificial annulus during flexion, extension, and lateral bending. Among all the models, the Mcopro50 model had the mobility closest to the intact model. It showed a 3% decrease in flexion, equal range of motion in extension, a 9% increase in left lateral bending, a 7% increase in right lateral bending, and a 3% decrease in axial rotation.</p></div><div><h3>Interpretation</h3><p>The feasibility of the new intervertebral disc prostheses, Movcore and Mcopro, has been established. The Mcopro prosthesis, which features an artificial annular structure, offers significant advantages in terms of reduced mobility of the operative level and peak stress of facet joint.</p></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141183916","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":"Does spinopelvic alignment affect femoral head cartilage and the proximal femoral physis in slipped capital femoral epiphysis? A finite element analysis","authors":"Yogesh Kumaran ,&nbsp;Muzammil Mumtaz ,&nbsp;Carmen Quatman ,&nbsp;Julie Balch-Samora ,&nbsp;Sophia Soehnlen ,&nbsp;Brett Hoffman ,&nbsp;Sudharshan Tripathi ,&nbsp;Norihiro Nishida ,&nbsp;Vijay K. Goel","doi":"10.1016/j.clinbiomech.2024.106269","DOIUrl":"10.1016/j.clinbiomech.2024.106269","url":null,"abstract":"<div><h3>Background</h3><p>Slipped capital femoral epiphysis is a prevalent pediatric hip disorder. Recent studies suggest the spine's sagittal profile may influence the proximal femoral growth plate's slippage, an aspect not extensively explored. This study utilizes finite element analysis to investigate how various spinopelvic alignments affect shear stress and growth plate slip.</p></div><div><h3>Methods</h3><p>A finite element model was developed from CT scans of a healthy adult male lumbar spine, pelvis, and femurs. The model was subjected to various sagittal alignments through reorientation. Simulations of two-leg stance, one-leg stance, walking heel strike, ascending stairs heel strike, and descending stairs heel strike were conducted. Parameters measured included hip joint contact area, stress, and maximum growth plate Tresca (shear) stress.</p></div><div><h3>Findings</h3><p>Posterior pelvic tilt cases indicated larger shear stresses compared to the anterior pelvic tilt variants except in two leg stance. Two leg stance resulted in decreases in the posterior tilted pelvi variants hip contact and growth plate Tresca stress compared to anterior tilted pelvi, however a combination of posterior pelvic tilt and high pelvic incidence indicated larger shear stresses on the growth plate. One leg stance and heal strike resulted in higher shear stress on the growth plate in posterior pelvic tilt variants compared to anterior pelvic tilt, with a combination of posterior pelvic tilt and high pelvic incidence resulting in the largest shear.</p></div><div><h3>Interpretation</h3><p>Our findings suggest that posterior pelvic tilt and high pelvic incidence may lead to increased shear stress at the growth plate. Activities performed in patients with these alignments may predispose to biomechanical loading that shears the growth plate, potentially leading to slip.</p></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0268003324001013/pdfft?md5=3991b0a392a0673a74ef0b3ff342ac9a&pid=1-s2.0-S0268003324001013-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141139306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomechanical role of bone grafting for calcaneal fracture fixation in the presence of bone defect: A finite element analysis","authors":"Zhihao Su ,&nbsp;Ming Ding ,&nbsp;Ning Zhu ,&nbsp;James Chung-Wai Cheung ,&nbsp;Duo Wai-Chi Wong ,&nbsp;Wanju Sun ,&nbsp;Ming Ni","doi":"10.1016/j.clinbiomech.2024.106278","DOIUrl":"10.1016/j.clinbiomech.2024.106278","url":null,"abstract":"<div><h3>Background</h3><p>The purpose of this study was to compare the biomechanical stress and stability of calcaneal fixations with and without bone defect, before and after bone grafting, through a computational approach.</p></div><div><h3>Methods</h3><p>A finite element model of foot-ankle complex was reconstructed, impoverished with a Sanders III calcaneal fracture without bone defect and with moderate and severe bone defects. Plate fixations with and without bone grafting were introduced with walking stance simulated. The stress and fragment displacement of the calcaneus were evaluated.</p></div><div><h3>Findings</h3><p>Moderate and severe defect increased the calcaneus stress by 16.11% and 32.51%, respectively and subsequently decreased by 10.76% and 20.78% after bone grafting. The total displacement was increased by 3.99% and 24.26%, respectively by moderate and severe defect, while that of posterior joint facet displacement was 86.66% and 104.44%. The former was decreased by 25.73% and 35.96% after grafting, while that of the latter was reduced by 88.09% and 84.78% for moderate and severe defect, respectively.</p></div><div><h3>Interpretation</h3><p>Our finite element prediction supported that bone grafting for fixation could enhance the stability and reduce the risk of secondary stress fracture in cases of bone defect in calcaneal fracture.