Biomechanical characteristics of different types of lumbar disc herniation: a finite element analysis
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Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine

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    Abstract:

    Objective: To explore the biomechanical characteristics of different types of lumbar disc herniation, and to provide a theoretical basis for the clinical classification, diagnosis, and treatment of LDH. Methods: To construct a normal lumbar spine model with spinal nerves and four types of LDH models (Central type, Paracentral type/lateral recess type, Intervertebral foramen type, Extreme type), analyze the biomechanical characteristics of the intervertebral discs and nerve roots under neutral posture and six degrees of freedom conditions. Results: ① In the neutral position, the stress of normal intervertebral disc is greater than that of the herniated intervertebral disc, and the stress ratio of annulus fibrosus and nucleus pulposus in the normal model is greater than those of annulus fibrosus and nucleus pulposus in herniated models: the intervertebral disc stress of normal type, central type, lateral recess type, intervertebral foramen type and Extreme type were 0.76Mpa, 0.32Mpa, 0.55Mpa, 0.35Mpa and 0.35Mpa, respectively, The stress ratios of fibrous annulus and nucleus pulposus were 3.67:1, 1.32:1, 1.42:1, 1.40:1 and 1.45:1, respectively. ② In the neutral position, the disc stress was mainly concentrated at the incisor between the protrusion and normal part, and recruitment occurred at the disc's outer edge. ③ In the flexion and extension position, the stress of the herniated intervertebral disc shifted to the affected side. The maximum stress of herniated intervertebral disc appeared in the right flexion condition, where the intervertebral disc stress of normal type, central type, lateral recess type, intervertebral foraminal type, and extreme type was 0.59Mpa, 0.67Mpa, 0.64Mpa and 0.63Mpa, respectively. The nerve root stress on the affected side was greater than that on the healthy side. The stress of the herniated intervertebral disc in the right rotation condition is slightly lower than that in the right flexion condition, and the stress of nerve root on the affected side is less than that on the healthy side. Conclusion: The intervertebral disc is important in maintaining lumbar dynamic and static stability and flexibility. Different positions have obvious effects on the stress of the intervertebral disc. For patients with LDH, forward bending, flexion of the affected side and large extension should be avoided. Appropriate rotation of the affected side can help relieve the symptoms of nerve root compression.

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History
  • Received:August 01,2024
  • Revised:September 11,2024
  • Adopted:September 12,2024
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