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Optimization of a lumbar interspinous fixation device for the lumbar spine with degenerative disc disease

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  • Minhyeok Heo
  • Jihwan Yun
  • Hanjong Kim
  • Sang-Soo Lee
  • Seonghun Park

Abstract

Interspinous spacer devices used in interspinous fixation surgery remove soft tissues in the lumbar spine, such as ligaments and muscles and may cause degenerative diseases in adjacent segments its stiffness is higher than that of the lumbar spine. Therefore, this study aimed to structurally and kinematically optimize a lumbar interspinous fixation device (LIFD) using a full lumbar finite element model that allows for minimally invasive surgery, after which the normal behavior of the lumbar spine is not affected. The proposed healthy and degenerative lumbar spine models reflect the physiological characteristics of the lumbar spine in the human body. The optimum number of spring turns and spring wire diameter in the LIFD were selected as 3 mm and 2 turns, respectively—from a dynamic range of motion (ROM) perspective rather than a structural maximum stress perspective—by applying a 7.5 N∙m extension moment and 500 N follower load to the LIFD-inserted lumbar spine model. As the spring wire diameter in the LIFD increased, the maximum stress generated in the LIFD increased, and the ROM decreased. Further, as the number of spring turns decreased, both the maximum stress and ROM of the LIFD increased. When the optimized LIFD was inserted into a degenerative lumbar spine model with a degenerative disc, the facet joint force of the L3-L4 lumbar segment was reduced by 56%–98% in extension, lateral bending, and axial rotation. These results suggest that the optimized device can strengthen the stability of the lumbar spine that has undergone interspinous fixation surgery and reduce the risk of degenerative diseases at the adjacent lumbar segments.

Suggested Citation

  • Minhyeok Heo & Jihwan Yun & Hanjong Kim & Sang-Soo Lee & Seonghun Park, 2022. "Optimization of a lumbar interspinous fixation device for the lumbar spine with degenerative disc disease," PLOS ONE, Public Library of Science, vol. 17(4), pages 1-18, April.
    • Handle: RePEc:plo:pone00:0265926
    DOI: 10.1371/journal.pone.0265926
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    References listed on IDEAS

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    1. Ugur Ayturk & Christian Puttlitz, 2011. "Parametric convergence sensitivity and validation of a finite element model of the human lumbar spine," Computer Methods in Biomechanics and Biomedical Engineering, Taylor & Francis Journals, vol. 14(08), pages 695-705.
    2. J. P. Little, 2008. "Are coupled rotations in the lumbar spine largely due to the osseo-ligamentous anatomy?—A modeling study," Computer Methods in Biomechanics and Biomedical Engineering, Taylor & Francis Journals, vol. 11(1), pages 95-103.
    3. J. P. Little, 2008. "Are coupled rotations in the lumbar spine largely due to the osseo-ligamentous anatomy? – A modelling study," Computer Methods in Biomechanics and Biomedical Engineering, Taylor & Francis Journals, vol. 11(2), pages 214-214.
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