</p></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141137601","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 improvements in gait following medial pivot knee implant surgery","authors":"D. Dabirrahmani ,&nbsp;S. Farshidfar ,&nbsp;J. Cadman ,&nbsp;H. Shahidian ,&nbsp;L. Kark ,&nbsp;J. Sullivan ,&nbsp;R. Appleyard","doi":"10.1016/j.clinbiomech.2024.106267","DOIUrl":"https://doi.org/10.1016/j.clinbiomech.2024.106267","url":null,"abstract":"<div><h3>Background</h3><p>Total knee replacements are used to improve function and reduce pain in patients with advanced osteoarthritis. The medially stabilising implant is designed to mimic a healthy knee. This study aims to provide a comprehensive analysis of the kinematics and kinetics of a medially stabilising knee implant, comparing it to a healthy control group, as well as to its pre-operative state and the contralateral limb.</p></div><div><h3>Methods</h3><p>Sixteen total knee replacement patients and ten healthy participants were recruited. Patients underwent testing 4–6 weeks before surgery and repeated the same tests 12 months after surgery. Healthy participants completed the same tests at a single time point. All participants completed three walking trials: kinematics was captured with eight cameras; kinetics with in-ground force plates. Subject-specific musculoskeletal models were developed in OpenSim. Inverse kinematics and inverse dynamics were used to determine gait parameters. Joint angles and joint moments were evaluated using Statistical Parametric Mapping. Patient-reported outcome measures were also collected at both time points.</p></div><div><h3>Findings</h3><p>Spatiotemporal results indicate significant differences in velocity and step length between pre-operative patients and control participants. Differences are observed in the adduction angles between the contralateral and ipsilateral limbs pre-operatively. Postoperatively, there was an increase in the 1st peak flexion moment, reduced adduction moment and reduced internal rotation moment. In PROMs, patients all report improvements in pain levels and high satisfaction levels following surgery.</p></div><div><h3>Interpretations</h3><p>Following medial stabilising total knee arthroplasty, patients displayed improved clinical parameters and joint moments reflecting a shift towards more normal, healthy gait.</p></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0268003324000998/pdfft?md5=2f693474b04e3befd62ef53990f7c880&pid=1-s2.0-S0268003324000998-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141244809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Promising results of a non-invasive measurement of knee implant loosening using a loading device, CT-scans and 3D image analysis” [Clinical Biomechanics volume 104, 105930, April 2023, 105930]","authors":"Arthur J. Kievit ,&nbsp;George S. Buijs ,&nbsp;Johannes G.G. Dobbe ,&nbsp;Maaike A. Ter Wee ,&nbsp;Gino M.M.J. Kerkhoffs ,&nbsp;Geert J. Streekstra ,&nbsp;Matthias U. Schafroth ,&nbsp;Leendert Blankevoort","doi":"10.1016/j.clinbiomech.2024.106283","DOIUrl":"10.1016/j.clinbiomech.2024.106283","url":null,"abstract":"","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0268003324001153/pdfft?md5=f2ffa086af070ce45e1f69cf7c626641&pid=1-s2.0-S0268003324001153-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141249014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Human-in-the-loop optimization of rocker shoe to reduce plantar pressure and collision work simultaneously","authors":"R.R. Kurnianto ,&nbsp;J.M. Hijmans ,&nbsp;C. Greve ,&nbsp;H. Houdijk","doi":"10.1016/j.clinbiomech.2024.106282","DOIUrl":"https://doi.org/10.1016/j.clinbiomech.2024.106282","url":null,"abstract":"<div><h3>Background</h3><p>Rocker shoes can be used to reduce foot pressure and adjust lower limb kinetics for various patient population, such as people with diabetic peripheral neuropathy. Selecting adequate properties of the rocker sole is of great importance for its efficacy. This study investigated the capability of human-in-the-loop optimization (HILO) to individually optimize apex position and angle of rocker shoe to reduce peak pressure and collision work simultaneously.</p></div><div><h3>Methods</h3><p>Peak pressure, kinetic, and kinematic data were recorded from 10 healthy participants while walking at preferred speed wearing rocker shoes with adjustable apex position and angle. An evolutionary algorithm was used to find optimal apex parameters to reduce both peak pressure in medial forefoot and collision work. The optimized shoe (HILO shoe) was compared with generic optimal rocker settings (Chapman settings) and normal shoe.</p></div><div><h3>Findings</h3><p>Compared to normal shoe, the HILO shoe had lower plantar pressure (p_HILO = 0.007; p_Chapman = 0.044) and Chapman shoe showed higher collision work (p_HILO = 0.025; p_Chapman = 0.014). Both HILO and Chapman shoe had smaller push-off work than normal shoe (p_HILO = 0.001; p_Chapman &lt; 0.001) with the Chapman shoe exhibited earlier push-off onset (p_HILO = 0.257; p_Chapman = 0.016).