| Title |
The influence of spinal fusion length on proximal junction biomechanics: a parametric computational study
|
|---|---|
| Published in |
European Spine Journal, July 2018
|
| DOI | 10.1007/s00586-018-5700-3 |
| Pubmed ID | |
| Authors |
Dominika Ignasiak, Tobias Peteler, Tamás F. Fekete, Daniel Haschtmann, Stephen J. Ferguson |
| Abstract |
Proximal junctional kyphosis and failure are frequent complications in adult spinal deformity surgery with long fusion constructs. The aim of this study was to assess the biomechanics of the proximal segment for fusions of various lengths. A previously established musculoskeletal model of thoracolumbar spine was used to simulate full-range flexion task for fusions (modeled by introduction of rigid constraints) with lower instrumented vertebrae at L5 or S1 and upper instrumented vertebrae (UIV) at any level above, up to T2. Inverse dynamics simulations with force-dependent kinematics were performed for gradually increasing spinal flexion in order to predict global and segmental range of flexion, maximum passive moment, segmental compression and shear forces, which were compared to the uninstrumented case. For long fusions, with the UIV at T11 or higher, the model predicted an increase in segmental flexion (by 33-860%, or 1.6°-4.7°) and passive moment (by 39-1370%, or 13-31 Nm) at the proximal junction-generally increasing with fusion length. While the maximum shear force was 57-239% (135-283 N) higher for the proximal junction at the upper thorax (UIV at T6 or above), the compression forces were reduced by up to 44% (375 N). The length of the instrumentation has an important effect on the proximal segment biomechanics. Despite the limitations of the current model, musculoskeletal modeling appears to be a promising and versatile method to support planning of spinal instrumentation surgeries in the future. These slides can be retrieved under Electronic Supplementary Material. |
X Demographics
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Geographical breakdown
| Country | Count | As % |
|---|---|---|
| France | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 54 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 54 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 12 | 22% |
| Student > Ph. D. Student | 10 | 19% |
| Researcher | 7 | 13% |
| Student > Doctoral Student | 2 | 4% |
| Student > Bachelor | 2 | 4% |
| Other | 7 | 13% |
| Unknown | 14 | 26% |
| Readers by discipline | Count | As % |
|---|---|---|
| Engineering | 16 | 30% |
| Medicine and Dentistry | 12 | 22% |
| Nursing and Health Professions | 3 | 6% |
| Neuroscience | 2 | 4% |
| Computer Science | 1 | 2% |
| Other | 2 | 4% |
| Unknown | 18 | 33% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 23 July 2018.
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#18,643,992
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Outputs from European Spine Journal
#2,509
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Outputs of similar age from European Spine Journal
#47
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