Objective. To investigate the biomechanical aspects of etiology,pathology, clinical manifestation, diagnosis and surgical treatment of the lumbar spinal stenosis. Methods’ A series of biomechanical methods, such as t...Objective. To investigate the biomechanical aspects of etiology,pathology, clinical manifestation, diagnosis and surgical treatment of the lumbar spinal stenosis. Methods’ A series of biomechanical methods, such as three-dimensional finite element models. three-dimensional kinematic measurement, cadeveric evaluation, and imaging assessment was applied to correlate lumbar biomechanics and lumbar spinal stenosis. Surgery of lumbar spinal stenosis has been improved. Results. The stresses significantly concentrate on the posterolateral part of the annulus fibrosus of disc, the posterior surface of vertebral body, the pedicle, the interarticularis and the facet joints. This trend is intensified by disc degeneration and lumbar backward extension. Posterior element resection has a definite effect upon the biomechanical behavior of lumbar vertebrae. The improved operations proved satis- factory. Conclusion. Stress concentration in the lumbar vertebrae is of importance to the etiology of degenerative lumbar spinal stenosis, and disc degeneration is the initial key of this process. Then these will be aggravated by backward extension. Functional radiography and myelography are of assistance to the diagnosis o f the lumbar spinal stenosis. For the surgical treatment of the lumbar spinal stenosis, destruction of the posterior element should be avoid as far as possible based upon the thorough decompression. Maintaining the lumbar spine in flexion by fusion after decompression has been proved a useful method. When developmental spinal stenosis is combined with disc herniation, discectomy through laminotomy is recommend for decompression.展开更多
Objective To evaluate the outcome of two methods for stabilization and fusion: posterolateral fusion and circumferential fusion involving posterior lumbar interbody fusion for lumbar stenosis with Grades 1 and 2 lumba...Objective To evaluate the outcome of two methods for stabilization and fusion: posterolateral fusion and circumferential fusion involving posterior lumbar interbody fusion for lumbar stenosis with Grades 1 and 2 lumbar spondylolisthesis.Methods From April 1998 to April 2003, 45 patients suffering from lumbar stenosis with low degree lumbar spondylolisthesis treated in our hospital were retrospectively reviewed and assigned to two groups.Among them, 24 patients (group A) were treated with instrumented posterolateral fusion and 21 patients (group B) with instrumented circumferential fusion.The two groups were compared for clinical and radiological outcomes.Results All patients were followed up for 12 to 72 months.In group A, results showed preoperative clinical symptoms disappeared completely in 12 of 24 patients, and pain relief was seen in 91.7% (22/24).Two cases suffered from residual symptoms.Twenty-two cases obtained complete reduction of olisthy vertebral bodies, and anatomical reduction rate was 91.7%.No infection or neurological complication occurred in this group.In group B, results showed preoperative clinical symptoms disappeared completely in 13 of 21 patients, and pain relief was seen in 90.5% (19/21).One case suffered from residual symptoms.Twenty cases obtained complete reduction of the olisthy vertebral bodies, and anatomical reduction rate was 95.2%.Four cases of infection or neurological complication occurred in this group.Both groups indicated no significant difference in clinical outcomes and anatomical reduction rate during follow-up.But group A had better intraoperative circumstances and postoperative outcome than group B, while group B had better postoperative parameters in X-ray of Angle of Slipping and Disc Index than group A.Conclusions The first choice of surgical method for lumbar stenosis with low degree lumbar spondylolisthesis is instrumented posterolateral fusion.Only when patients suffer from severe preoperative disc degeneration and low back pain or intervertebral instability should we consider indications for additional use of CAGE.展开更多
