Skip to main content

Biomechanische Konsequenzen von verschiedenen Positionierungen bewegungserhaltender Bandscheibenimplantate

Eine Finite-Elemente-Studie an der Lendenwirbelsäule

Biomechanical consequences of variations in artificial disc positioning

A finite element study on the lumbar spine

Der Orthopäde volume 36, pages 205–211 (2007)Cite this article

Zusammenfassung

Bandscheibenprothesen gewinnen durch die Behandlung degenerativer Bandscheibenerkrankungen mit Non-Fusion-Techniken zunehmend an Bedeutung. Der Einfluss der Lage des Implantats im Intersegmentalraum auf die Biomechanik der Lendenwirbelsäule ist jedoch bisher kaum untersucht worden. In einer Studie wurden daher vom Idealen abweichende Implantatpositionen und -ausrichtungen, wie sie insbesondere bei ventrolateralem Zugang auftreten können, mithilfe eines validierten Finite-Elemente-Modells simuliert. Die Simulationen ergaben besonders bei lateraler Exzentrizität des Implantats stark vergrößerte Belastungen, sodass auf eine optimale Implantatposition wert gelegt werden muss.

Abstract

Artificial disc prostheses are becoming more and more attractive for the treatment of degenerative disc diseases using non-fusion techniques. However, the influence of disc position within the intersegmental space on lumbar biomechanics has scarcely been investigated. A validated finite element model of the lumbar spine was used to investigate the effects of non-ideal implant positioning and orientation, which are more likely to occur using ventrolateral approaches. The model predicts, especially for lateral eccentricities, strongly increased lumbar loads. Therefore, great care should be taken in placing the implant in an optimal position.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

Abb. 1
Abb. 2
Abb. 3
Abb. 4
Abb. 5
Abb. 6

Literatur

  1. Berthonnaud E, Dimnet J, Roussouly P, Labelle H (2005) Analysis of the sagittal balance of the spine and pelvis using shape and orientation parameters. J Spinal Disord Tech 18: 40–47

    Article  PubMed  Google Scholar 

  2. Boulay C, Tardieu C, Hecquet J et al. (2006) Sagittal alignment of spine and pelvis regulated by pelvic incidence: standard values and prediction of lordosis. Eur Spine J 15: 415–422

    Article  PubMed  Google Scholar 

  3. Heuer F, Schmidt H, Klezl Z et al. (2007) Stepwise reduction of functional spinal structures increase range of motion and change lordosis angle. J Biomech 40(2): 271–280

    Article  PubMed  Google Scholar 

  4. Heuer F, Schmidt H, Klezl Z et al. (2007) Stepwise reduction of functional spinal structures increase vertebral translation and intradiscal pressure. J Biomech 40(4): 795–803

    Article  PubMed  Google Scholar 

  5. Huang RC, Girardi FP, Cammisa FP, Wright TM (2003) The implications of constraint in lumbar total disc replacement. J Spinal Disord Tech 16: 412–417

    Article  PubMed  Google Scholar 

  6. Masharawi Y, Rothschild B, Dar G et al. (2004) Facet orientation in the thoracolumbar spine: three-dimensional anatomic and biomechanical analysis. Spine 29: 1755–1763

    Article  PubMed  Google Scholar 

  7. Masharawi Y, Rothschild B, Salame K et al. (2005) Facet tropism and interfacet shape in the thoracolumbar vertebrae: characterization and biomechanical interpretation. Spine 30: E281–E292

    Article  PubMed  Google Scholar 

  8. Panjabi MM, Goel V, Oxland T et al. (1992) Human lumbar vertebrae. Quantitative three-dimensional anatomy. Spine 17: 299–306

    Article  PubMed  Google Scholar 

  9. Patwardhan AG, Havey RM, Meade KP et al. (1999) A follower load increases the load-carrying capacity of the lumbar spine in compression. Spine 24: 1003–1009

    Article  PubMed  Google Scholar 

  10. Rohlmann A, Neller S, Claes L et al. (2001) Influence of a follower load on intradiscal pressure and intersegmental rotation of the lumbar spine. Spine 26: E557–E561

    Article  PubMed  Google Scholar 

  11. Rohlmann A, Zander T, Bergmann G (2006) Spinal loads after osteoporotic vertebral fractures treated by vertebroplasty or kyphoplasty. Eur Spine J 15: 1255–1264

    Article  PubMed  Google Scholar 

  12. Rohlmann A, Zander T, Bock B, Bergmann G (2007) Effect of position and height of a mobile core type artificial disc on the mechanical behaviour of the lumbar spine. Proc Inst Mech Eng [H] (submitted)

  13. Zander T, Rohlmann A, Bergmann G (2006) Comparison of conventional and kinematic modelling of an artificial disc. In 7th international symposium on computer methods in biomechanics and biomedical engineering. Antibes, France

  14. Zander T, Rohlmann A, Calisse J, Bergmann G (2001) Estimation of muscle forces in the lumbar spine during upper-body inclination. Clin Biomech 16: S73–S80

    Article  Google Scholar 

Download references

Interessenkonflikt

Die Studie wurde von der Deutschen Forschungsgemeinschaft (Ro 581/17–1) und der Fa. Aesculap unterstützt. Es bestehen keine Interessenkonflikte. Die Ergebnisse basieren auf einem Implantat der Fa. Aesculap, lassen sich jedoch auf Implantate gleichen Prinzips übertragen und sind daher produktneutral.

Author information

Affiliations

  1. Campus Benjamin Franklin, Klink für Orthopädie,Biomechanik-Labor, Charité - Universitätsmedizin Berlin, Hindenburgdamm 30, 12203, Berlin, Deutschland

    T. Zander,  A. Rohlmann, B. Bock & G. Bergmann

Authors
  1. T. Zander
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Rohlmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. B. Bock
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. G. Bergmann
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to A. Rohlmann.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Zander, T., Rohlmann, A., Bock, B. et al. Biomechanische Konsequenzen von verschiedenen Positionierungen bewegungserhaltender Bandscheibenimplantate. Orthopäde 36, 205–211 (2007). https://doi.org/10.1007/s00132-007-1056-9

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00132-007-1056-9

Schlüsselwörter

  • Lendenwirbelsäule
  • Finite Elemente
  • Bandscheibenprothese
  • Kinematik
  • Biomechanik

Keywords

  • Lumbar spine
  • Finite elements
  • Artificial disc
  • Kinematics
  • Biomechanics