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dc.contributor.authorChen, Shih-Haoen_US
dc.contributor.authorZhong, Zheng-Chengen_US
dc.contributor.authorChen, Chen-Shengen_US
dc.contributor.authorChen, Wen-Jeren_US
dc.contributor.authorHung, Chinghuaen_US
dc.date.accessioned2014-12-08T15:09:52Z-
dc.date.available2014-12-08T15:09:52Z-
dc.date.issued2009-03-01en_US
dc.identifier.issn1350-4533en_US
dc.identifier.urihttp://dx.doi.org/10.1016/j.medengphy.2008.07.007en_US
dc.identifier.urihttp://hdl.handle.net/11536/7551-
dc.description.abstractThe artificial disc is a mobile implant for degenerative disc replacement that attempts to lessen the degeneration of the adjacent elements. However, inconsistent biomechanical results for the neighboring elements have been reported in a number of studies. The present study used finite element (FE) analysis to explore the biomechanical differences at the surgical and both adjacent levels following artificial disc replacement and interbody fusion procedures. First, a three-dimensional FE model of a five-level lumbar spine was established by the commercially available medical imaging software Amira 3.1.1, and FE software ANSYS 9.0. After validating the five-level intact (INT) model with previous in vitro studies, the L3/L4 level of the INT model was modified to either insert an artificial disc (ProDisc II; ADR) or incorporate bilateral posterior lumbar interbody fusion (PLIF) cages with a pedicle screw fixation system. All models were constrained at the bottom of the L5 vertebra and subjected to 150 N preload and 10 N m moments under four physiological motions. The ADR model demonstrated higher range of motion (ROM), annulus stress, and facet contact pressure at the surgical level compared to the non-modified INT model. At both adjacent levels, ROM and annulus stress were similar to that of the INT model and varied less than 7%. In addition, the greatest displacement of posterior annulus occurred at the superior-lateral region. Conversely, the PLIF model showed less ROM, less annulus stress, and no facet contact pressure at the surgical level compared to the INT model. The adjacent levels had obviously high ROM, annulus stress, and facet contact pressure, especially at the adjacent L2/3 level. In conclusion, the artificial disc replacement revealed no adjacent-level instability. However, instability was found at the surgical level, which might accelerate degeneration at the highly stressed annulus and facet joint. In contrast to disc replacement results, the posterior interbody fusion procedure revealed possibly accelerative degeneration of the annulus and facet joint at both adjacent levels. (C) 2008 IPEM. Published by Elsevier Ltd. All rights reserved.en_US
dc.language.isoen_USen_US
dc.subjectFinite element methodsen_US
dc.subjectArtificial disc replacementen_US
dc.subjectLumbar interbody fusionen_US
dc.subjectAdjacent segment degenerationen_US
dc.titleBiomechanical comparison between lumbar disc arthroplasty and fusionen_US
dc.typeArticleen_US
dc.identifier.doi10.1016/j.medengphy.2008.07.007en_US
dc.identifier.journalMEDICAL ENGINEERING & PHYSICSen_US
dc.citation.volume31en_US
dc.citation.issue2en_US
dc.citation.spage244en_US
dc.citation.epage253en_US
dc.contributor.department機械工程學系zh_TW
dc.contributor.departmentDepartment of Mechanical Engineeringen_US
dc.identifier.wosnumberWOS:000263872200011-
dc.citation.woscount38-
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