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Biomechanics of Intervertebral Disc Herniation: in Silica Examinations of Spinal Decompression Surgery and Its Effect on Intervertebral Disc Herniation Risk.

Record Type:	Electronic resources : Monograph/item
Title/Author:	Biomechanics of Intervertebral Disc Herniation: in Silica Examinations of Spinal Decompression Surgery and Its Effect on Intervertebral Disc Herniation Risk./
Author:	Rossman, Stephanie.
Published:	Ann Arbor : ProQuest Dissertations & Theses, : 2021,
Description:	159 p.
Notes:	Source: Dissertations Abstracts International, Volume: 83-06, Section: B.
Contained By:	Dissertations Abstracts International83-06B.
Subject:	Biomechanics. -
Online resource:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=28776526
ISBN:	9798496560900

Biomechanics of Intervertebral Disc Herniation: in Silica Examinations of Spinal Decompression Surgery and Its Effect on Intervertebral Disc Herniation Risk.
Rossman, Stephanie.

Biomechanics of Intervertebral Disc Herniation: in Silica Examinations of Spinal Decompression Surgery and Its Effect on Intervertebral Disc Herniation Risk. - Ann Arbor : ProQuest Dissertations & Theses, 2021 - 159 p.

Source: Dissertations Abstracts International, Volume: 83-06, Section: B.

Thesis (Ph.D.)--Lawrence Technological University, 2021.

This item must not be sold to any third party vendors.

Lumbar spine finite element (FE) models have had limited use in clinical applications related to the effects of spinal decompression surgical techniques due to their lack of physiological loading conditions or failure to investigate intervertebral disc (IVD) loads associated with IVD herniation risk. Therefore, the objective of the current study was to develop a FE model that appropriately evaluates the IVD loads associated with IVD herniation risk, while also applying loading conditions that mimic physiological spinal loading and utilize the FE model to investigate the effect of a variety of decompression techniques on the risk of re-herniation.This dissertation includes a thorough literature review of the mechanics of IVD herniation and previous in vitro studies that have induced herniation. As a part of the literature review, previous FE models that have studied lumbar spine biomechanics are reviewed and will demonstrate that there are no known FE models that accurately predict IVD herniation risk while also applying physiological loading conditions. The first study involved several FE studies conducted to validate the current lumbar model and utilize the validated lumber FE model to accurately predict IVD herniation risk when exposed to loading mechanisms known to cause IVD herniation in vitro. The second study involved a series of FE studies utilizing the validated lumbar model to establish a set of loading conditions that mimic physiological spinal loads during upright standing and forward bending. As a part of the second study, the FE model was utilized to investigate the relationship between posterior extensor muscle force, facet joint contact, and IVD loads during forward bending. Lastly, the final study involved a series of FE studies utilizing the same validated lumbar FE model to investigate the effects of spinal decompression surgery techniques on IVD re-herniation risks.Results of the first study showed that the FE model predicted an increase in posterolateral nucleus pulposus (NP) extrusion force when the model was exposed to increasing levels of compression in conjunction with flexion. Additionally, the model predicted an increase in the posterior annular stress under these same loading modes. Therefore, this study provides a FE model with the ability to evaluate IVD herniation risk factors under a variety of loading mechanisms.The second study demonstrated FE model loading conditions that mimic physiological spinal loads during upright standing and forward bending. Further, this study demonstrated the relationship between the posterior extensor muscles (PEMs), facet joint contact, and disc loads. Specifically, when PEM force is increased the facet joint contact forces also increase resulting in decreased stresses in the IVD. These results have many clinical applications including understanding the effect of posterior muscle and facet joint alterations during surgical interventions to treat disc herniations.The final study demonstrated that the risk of IVD herniation was increased with partial or complete detachment of the PEM following decompression surgery. However, there was no significant change in the risk of re-herniation after hemilaminotomy or facetectomy when the muscles where left intact or when there was only limited muscle detachment. Thus, the most important factor for reducing the risk of re-herniation following decompression is to utilize the least invasive surgical approach possible to reduce muscle damage. If muscle detachment is unavoidable, post-operative care should include avoiding excessive spinal flexion that may distort the IVD and increase risk for re-herniation.This dissertation shows that when evaluating IVD herniation risk it is imperative to evaluate loads associated with IVD herniation including NP extrusion force and posterior IVD stress. For the FE model to be clinically relevant, physiological loading should be applied to the model ensuring that the lines of action of gravity loads and muscle loads are maintained. The posterior muscles of the lumbar spine are the most important influence that contributes to facet engagement and unloading the IVD. The most important factor for reducing IVD herniation risk after decompression surgery is to minimize posterior muscle damage by utilizing the most non-invasive surgical approach possible. While there were limitations, these studies lay the foundation for future lumbar FE modeling studies involving the investigation IVD herniation risk.

ISBN: 9798496560900Subjects--Topical Terms:

548685
Biomechanics.
Subjects--Index Terms:

Finite element model

Biomechanics of Intervertebral Disc Herniation: in Silica Examinations of Spinal Decompression Surgery and Its Effect on Intervertebral Disc Herniation Risk.
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