Biomechanical analysis of adjacent segments after correction surgery for adult idiopathic scoliosis: a finite element analysis

Dong-hai Wang; Dan-ni Wu; Da-qi Xin; Qin Shi; Wen-xuan Wang; Wen-hua Xing; Hui-lin Yang

doi:10.1038/s41598-024-63113-9

Scientific Reports (Jun 2024)

Biomechanical analysis of adjacent segments after correction surgery for adult idiopathic scoliosis: a finite element analysis

Dong-hai Wang,
Dan-ni Wu,
Da-qi Xin,
Qin Shi,
Wen-xuan Wang,
Wen-hua Xing,
Hui-lin Yang

Affiliations

Dong-hai Wang: Department of Orthopedics, The First Affiliated Hospital of Soochow University, Orthopedic Institute of Soochow University
Dan-ni Wu: School of Kinesiology, Shanghai University of Sport
Da-qi Xin: Department of Orthopedics, The Second Affiliated Hospital of Inner Mongolia Medical University, Orthopedic Institute of Inner Mongolia Autonomous Region
Qin Shi: Department of Orthopedics, The First Affiliated Hospital of Soochow University, Orthopedic Institute of Soochow University
Wen-xuan Wang: Department of Orthopedics, The Second Affiliated Hospital of Inner Mongolia Medical University, Orthopedic Institute of Inner Mongolia Autonomous Region
Wen-hua Xing: Department of Orthopedics, The Second Affiliated Hospital of Inner Mongolia Medical University, Orthopedic Institute of Inner Mongolia Autonomous Region
Hui-lin Yang: Department of Orthopedics, The First Affiliated Hospital of Soochow University, Orthopedic Institute of Soochow University

DOI: https://doi.org/10.1038/s41598-024-63113-9
Journal volume & issue: Vol. 14, no. 1
pp. 1 – 15

Abstract

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Abstract The biomechanical aspects of adjacent segment degeneration after Adult Idiopathic Scoliosis (AdIS) corrective surgery involving postoperative changes in motion and stress of adjacent segments have yet to be investigated. The objective of this study was to evaluate the biomechanical effects of corrective surgery on adjacent segments in adult idiopathic scoliosis by finite element analysis. Based on computed tomography data of the consecutive spine from T1–S1 of a 28-year-old male patient with adult idiopathic scoliosis, a three-dimensional finite element model was established to simulate the biomechanics. Two posterior long-segment fixation and fusion operations were designed: Strategy A, pedicle screws implanted in all segments of both sides, and Strategy B, alternate screws instrumentation on both sides. The range of motion (ROM), Maximum von Mises stress value of intervertebral disc (IVD), and Maximum von Mises stress of the facet joint (FJ) at the fixation adjacent segment were calculated and compared with data of the preoperative AdIS model. Corrective surgery decreased the IVD on the adjacent segments, increased the FJ on the adjacent segments, and decreased the ROM of the adjacent segments. A greater decrease of Maximum von Mises stress was observed on the distal adjacent segment compared with the proximal adjacent segment. The decrease of Maximum von Mises stress and increment of Maximum von Mises stress on adjacent FJ in strategy B was greater than that in strategy A. Under the six operation modes, the change of the Maximum von Mises stress on the adjacent IVD and FJ was significant. The decrease in ROM in the proximal adjacent segment was greater than that of the distal adjacent segment, and the decrease of ROM in strategy A was greater than that in strategy B. This study clarified the biomechanical characteristics of adjacent segments after AdIS corrective surgery, and further biomechanical analysis of two different posterior pedicle screw placement schemes by finite element method. Our study provides a theoretical basis for the pathogenesis, prevention, and treatment of adjacent segment degeneration after corrective surgery for AdIS.

Published in Scientific Reports

ISSN: 2045-2322 (Online)
Publisher: Nature Portfolio
Country of publisher: United Kingdom
LCC subjects: Medicine; Science
Website: https://www.nature.com/srep/

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