TY - CHAP A1 - Galibarov, Pavel E. A1 - Al-Munajjed, Amir Andreas A1 - Dendorfer, Sebastian A1 - Christensen, Soeren Toerholm A1 - Rasmussen, John T1 - The effect of varying the stiffness of spinal fusion devices on the adjacent levels using multibody dynamics simulation T2 - Orthopaedic Proceedings N2 - INTRODUCTION Several clinical studies demonstrated long-term adjacent-level effects after implantation of spinal fusion devices[1]. These effects have been reported as adjacent joint degeneration and the development of new symptoms correlating with adjacent segment degeneration[2] and the trend has therefore gone to motion preservation devices; however, these effects have not been understood very well and have not been investigated thoroughly[3]. The aim of this study is to investigate the effect of varying the stiffness of spinal fusion devices on the adjacent vertebral levels. Disc forces, moments and facet joint forces were analyzed. METHODS The AnyBody Modeling System was used to compute the in-vivo muscle and joint reaction forces of a musculoskeletal model. The full body model used in this study consists of 188 muscle fascicles in the lumbar spine and more than 1000 individual muscle branches in total. The model has been proposed by de Zee et al.[3], validated by Rasmussen et al.[4] and by Galibarov et al.[5]. The new model[5] determines the individual motions between vertebrae based on the equilibrium between forces acting on the vertebrae from muscles and joints and the passive stiffness in disks and ligaments, figure 1a. An adult of 1.75 m and 75 kg with a spinal implant in L4L5 was modeled. This model was subjected to a flexion-extension motion using different elastic moduli to analyze and compare to a non-implanted scenario. The analyzed variables were vertebral motion, the disc reaction forces and moments, as well as facet joint forces in the treated and the adjacent levels: L2L3, L3L4, L4L5 and L5-Sacrum. RESULTS When introducing a spinal fusion device in the L4L5 joint the reaction forces and moments decreased in this joint with stiffer devices leading to lower joint loads. However, in the adjacent joints, L3L4 and L5Sacrum, an increase was observed when implanting stiffer devices. Similar trends could be found for the L2L3 joint. The loads in the facet joints showed the same trends. While introducing a spinal fusion device reduced the facet joint forces in the treated joint, the loads in the adjacent facet joints were increased according to the stiffness of the implanted device, figure 1b. DISCUSSION While the treated disc joint showed reduced motion and loads, the adjacent levels demonstrated a significant increase. In particular, the increased facet joint forces in the adjacent levels can lead to adjacent level facet pain or accelerated facet joint degeneration. Introducing a device resulted in preventing facet contact and therefore facet joint loads, even using the device with the lowest stiffness. CONCLUSION The presented model shows that clinical complications such as facet joint degeneration in adjacent levels after implantation of spinal fusion device are consistent with the change in the mechanical-stimulus distribution in the system. Y1 - 2011 VL - 94-B IS - SUPP_XL01 Sep 2012 SP - 2 ER - TY - CHAP A1 - Galibarov, Pavel E. A1 - Dendorfer, Sebastian A1 - Christensen, Soeren Toerholm T1 - On modelling spine curvature dependent on muscular and external forces in multibody dynamics system T2 - International Society of Biomechanics (ISB), 13th congress, 2011, Brussels, Belgium N2 - This paper presents a computational approach for investigating effect of muscular and external forces on curvature of the lumbar spine. Multibody dynamics system is used to compute the lumbar spine curvature using a force-dependent kinematics facility, e.g. this method allows releasing some degrees of freedom in order to be computed based on the current load configuration. Y1 - 2011 UR - https://paperpile.com/shared/63VCBY/download/2608c6d1-adef-0330-86f8-7996e623c627 SP - 2 ER - TY - CHAP A1 - Rasmussen, John A1 - Bichler, R. A1 - Christensen, Soeren Toerholm A1 - Wirix-Speetjens, Roel A1 - Dendorfer, Sebastian A1 - Renkawitz, Tobias T1 - Subject-specific Musculoskeletal Simulation of Hip Dislocation Risk in Activities of Daily Living T2 - Proceedings of the 2011 ORS Annual Meeting, Long Beach, CA. Y1 - 2011 UR - http://www.ors.org/Transactions/57/0306.pdf IS - Paper No. 306 ER - TY - CHAP A1 - Robie, Bruce A1 - Dendorfer, Sebastian A1 - Rasmussen, John A1 - Christensen, Soeren Toerholm T1 - Axial Rotation Requires Greatest Load in Multifidus Muscle – Potential Association with Low Back Pain? T2 - Annual Meeting of the AANS/CNS Section on Disorders of the Spine and Peripheral Nerves, 2011, Phoenix, Arizona Y1 - 2011 UR - https://paperpile.com/shared/o0LQEG ER - TY - CHAP A1 - Dendorfer, Sebastian A1 - Rasmussen, John A1 - Christensen, Soeren Toerholm A1 - Robie, Bruce T1 - The Effect of Spinal Disc Herniation on Multifidus Muscles T2 - 56th Orthopaedic Research Society Meeting, New Orleans, USA, 2010 Y1 - 2010 UR - https://www.ors.org/Transactions/56/1487.pdf ER - TY - CHAP A1 - Robie, Bruce A1 - Rasmussen, John A1 - Christensen, Soeren Toerholm A1 - Dendorfer, Sebastian T1 - Herniation Induces 55% Increase in Load of Key Stabilizing Muscle – Impact on Herniation Treatment Devices? T2 - Spine Arthoplasty Society Meeting, New Orleans, 2010 Y1 - 2010 ER -