Biomechanical comparison between lumbar disc arthroplasty and fusion.pdfVIP

Available online at Medical Engineering Physics 31 (2009) 244–253 Biomechanical comparison between lumbar disc arthroplasty and fusion Shih-Hao Chen a , Zheng-Cheng Zhongb , Chen-Sheng Chen c , Wen-Jer Chen d , Chinghua Hungb,∗ a Department of Orthopaedics, Tzu Chi General Hospital, Taichung, Taiwan b Department of Mechanical Engineering, National Chiao Tung University, 1001 Ta Hsueh Road, Hsinchu, Taiwan 300, ROC c Department of Physical Therapy and Assistive Technology, National Yang Ming University, Taipei, Taiwan d Department of Orthopaedics, Chang Gung Memorial Hospital, Taoyuan, Taiwan Received 5 November 2007; received in revised form 3 July 2008; accepted 16 July 2008 Abstract The 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 (ProDis