A three-dimensional finite element model of the lumbar motion segment was used to predict the stress distribution in lumbar spine with posterior element resection. It was shown that the stress level in all parts of th...A three-dimensional finite element model of the lumbar motion segment was used to predict the stress distribution in lumbar spine with posterior element resection. It was shown that the stress level in all parts of the lumbar spine was elevated although the stress distribution remained unchanged. The authors concluded that the posterior element resection in lumbar surgery should be avoided as much as possible.展开更多
The lumbar ligaments play an important role in spinal biomechanics.The results ofthree-dimensional finite dement analysis showed that one of the functions of lumbar ligaments istransmission of the tensile load between...The lumbar ligaments play an important role in spinal biomechanics.The results ofthree-dimensional finite dement analysis showed that one of the functions of lumbar ligaments istransmission of the tensile load between the lumbar vertebrae.The anterior longitudinal ligament isloaded in extension of lumbar spine and the resistance to the tensile load in flexion is providedby other ligaments.These ligaments are subject to much more tension with degeneration of theintervertebral disc so that a series of pathological changes occur.Relevant significance in clinical as-pect is also discussed.展开更多
Objective:To investigate the relationship between morphological abnormalities and spinal cord deficit in thoracolumbar burst fractures. Methods: Seventy-eight patients with thoracolumbar burst fractures were retrospec...Objective:To investigate the relationship between morphological abnormalities and spinal cord deficit in thoracolumbar burst fractures. Methods: Seventy-eight patients with thoracolumbar burst fractures were retrospectively reviewed to calculate the stenotic ratio of spinal canal based on the midsagittal diameters and the hyphosis angle according to Cobb. The ASIA scoring of motor function of lower extremities was recorded . Results: The differences (P > 0.05) of the stenotic ratio of spinal canal and the kyphosis angle were not significant between patients without neurological deficit, with incomplete and complete lesions. No significant correlation(P > 0.05) between the stenotic ratio of spinal canal and the kyphosis angle, and ASIA scoring was noted. Conclusion:The severity of spinal cord injuries in thoracolumbar burst fractures is not predicted according to the percentage of canal stenosis or the degree of kyphesis induced by thoracolumbar burst fractures.展开更多
目的基于Cite Space探讨腰椎黄韧带有限元模型研究的热点与趋势。方法检索1990年1月至2023年8月中国知网、维普网、万方数据知识服务平台3大数据库中,腰椎黄韧带有限元模型的相关中文文献;运用Cite Space 5.7.R5软件生成作者、机构合作...目的基于Cite Space探讨腰椎黄韧带有限元模型研究的热点与趋势。方法检索1990年1月至2023年8月中国知网、维普网、万方数据知识服务平台3大数据库中,腰椎黄韧带有限元模型的相关中文文献;运用Cite Space 5.7.R5软件生成作者、机构合作、关键词等图谱。结果共纳入文献1395篇,发文量总体呈增长趋势;核心作者丁宇发文最多;发文量最多机构为上海大学期刊社;关键词中“生物力学”出现频次最高;生成了“生物力学”等9个聚类;时间线路图中,最大的节点为“姿势性脊柱后凸”;突现图中“活动度”的研究持续至今。结论腰椎黄韧带有限元模型领域的研究总体增加,主要热点是“生物力学”,“脊柱”将是未来有限元领域的研究重点。展开更多
基金This project was supported by the National Natural ScienceFoundation of China.
文摘Objective. To investigate the biomechanical aspects of etiology,pathology, clinical manifestation, diagnosis and surgical treatment of the lumbar spinal stenosis. Methods’ A series of biomechanical methods, such as three-dimensional finite element models. three-dimensional kinematic measurement, cadeveric evaluation, and imaging assessment was applied to correlate lumbar biomechanics and lumbar spinal stenosis. Surgery of lumbar spinal stenosis has been improved. Results. The stresses significantly concentrate on the posterolateral part of the annulus fibrosus of disc, the posterior surface of vertebral body, the pedicle, the interarticularis and the facet joints. This trend is intensified by disc degeneration and lumbar backward extension. Posterior element resection has a definite effect upon the biomechanical behavior of lumbar vertebrae. The improved operations proved satis- factory. Conclusion. Stress concentration in the lumbar vertebrae is of importance to the etiology of degenerative lumbar spinal stenosis, and disc degeneration is the initial key of this process. Then these will be aggravated by backward extension. Functional radiography and myelography are of assistance to the diagnosis o f the lumbar spinal stenosis. For the surgical treatment of the lumbar spinal stenosis, destruction of the posterior element should be avoid as far as possible based upon the thorough decompression. Maintaining the lumbar spine in flexion by fusion after decompression has been proved a useful method. When developmental spinal stenosis is combined with disc herniation, discectomy through laminotomy is recommend for decompression.
