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

PLoS One. 2022 Apr 7;17(4):e0265926. doi: 10.1371/journal.pone.0265926. eCollection 2022.

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biomechanical Phenomena / physiology
  • Finite Element Analysis
  • Humans
  • Intervertebral Disc Degeneration* / surgery
  • Lumbar Vertebrae / diagnostic imaging
  • Lumbar Vertebrae / physiology
  • Lumbar Vertebrae / surgery
  • Range of Motion, Articular / physiology
  • Spinal Fusion* / methods

Grants and funding

Initials of the authors who received each award - 1: SP (Seonghun Park), 2: SP, 3: SP Grant numbers awarded to each author - 1: 2-Year Research Grant, 2: NRF-2016R1A2B4012561, 3: NRF- 2021R1F1A1046890 The full name of each funder - 1: Pusan National University, 2: National Research Foundation (NRF) funded by Korean government (MSIT), 3: National Research Foundation (NRF) funded by Korean government (MSIT) URL of each funder website - 1: https://www.pusan.ac.kr, 2: https://www.nrf.re.kr/eng/inde, 3: https://www.nrf.re.kr/eng/inde.