</p></div><div><h3>Interpretation</h3><p>The Human-in-the-loop optimization approach resulted in individualized apex settings which performed on average similar to Chapman settings but, were superior in selected cases. In these cases, medial forefoot could be further offloaded with apex angles larger than generic settings. The larger apex angle might increase the external ankle moment arm and push-off work. However, there is limited room for improvement on collision work compared to generic settings.</p></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141291623","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":"Plantar pressure reduction in the heel region through self-adjusting insoles with a heel cup in standard and individualized rocker shoes","authors":"Athra Malki ,&nbsp;Mahdieh Hajibozorgi ,&nbsp;Gijsbertus J. Verkerke ,&nbsp;Rienk Dekker ,&nbsp;Juha M. Hijmans","doi":"10.1016/j.clinbiomech.2024.106281","DOIUrl":"https://doi.org/10.1016/j.clinbiomech.2024.106281","url":null,"abstract":"<div><h3>Background</h3><p>Effectiveness of therapeutic footwear in reducing peak pressure in persons with diabetes and loss of protective sensation to prevent diabetic foot ulcers varies due to manual production and possible changing foot structure. A previous two-way approach to address this issue, featuring individualized 3D-printed rocker midsoles and self-adjusting insoles, proved effective in the forefoot but less in the heel. To address this, new insoles incorporating a heel cup are developed.</p></div><div><h3>Methods</h3><p>In-shoe pressure was measured, while persons with diabetes and loss of protective sensation with high peak pressure (≥ 200 kPa) in the heel walked on a treadmill with control and individualized rocker shoe paired with control and new insole.</p></div><div><h3>Findings</h3><p>Generalized estimating equations revealed significant decrease in peak pressure in the proximal heel with the new insole alone and combined with rocker shoe compared to rocker shoe alone. For the distal heel, significant decrease in peak pressure is shown with the combination of new insole and rocker shoe compared to control shoe. For the forefoot and toes (excluding hallux) significant decrease in peak pressure is shown using the rocker shoe alone or combined with the heel cup compared to control shoe.</p></div><div><h3>Interpretation</h3><p>The new insole paired with rocker shoe is effective in reducing peak pressure in the distal heel. To have similar (or more) success in proximal heel, one could replace the rocker midsole with more compliant materials. The rocker shoe used separately or combined with a heel cup effectively reduces the peak pressure in the forefoot and other toes.</p></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S026800332400113X/pdfft?md5=5b5b3dd553869aaee9e16e7f02a2cd50&pid=1-s2.0-S026800332400113X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141291628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomechanical investigation of a customized interspinous spacer system in the treatment of degenerative disc diseases: A finite element analysis","authors":"Gaiping Zhao ,&nbsp;Zhehua Jiang ,&nbsp;Eryun Chen ,&nbsp;Tong Ma ,&nbsp;Jie Wu ,&nbsp;Chengli Song ,&nbsp;Weiqi Li","doi":"10.1016/j.clinbiomech.2024.106270","DOIUrl":"https://doi.org/10.1016/j.clinbiomech.2024.106270","url":null,"abstract":"<div><h3>Background</h3><p>A novel interspinous fixation system based on anatomical parameters and incorporating transfacetopedicular screws, was developed to treat degenerative disc diseases. The biomechanical characteristics of the novel system were evaluated using finite element analysis in comparison to other classical interspinous spacers.</p></div><div><h3>Methods</h3><p>The L1-S1 lumbar spine finite element models were surgically implanted with the novel system, Coflex and DIAM devices at the L4/L5 segment to assess the range of motion, the pression distribution of intervertebral disc, the peak stresses on the spinous process and implant during various motions.</p></div><div><h3>Findings</h3><p>Range of motions of the L4/L5 surgical segment were reduced by 29.13%, 61.27%, 77.35%, 33.33%, and the peak stresses of intervertebral disc were decreased by 36.82%, 67.31%, 73.00%, 69.57% for the novel system in flexion, extension, lateral bending, and axial rotation when compared with the Coflex, and they were declined by 34.53%, 57.86%, 75.81%, 25.21%; 36.22%, 67.31%, 75.01%, 71.40% compared with DIAM. The maximum stresses of the spinous process were 29.93 MPa, 24.66 MPa, 14.45 MPa, 24.37 MPa in the novel system, and those of Coflex and DIAM were 165.3 MPa, 109 MPa, 84.79 MPa, 47.66 MPa and 52.59 MPa, 48.78 MPa, 50.27 MPa, 44.16 MPa during the same condition.</p></div><div><h3>Interpretation</h3><p>Compared to other interspinous spacer devices, the novel interspinous fixation system demonstrated excellent stability, effectively distributing load on the intervertebral disc, and reducing the risk of spinous process fractures. The personalized design of the novel interspinous fixation system could be a viable option for treating degenerative disc diseases.</p></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141078149","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}