文摘Objective To evaluate the outcome of two methods for stabilization and fusion: posterolateral fusion and circumferential fusion involving posterior lumbar interbody fusion for lumbar stenosis with Grades 1 and 2 lumbar spondylolisthesis.Methods From April 1998 to April 2003, 45 patients suffering from lumbar stenosis with low degree lumbar spondylolisthesis treated in our hospital were retrospectively reviewed and assigned to two groups.Among them, 24 patients (group A) were treated with instrumented posterolateral fusion and 21 patients (group B) with instrumented circumferential fusion.The two groups were compared for clinical and radiological outcomes.Results All patients were followed up for 12 to 72 months.In group A, results showed preoperative clinical symptoms disappeared completely in 12 of 24 patients, and pain relief was seen in 91.7% (22/24).Two cases suffered from residual symptoms.Twenty-two cases obtained complete reduction of olisthy vertebral bodies, and anatomical reduction rate was 91.7%.No infection or neurological complication occurred in this group.In group B, results showed preoperative clinical symptoms disappeared completely in 13 of 21 patients, and pain relief was seen in 90.5% (19/21).One case suffered from residual symptoms.Twenty cases obtained complete reduction of the olisthy vertebral bodies, and anatomical reduction rate was 95.2%.Four cases of infection or neurological complication occurred in this group.Both groups indicated no significant difference in clinical outcomes and anatomical reduction rate during follow-up.But group A had better intraoperative circumstances and postoperative outcome than group B, while group B had better postoperative parameters in X-ray of Angle of Slipping and Disc Index than group A.Conclusions The first choice of surgical method for lumbar stenosis with low degree lumbar spondylolisthesis is instrumented posterolateral fusion.Only when patients suffer from severe preoperative disc degeneration and low back pain or intervertebral instability should we consider indications for additional use of CAGE.
文摘A three-dimensional finite element model of the lumbar motion segment was used to predict the stress distribution in lumbar spine with posterior element resection. It was shown that the stress level in all parts of the lumbar spine was elevated although the stress distribution remained unchanged. The authors concluded that the posterior element resection in lumbar surgery should be avoided as much as possible.
基金The project was supported by the National Natura Science Foundation of China
文摘The lumbar ligaments play an important role in spinal biomechanics.The results ofthree-dimensional finite dement analysis showed that one of the functions of lumbar ligaments istransmission of the tensile load between the lumbar vertebrae.The anterior longitudinal ligament isloaded in extension of lumbar spine and the resistance to the tensile load in flexion is providedby other ligaments.These ligaments are subject to much more tension with degeneration of theintervertebral disc so that a series of pathological changes occur.Relevant significance in clinical as-pect is also discussed.
文摘Objective:To investigate the relationship between morphological abnormalities and spinal cord deficit in thoracolumbar burst fractures. Methods: Seventy-eight patients with thoracolumbar burst fractures were retrospectively reviewed to calculate the stenotic ratio of spinal canal based on the midsagittal diameters and the hyphosis angle according to Cobb. The ASIA scoring of motor function of lower extremities was recorded . Results: The differences (P > 0.05) of the stenotic ratio of spinal canal and the kyphosis angle were not significant between patients without neurological deficit, with incomplete and complete lesions. No significant correlation(P > 0.05) between the stenotic ratio of spinal canal and the kyphosis angle, and ASIA scoring was noted. Conclusion:The severity of spinal cord injuries in thoracolumbar burst fractures is not predicted according to the percentage of canal stenosis or the degree of kyphesis induced by thoracolumbar burst fractures.
文摘目的基于Cite Space探讨腰椎黄韧带有限元模型研究的热点与趋势。方法检索1990年1月至2023年8月中国知网、维普网、万方数据知识服务平台3大数据库中,腰椎黄韧带有限元模型的相关中文文献;运用Cite Space 5.7.R5软件生成作者、机构合作、关键词等图谱。结果共纳入文献1395篇,发文量总体呈增长趋势;核心作者丁宇发文最多;发文量最多机构为上海大学期刊社;关键词中“生物力学”出现频次最高;生成了“生物力学”等9个聚类;时间线路图中,最大的节点为“姿势性脊柱后凸”;突现图中“活动度”的研究持续至今。结论腰椎黄韧带有限元模型领域的研究总体增加,主要热点是“生物力学”,“脊柱”将是未来有限元领域的研究重点。
