Background

Laminectomy is a traditional method for treating lumbar diseases; however, the destruction of the posterior structures may cause postoperative symptoms. An individualized poly-ether-ether-ketone (PEEK) artificial lamina was designed to reconstruct the posterior structures after laminectomy. This study aimed to explore the biomechanical effects of reconstruction of the posterior structures with an individualized PEEK artificial lamina using validated finite element models.

Objective

To examine the biomechanical effects of individualized PEEK artificial lamina on postlaminectomy lumbar.

Methods

A finite element (FE) model of L3-5 was developed based on computed tomography images. Four surgical models (laminectomy, artificial lamina alone, ligament reconstruction, and osseointegration) were constructed, representing different stages of L4 artificial lamina implantation. The range of motion (ROM), intradiscal pressure (IDP), stresses in the annulus fibrosus at the surgical level and cephalad adjacent level, and stresses in the artificial lamina and screws were measured.

Results

The ROM, IDP, and stresses in the annulus fibrosus of the different artificial lamina models decreased compared to those of the laminectomy model at both surgical and adjacent levels for all motion patterns, most notably in the osseointegration model. In addition, the results of the stresses in the implants showed that the artificial lamina could enhance the lumbar isthmus and disperse the abnormally concentrated stresses after laminectomy.

Conclusion

The application of a PEEK artificial lamina has the potential to stabilize the postlaminectomy lumbar spine and prevent adjacent segment disease (ASD) and iatrogenic lumbar deformities, resulting in a reduction in the incidence of post-lumbar surgery syndrome.

中文翻译：

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个体化聚醚醚酮 (PEEK) 人工椎板椎板切除术后后部结构重建的生物力学效应

背景

椎板切除术是治疗腰椎疾病的传统方法；然而，后部结构的破坏可能会导致术后症状。一种个性化的聚醚醚酮 (PEEK) 人工椎板被设计用于重建椎板切除术后的后部结构。本研究旨在使用经过验证的有限元模型探索使用个性化 PEEK 人工椎板重建后部结构的生物力学效果。

客观的

研究个性化 PEEK 人工椎板对椎板切除术后腰椎的生物力学影响。

方法

基于计算机断层扫描图像开发了 L3-5 的有限元 (FE) 模型。构建了四种手术模型（椎板切除术、单独人工椎板、韧带重建和骨整合），代表了 L4 人工椎板植入的不同阶段。测量了运动范围（ROM）、椎间盘内压力（IDP）、手术水平和头侧邻近水平的纤维环应力，以及人造椎板和螺钉中的应力。

结果

与椎板切除模型相比，不同人工椎板模型的 ROM、IDP 和纤维环中的应力在所有运动模式的手术水平和相邻水平上均有所下降，尤其是在骨整合模型中。此外，植入物应力结果表明，人工椎板可以增强腰峡部，分散椎板切除术后异常集中的应力。

结论

PEEK人工椎板的应用有可能稳定椎板切除术后腰椎，预防邻近节段疾病（ASD）和医源性腰椎畸形，从而降低腰椎手术后综合征的发生率。