A finite element study of the relationship between upper body weight and the loads experienced by the human lumbosacral spine, and fusion instrumentation, in a standing upright posture

Background: A quantitative relationship between increasing upper body weight and both 1) non-instrumented lumbosacral joint loading and 2) fusion instrumentation reactions is established using a three-dimensional (3D) finite element model (FEM) of the human thoracolumbosacral spine. Methods: A 3D FE...

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Autores principales:	Justin M Warren, MS, PhD, Lloyd A Hey, MD, MS, Andre P Mazzoleni, PhD
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Obesity Overweight Finite Element Method Fusion Low Back Pain Medical technology R855-855.5
Acceso en línea:	https://doaj.org/article/b5558a720307492ba2c4cc8ada247b1e
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spelling	oai:doaj.org-article:b5558a720307492ba2c4cc8ada247b1e2021-12-02T05:04:35ZA finite element study of the relationship between upper body weight and the loads experienced by the human lumbosacral spine, and fusion instrumentation, in a standing upright posture2667-099210.1016/j.bea.2021.100023https://doaj.org/article/b5558a720307492ba2c4cc8ada247b1e2021-12-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2667099221000232https://doaj.org/toc/2667-0992Background: A quantitative relationship between increasing upper body weight and both 1) non-instrumented lumbosacral joint loading and 2) fusion instrumentation reactions is established using a three-dimensional (3D) finite element model (FEM) of the human thoracolumbosacral spine. Methods: A 3D FEM of the thoracolumbosacral spine (both non-instrumented and instrumented with fusion instrumentation) is developed and validated against cadaveric spine specimens. Upper body weight loading is applied to simulate an individual with varying levels of body mass index (BMI) including 25 kg/m2, 30 kg/m2, 35 kg/m2, and 40 kg/m2. Maximum force/moment joint reactions from L1–S1 in the non-instrumented model are recorded. Maximum instrumentation reactions in the fusion model are recorded. Findings: With BMI of 25 kg/m2 as a reference, nearly all joints experience amplified percent increases in joint loading compared to percent weight gain for each level of obesity studied. Considering spinal fusion instrumentation, rod stresses and pedicle screw reactions likewise experience amplified loading increases compared to body weight. Compressive force at L5–S1 increases by 47%, 86%, and 132% for total body weight increases of 20%, 40%, and 60%, respectively. Fusion rod stresses increase by 47%, 86%, and 128% for the same body weight increases. Interpretations: This paper quantitatively illustrates the importance of nutrition and weight control as part of a comprehensive approach to low back pain management and treatment. Increases in loading on the joints in the lumbosacral spine and in fusion instrumentation are amplified when compared to the corresponding increases in body weight for various clinical levels of obesity. These results illustrate that moderate weight loss can produce significant lower back and spine benefits.Justin M Warren, MS, PhDLloyd A Hey, MD, MSAndre P Mazzoleni, PhDElsevierarticleObesityOverweightFinite Element MethodFusionLow Back PainMedical technologyR855-855.5ENBiomedical Engineering Advances, Vol 2, Iss , Pp 100023- (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Obesity Overweight Finite Element Method Fusion Low Back Pain Medical technology R855-855.5
spellingShingle	Obesity Overweight Finite Element Method Fusion Low Back Pain Medical technology R855-855.5 Justin M Warren, MS, PhD Lloyd A Hey, MD, MS Andre P Mazzoleni, PhD A finite element study of the relationship between upper body weight and the loads experienced by the human lumbosacral spine, and fusion instrumentation, in a standing upright posture
description	Background: A quantitative relationship between increasing upper body weight and both 1) non-instrumented lumbosacral joint loading and 2) fusion instrumentation reactions is established using a three-dimensional (3D) finite element model (FEM) of the human thoracolumbosacral spine. Methods: A 3D FEM of the thoracolumbosacral spine (both non-instrumented and instrumented with fusion instrumentation) is developed and validated against cadaveric spine specimens. Upper body weight loading is applied to simulate an individual with varying levels of body mass index (BMI) including 25 kg/m2, 30 kg/m2, 35 kg/m2, and 40 kg/m2. Maximum force/moment joint reactions from L1–S1 in the non-instrumented model are recorded. Maximum instrumentation reactions in the fusion model are recorded. Findings: With BMI of 25 kg/m2 as a reference, nearly all joints experience amplified percent increases in joint loading compared to percent weight gain for each level of obesity studied. Considering spinal fusion instrumentation, rod stresses and pedicle screw reactions likewise experience amplified loading increases compared to body weight. Compressive force at L5–S1 increases by 47%, 86%, and 132% for total body weight increases of 20%, 40%, and 60%, respectively. Fusion rod stresses increase by 47%, 86%, and 128% for the same body weight increases. Interpretations: This paper quantitatively illustrates the importance of nutrition and weight control as part of a comprehensive approach to low back pain management and treatment. Increases in loading on the joints in the lumbosacral spine and in fusion instrumentation are amplified when compared to the corresponding increases in body weight for various clinical levels of obesity. These results illustrate that moderate weight loss can produce significant lower back and spine benefits.
format	article
author	Justin M Warren, MS, PhD Lloyd A Hey, MD, MS Andre P Mazzoleni, PhD
author_facet	Justin M Warren, MS, PhD Lloyd A Hey, MD, MS Andre P Mazzoleni, PhD
author_sort	Justin M Warren, MS, PhD
title	A finite element study of the relationship between upper body weight and the loads experienced by the human lumbosacral spine, and fusion instrumentation, in a standing upright posture
title_short	A finite element study of the relationship between upper body weight and the loads experienced by the human lumbosacral spine, and fusion instrumentation, in a standing upright posture
title_full	A finite element study of the relationship between upper body weight and the loads experienced by the human lumbosacral spine, and fusion instrumentation, in a standing upright posture
title_fullStr	A finite element study of the relationship between upper body weight and the loads experienced by the human lumbosacral spine, and fusion instrumentation, in a standing upright posture
title_full_unstemmed	A finite element study of the relationship between upper body weight and the loads experienced by the human lumbosacral spine, and fusion instrumentation, in a standing upright posture
title_sort	finite element study of the relationship between upper body weight and the loads experienced by the human lumbosacral spine, and fusion instrumentation, in a standing upright posture
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/b5558a720307492ba2c4cc8ada247b1e
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A finite element study of the relationship between upper body weight and the loads experienced by the human lumbosacral spine, and fusion instrumentation, in a standing upright posture

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