title: Preserving Posterior Complex Can Prevent Adjacent Segment Disease following Posterior Lumbar Interbody Fusion Surgeries: A Finite Element Analysis.
abstract: OBJECTIVE
  To investigate the biomechanical effects of the lumbar posterior complex on the adjacent segments after posterior lumbar interbody fusion (PLIF) surgeries.
  
  
  METHODS
  A finite element model of the L1-S1 segment was modified to simulate PLIF with total laminectomy (PLIF-LAM) and PLIF with hemilaminectomy (PLIF-HEMI) procedures. The models were subjected to a 400N follower load with a 7.5-N.m moment of flexion, extension, torsion, and lateral bending. The range of motion (ROM), intradiscal pressure (IDP), and ligament force were compared.
  
  
  RESULTS
  In Flexion, the ROM, IDP and ligament force of posterior longitudinal ligament, intertransverse ligament, and capsular ligament remarkably increased at the proximal adjacent segment in the PLIF-LAM model, and slightly increased in the PLIF-HEMI model. There was almost no difference for the ROM, IDP and ligament force at L5-S1 level between the two PLIF models although the ligament forces of ligamenta flava remarkably increased compared with the intact lumbar spine (INT) model. For the other loading conditions, these two models almost showed no difference in ROM, IDP and ligament force on the adjacent discs.
  
  
  CONCLUSIONS
  Preserved posterior complex acts as the posterior tension band during PLIF surgery and results in less ROM, IDP and ligament forces on the proximal adjacent segment in flexion. Preserving the posterior complex during decompression can be effective on preventing adjacent segment degeneration (ASD) following PLIF surgeries.
authors.affiliation: Department of Orthopaedics, The First Affiliated Hospital of Fujian Medical University, Fuzhou City, Fujian Province, 350005, China.
authors.forename: Yun-Peng
authors.initials: YP
authors.lastname: Huang
authors.affiliation: Tianjin Key Laboratory for Advanced Mechatronic System Design and Intelligent Control, Tianjin University of Technology, Tianjin, 300384, China.|Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, International Research Center for Implantable and Interventional Medical Devices, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, China.
authors.forename: Cheng-Fei
authors.initials: CF
authors.lastname: Du
authors.affiliation: Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, International Research Center for Implantable and Interventional Medical Devices, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, China.|Orthopaedic Device Research Center, National Yang-Ming University, 11221, Taipei, China.
authors.forename: Cheng-Kung
authors.initials: CK
authors.lastname: Cheng
authors.affiliation: Orthopaedic Device Research Center, National Yang-Ming University, 11221, Taipei, China.
authors.forename: Zheng-Cheng
authors.initials: ZC
authors.lastname: Zhong
authors.affiliation: Department of Orthopaedics, The First Affiliated Hospital of Fujian Medical University, Fuzhou City, Fujian Province, 350005, China.
authors.forename: Xuan-Wei
authors.initials: XW
authors.lastname: Chen
authors.affiliation: Department of Orthopaedics, The First Affiliated Hospital of Fujian Medical University, Fuzhou City, Fujian Province, 350005, China.
authors.forename: Gui
authors.initials: G
authors.lastname: Wu
authors.affiliation: Department of Orthopaedics, The First Affiliated Hospital of Fujian Medical University, Fuzhou City, Fujian Province, 350005, China.
authors.forename: Zhe-Cheng
authors.initials: ZC
authors.lastname: Li
authors.affiliation: Tianjin Key Laboratory for Advanced Mechatronic System Design and Intelligent Control, Tianjin University of Technology, Tianjin, 300384, China.
authors.forename: Jin-Duo
authors.initials: JD
authors.lastname: Ye
authors.affiliation: Department of Orthopaedics, The First Affiliated Hospital of Fujian Medical University, Fuzhou City, Fujian Province, 350005, China.
authors.forename: Jian-Hua
authors.initials: JH
authors.lastname: Lin
authors.affiliation: Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, International Research Center for Implantable and Interventional Medical Devices, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, China.
authors.forename: Li Zhen
authors.initials: LZ
authors.lastname: Wang
mesh_terms: D001696:Biomechanical Phenomena; D020342:Finite Element Analysis; D006801:Humans; D007796:Laminectomy / Q000379:methods*; D017846:Longitudinal Ligaments; D008159:Lumbar Vertebrae / Q000503:physiopathology / Q000601:surgery*; D016059:Range of Motion, Articular; D013123:Spinal Fusion / Q000009:adverse effects*