Hybrid stabilization is widely performed for the surgical treatment of degenerative disk diseases. Pedicle-based hybrid stabilization intends to reduce fusion-associated drawbacks of adjacent segment degeneration, construct failure, and pseudoarthrosis. Recently, many types of pedicle-based hybrid stabilization systems have been developed and optimized, using polymeric devices as an adjunct for lumbar fusion procedures. Therefore, the purpose of this study was to evaluate the effect of new pedicle-based hybrid stabilization on bending stiffness and center of rotation at operated and adjacent levels in comparison with established semirigid and rigid devices in lumbar fusion procedures. A validated three-dimensional finite element model of the L3–S1 segments was modified to simulate postoperative changes during combined loading (moment of 7.5 N m + follower load of 400 N). Two models instrumented with pedicle-based hybrid stabilization (Dynesys Transition Optima, NFlex), semirigid system (polyetheretherketone), and rigid fixation system (titanium rod (Ti) were compared with those of the healthy and degenerated models. Contact force on the facet joint during extension increased in fusion (40 N) with an increase of bending stiffness in Dynesys and NFlex. The center of rotation shifted in posterior and cranial directions of the fused level. The centers of rotation in the lower lumbar spine is segment dependent and altered with the adopted construct. The bending stiffness was varied from 1.47 N m/° in lateral bending for the healthy model to 5.75 N m/° for the NFlex stabilization, which had the closest center of rotation, compared to the healthy center of rotation. Locations of center of rotation, stress, and strain distribution varied according to construct design and materials used. These data could help understand the biomechanical effects of current pedicle-based hybrid stabilization on the behavior of the lower lumbar spine.

混合稳定广泛用于椎间盘退行性疾病的手术治疗。基于椎弓根的混合稳定旨在减少与融合相关的相邻节段退化、结构失败和假关节的缺点。最近，已经开发和优化了多种类型的基于椎弓根的混合稳定系统，使用聚合物装置作为腰椎融合手术的辅助手段。因此，本研究的目的是与腰椎融合手术中已建立的半刚性和刚性装置相比，评估新的基于椎弓根的混合稳定对手术和相邻水平的弯曲刚度和旋转中心的影响。对 L3-S1 节段经过验证的三维有限元模型进行了修改，以模拟联合负荷期间的术后变化（时刻为 7. 5 N·m + 400 N 的从动载荷）。将配备基于椎弓根的混合稳定装置（Dynesys Transition Optima，NFlex）、半刚性系统（聚醚醚酮）和刚性固定系统（钛棒 (Ti)）的两种模型与健康和退化模型的模型进行比较。小关节上的接触力在伸展期间融合 (40 N) 增加，Dynesys 和 NFlex 的弯曲刚度增加。旋转中心在融合水平的后部和颅骨方向移动。下腰椎的旋转中心依赖于节段，并随着弯曲刚度从健康模型横向弯曲的 1.47 N·m/° 变化到 NFlex 稳定器的 5.75 N·m/°，与健康的旋转中心相比，它具有最近的旋转中心。旋转中心的位置、应力和应变分布因构造设计和使用的材料而异。这些数据有助于了解当前基于椎弓根的混合稳定对下腰椎行为的生物力学影响。