000079119 001__ 79119
000079119 005__ 20210318091406.0
000079119 0247_ $$2doi$$a10.1016/j.cmpb.2018.05.022
000079119 0248_ $$2sideral$$a106391
000079119 037__ $$aART-2018-106391
000079119 041__ $$aeng
000079119 100__ $$0(orcid)0000-0002-7985-6412$$aCalvo-Echenique, A.$$uUniversidad de Zaragoza
000079119 245__ $$aStand-alone lumbar cage subsidence: A biomechanical sensitivity study of cage design and placement.
000079119 260__ $$c2018
000079119 5060_ $$aAccess copy available to the general public$$fUnrestricted
000079119 5203_ $$aBackground and objective: Spinal degeneration and instability are commonly treated with interbody fusion cages either alone or supplemented with posterior instrumentation with the aim to immobilise the segment and restore intervertebral height. The purpose of this work is to establish a tool which may help to understand the effects of intervertebral cage design and placement on the biomechanical response of a patient-specific model to help reducing post-surgical complications such as subsidence and segment instability.
Methods: A 3D lumbar functional spinal unit (FSU) finite element model was created and a parametric model of an interbody cage was designed and introduced in the FSU. A Drucker–Prager Cap plasticity formulation was used to predict plastic strains and bone failure in the vertebrae. The effect of varying cage size, cross-sectional area, apparent stiffness and positioning was evaluated under 500 N preload followed by 7.5 Nm multidirectional rotation and the results were compared with the intact model.
Results: The most influential cage parameters on the FSU were size, curvature congruence with the endplates and cage placement. Segmental stiffness was higher when increasing the cross-sectional cage area in all loading directions and when the cage was anteriorly placed in all directions but extension. In general, the facet joint forces were reduced by increasing segmental stiffness. However, these forces were higher than in the intact model in most of the cases due to the displacement of the instantaneous centre of rotation. The highest plastic deformations took place at the caudal vertebra under flexion and increased for cages with greater stiffness. Thus, wider cages and a more anteriorly placement would increase the volume of failed bone and, therefore, the risk of subsidence.
Conclusions: Cage geometry plays a crucial role in the success of lumbar surgery. General considerations such as larger cages may be applied as a guideline, but parameters such as curvature or cage placement should be determined for each specific patient. This model provides a proof-of-concept of a tool for the preoperative evaluation of lumbar surgical outcomes.
000079119 536__ $$9info:eu-repo/grantAgreement/ES/MINECO/DPI2016-79302-R$$9info:eu-repo/grantAgreement/ES/MEC/FPU13-01070
000079119 540__ $$9info:eu-repo/semantics/openAccess$$aby-nc-nd$$uhttp://creativecommons.org/licenses/by-nc-nd/3.0/es/
000079119 590__ $$a3.424$$b2018
000079119 591__ $$aCOMPUTER SCIENCE, INTERDISCIPLINARY APPLICATIONS$$b25 / 106 = 0.236$$c2018$$dQ1$$eT1
000079119 591__ $$aMEDICAL INFORMATICS$$b6 / 26 = 0.231$$c2018$$dQ1$$eT1
000079119 591__ $$aCOMPUTER SCIENCE, THEORY & METHODS$$b15 / 104 = 0.144$$c2018$$dQ1$$eT1
000079119 591__ $$aENGINEERING, BIOMEDICAL$$b22 / 80 = 0.275$$c2018$$dQ2$$eT1
000079119 592__ $$a0.753$$b2018
000079119 593__ $$aComputer Science Applications$$c2018$$dQ1
000079119 593__ $$aSoftware$$c2018$$dQ1
000079119 593__ $$aHealth Informatics$$c2018$$dQ1
000079119 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/acceptedVersion
000079119 700__ $$0(orcid)0000-0002-2967-6747$$aCegoñino, J.$$uUniversidad de Zaragoza
000079119 700__ $$aChueca, R.
000079119 700__ $$0(orcid)0000-0003-0669-777X$$aPérez-del Palomar, A.$$uUniversidad de Zaragoza
000079119 7102_ $$15004$$2605$$aUniversidad de Zaragoza$$bDpto. Ingeniería Mecánica$$cÁrea Mec.Med.Cont. y Teor.Est.
000079119 773__ $$g162 (2018), 211-219$$pComput. methods programs biomed.$$tComputer Methods and Programs in Biomedicine$$x0169-2607
000079119 8564_ $$s754064$$uhttps://zaguan.unizar.es/record/79119/files/texto_completo.pdf$$yPostprint
000079119 8564_ $$s37204$$uhttps://zaguan.unizar.es/record/79119/files/texto_completo.jpg?subformat=icon$$xicon$$yPostprint
000079119 909CO $$ooai:zaguan.unizar.es:79119$$particulos$$pdriver
000079119 951__ $$a2021-03-18-09:09:35
000079119 980__ $$aARTICLE