Capsule protection reduces the incidence risk of adjacent segment diseases after percutaneous endoscopic discectomy: a biomechanical analysis

doi:10.12307/2021.267

Abstract

Abstract: BACKGROUND: Biomechanical deterioration was the most significant trigger of lumbar degenerative diseases. Capsule of the zygapophyseal joint has been proven to be of great significance to maintain the overall biomechanical environment of lumbar spine.
OBJECTIVE: To investigate the biomechanical effect of various degrees of capsule injury in the percutaneous endoscopic discectomy on the deterioration of biomechanical indicators related to adjacent segment diseases.
METHODS: Lumbo-sacral finite element models from L3 to S1 constructed and validated in our previously published studies, and finite element models after percutaneous endoscopic discectomy were used. Different ranges of capsule injury in percutaneous endoscopic discectomy were simulated by adjusting the cross-sectional area of the joint capsule. To evaluate the risk of adjacent vertebral disease after operation, the changes of biomechanical indexes such as intradiscal pressure, maximum shear force of annulus fibrosus and von Mises stress of cartilage endplate were observed in different models before and after operation.
RESULTS AND CONCLUSION: (1) The decrease of the capsule cross-sectional areas in percutaneous endoscopic discectomy models leads to the obvious increase of the von-Mises stress of the cartilage endplate and the maximum shear force of annulus fibrosus, becoming an important risk factor for the increased risk of postoperative adjacent segment disease. (2) Therefore, joint capsule protection in percutaneous endoscopic discectomy plays an important positive role in reducing the risk of adjacent segment disease.

Key words: capsule of zygapophyseal joint, percutaneous endoscopic discectomy, adjacent segment diseases, finite element analysis, biomechanics

CLC Number:

Huang Chenyi, Li Jingchi, Xu Wenqiang, Zhang Xiaoyu, Fang Zhongxin, Liu Zongchao. Capsule protection reduces the incidence risk of adjacent segment diseases after percutaneous endoscopic discectomy: a biomechanical analysis[J]. Chinese Journal of Tissue Engineering Research, 2021, 25(30): 4818-4822.

Figures/Tables 1

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