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TECHNICAL PAPERS

Effect of Annular Incision Type on the Change in Biomechanical Properties in a Herniated Lumbar Intervertebral Disc

[+] Author and Article Information
R. N. Natarajan, G. B. J. Andersson

Department of Orthopedic Surgery, Rush-Presbyterian-St. Luke’s Medical Center, 1653 West Congress Parkway, Chicago, IL 60612

A. G. Patwardhan

Department of Orthopaedic Surgery, Loyola University Medical Center, Maywood, IL 60606

S. Verma

Department of Mechanical Engineering, Illinois Institute Of Technology, Chicago, IL 60616

J Biomech Eng 124(2), 229-236 (Mar 29, 2002) (8 pages) doi:10.1115/1.1449906 History: Received August 31, 1999; Revised October 08, 2001; Online March 29, 2002
Copyright © 2002 by ASME
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References

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Holones, H. E., and Rothman, R. H., 1983, “Technique of Lumbar Laminectomy,” AAOS Instruction Course Lecture, C. V. Mosby Co., St. Louis, MO, Vol. 34, pp. 200–207.
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Either,  D. B., Cain,  J. E., Yaszemski,  M. J., Glover,  J. M., Klucznik,  R. P., Pyka,  R. E., and Lauerman,  W. C., 1994, “The Influence of Annulotomy Selection on Disc Competence—A Radiographic, Biomechanical, and Histologic Analysis,” Spine , 19, pp. 2071–2076.
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Shirazi-Adl,  S. A., Shrivastava,  S. C., and Ahmed,  A. M., 1983, “Stress Analysis of the Lumbar Disc-Body Unit in Compression—A Three Dimensional Nonlinear Finite Element Study,” Spine , l9, pp. 120–134.
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ADINA, R&D Inc., Watertown, MA 02172, USA.

Figures

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Finite element model prediction of the motion segment’s mechanical behavior in an intact motion segment, in a motion segment with square annular incision and in a segment with annular injury combined with nucleotomy under all loads compared favorably with experimental results of Panjabi et al. 5
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Finite element mesh of the annulus with the four incisions included in the current study are shown here. Even though the circular incision is circular in shape, the graphical package could only reproduce it with straight edges. One of the slits in the cross incision was filled with finite elements to model the slit incision.
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Cross and slit incisions produced similar increase in motions under shear loads. Circular incision produced largest increase in motion under axial moment loading modes.
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Disc flexibility increased by a large amount when in addition to the annular incision, nucleus was removed. Cross and slit incisions produced largest increase in motion under shear forces. Cross incision produced largest increase in motion in all moment loads except axial moment. Circular incision produced the largest increase in motion under axial moment.
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The largest increase in facet load occurred in a motion segment with the circular incision. Increase in facet load was observed under anteriorly directed shear force, extension moment, and left axial moment loads.
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The increase in facet load due to combined annulotomy and discectomy was much larger as compared to increase in facet load due to annular incision alone. The largest increase in facet load was produced by cross incision while the smallest increase in facet load was produced by the circular incision.
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Coupled lateral translation and lateral rotational motions were large when nucleus was removed in addition to annulotomy. Lateral bending coupled motion was more pronounced with cross and slit incisions under extension and right axial moment loads. Axial rotation coupled motion was also found to increase predominantly under cross and slit incisions under right lateral bending moment load.

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