Document Detail

Effect of annular incision type on the change in biomechanical properties in a herniated lumbar intervertebral disc.
MedLine Citation:
PMID:  12002133     Owner:  NLM     Status:  MEDLINE    
The technique used to incise the disc during discectomy may play a role in the subsequent healing and change in biomechanical stiffness of the disc. Several techniques of lumbar disc annulotomy have been described in clinical reports. The purpose of this paper was to study the influence of annulotomy technique on motion segment stiffness using a finite element model. Four incision methods (square, circular, cross, and slit) were compared. The analyses showed that each of the annular incisions produced increase in motions under axial moment loadings with circular incision producing the largest change in the corresponding rotational motion. Under shear loading mode, cross and slit-type annular incisions produced slightly larger changes in the principal motions of the disc than square and circular incisions. All other incision types considered in the current study produced negligibly small increase in motion under rest of the loading conditions. In addition to annulotomy, when nucleotomy was also included in the analyses, once again cross and slit incisions produced larger change in motion under shear loading mode as compared to the other two incision types. A comparison between the four types of annular incisions showed that cross incision produced an increase in motion larger than those produced by the other three incisions under flexion/extension and lateral moment loading and both shear force loadings. Circular incision produced the largest increase in motion under axial moment load in comparison to those produced by square, cross, and slit incisions. Sagittal plane symmetry was influenced by the incision injury to the motion segment leading to coupled motions as well as increased facet loads. From the study it can be concluded that the increase inflexibility of the disc due to annulotomy depends on the type of annulotomy and the annulotomy also produce asymmetrical deformations leading to increased facet loading.
R N Natarajan; G B J Andersson; A G Patwardhan; S Verma
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, Non-P.H.S.; Validation Studies    
Journal Detail:
Title:  Journal of biomechanical engineering     Volume:  124     ISSN:  0148-0731     ISO Abbreviation:  J Biomech Eng     Publication Date:  2002 Apr 
Date Detail:
Created Date:  2002-05-10     Completed Date:  2002-11-15     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7909584     Medline TA:  J Biomech Eng     Country:  United States    
Other Details:
Languages:  eng     Pagination:  229-36     Citation Subset:  IM    
Department of Orthopedic Surgery, Rush-Presbyterian-St Luke's Medical Center, Chicago, IL 60612, USA.
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MeSH Terms
Computer Simulation*
Diskectomy / methods
Finite Element Analysis
Intervertebral Disk Displacement / physiopathology*,  surgery*
Lumbar Vertebrae / physiopathology*,  surgery*
Models, Biological*
Sensitivity and Specificity
Stress, Mechanical
Weight-Bearing / physiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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