12/30/2023 0 Comments Lumbar range of motionfound no difference in the patient’s radiographic results between single-level Coflex stabilization and traditional posterior fusion. Several previous studies found the Coflex technique to be safe and effective for treating lumbar disorders. The high frequency of secondary accelerated degenerative diseases at adjacent levels after lumbar fusion remains a challenge for orthopedic surgeons.Ĭoflex interspinous stabilization is a common non-fusion approach that aims to provide adequate stability while delaying the degeneration of adjacent segments by preserving partially segmental motion and allowing for physiological load transmission. In some circumstances, traditional lumbar fusion has intrinsic limitations, such as a longer operating time, increased blood loss, and enhanced stiffness, which may lead to overtreatment of the patient. Spine fusions alter the biomechanical environment within the vertebral body, impair blood oxygen and nutrient supply, and result in postoperative problems in adjacent segments. Type 3 and Type 4 lumbar have good compensatory ability and therefore allow for a wider range of surgical options, whereas surgical options for small lordotic Type 1 and Type 2 lumbar are more limited and severe.Īlthough lumbar fusion with posterior pedicle fixation is the gold standard for degenerative lumbar diseases, the incidence rate of secondary accelerated degeneration of adjacent segments is up to 25%. Compared to the single-level Fusion, the changes in motion and mechanics of the lumbar increased after both the double-level Coflex + Fusion and Fusion + Fusion fixations, while the differences between two double-level fixation methods on adjacent segments of the four lumbar models were similar to that of the single-level fixation. The difference between the two fixations was not apparent in Type 3 lumbar. For Type 4 lumbar, the L4–L5 Coflex did not have superiority over the L4–L5 Fusion, resulting in a greater increase in range of motion at adjacent segments in flexion and extension. Similarly, the L4–L5 Coflex offered considerable advantages in preserving the biomechanical properties of adjacent segments for Type 1 lumbar. For Type 2 lumbar, the L4–L5 Coflex effectively reduced the disc pressure and annulus fibrosis stress in adjacent segments compared to the L4–L5 Fusion. In all models, the upper adjacent segment was the most influenced by the implantation and bore the most compensation from the fixed segment. Resultsīoth single-level and double-level spinal fixation had the greatest effect on lumbar range of motion, disc pressure, and annulus fibrosis stress in flexion, followed by lateral bending, extension, and axial rotation. A pure moment of 7.5 Nm was applied to simulate the physiological activities of flexion, extension, lateral bending and axial rotation. The four Roussouly's type models were reassembled into four fusion models: single-level L4–5 Coflex fixation model, single-level L4–5 Fusion (pedicle screw fixation) model, double-level Coflex (L4–5) + Fusion (L5–S1) model, and double-level Fusion (L4–5) + Fusion (L4–5) model. The parametric finite element (FE) models of Roussouly’s type (1–4) were developed based on the radiological data of 625 Chinese community population. This study investigates whether four Roussouly’s sagittal alignment morphotypes have different biomechanical characteristics after different single- or double-level spinal fixations. Although it is critical to understand the accelerated degeneration of adjacent segments after fusion, the biomechanical properties of the spine have not been thoroughly studied after various fusion techniques.
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