Affordable Access

Access to the full text

Biomechanics of high-grade spondylolisthesis with and without reduction

Authors
  • Wang, Wenhai1, 2
  • Aubin, Carl-Eric1, 3
  • Cahill, Patrick4
  • Baran, George2
  • Arnoux, Pierre-Jean5
  • Parent, Stefan1
  • Labelle, Hubert1
  • 1 Sainte-Justine University Hospital Center (University of Montreal), 3175 Côte-Ste-Catherine Rd., Montreal, QC, H3T 1C5, Canada , Montreal (Canada)
  • 2 Temple University, College of Engineering, 1947N 12th Street, Philadelphia, PA, 19122, USA , Philadelphia (United States)
  • 3 Polytechnique Montreal, Department of Mechanical Engineering, Station “Centre-ville”, Montreal, QC, H3C 3A7, Canada , Montreal (Canada)
  • 4 Shriners Hospitals for Children–Philadelphia, 3551 North Broad Street, Philadelphia, PA, 19140, USA , Philadelphia (United States)
  • 5 UMRT24 IFSTTAR/Aix-Marseille Université, Laboratoire de Biomécanique Appliquée, Boulevard Pierre Dramard, Marseille Cedex 20, 13916, France , Marseille Cedex 20 (France)
Type
Published Article
Journal
Medical & Biological Engineering & Computing
Publisher
Springer-Verlag
Publication Date
Aug 02, 2015
Volume
54
Issue
4
Pages
619–628
Identifiers
DOI: 10.1007/s11517-015-1353-0
Source
Springer Nature
Keywords
License
Yellow

Abstract

The clinical advantages of reducing spondylolisthesis over fusion in situ have several intuitive reasons such as restore the spinal column into a more anatomic relationship and alignment. However, there is only little evidence in the literature supporting the theoretical advantages of reduction, and its effect on spinopelvic alignment remains poorly defined. In this study, a comprehensive finite element model was developed to analyze the biomechanics of the spine after spinal fusion at L5–S1 in both types of high-grade spondylolisthesis (balanced and unbalanced pelvis). The relevant clinical indices (i.e. spondylolisthesis grade and Dubousset lumbosacral angle), the displacement of L4–L5, pressure within the annulus and nucleus, and stress at L4–L5 were evaluated and compared. The model can well predict the changes of the important clinical indices during the surgery. For a balanced pelvis, the reduction has a minimal effect on the biomechanical conditions at the adjacent level during postsurgical activities. In the unbalanced case, reduction induced larger deformation in the lumbosacral region and a higher stress concentration at adjacent level. Whether such a stress concentration can lead to long-term disc degeneration is not known. The results provide additional information for the clinician considering reduction of high-grade spondylolisthesis.

Report this publication

Statistics

Seen <100 times