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Journal of Healthcare Engineering
Volume 2017 (2017), Article ID 7981513, 6 pages
https://doi.org/10.1155/2017/7981513
Research Article

Effect of Graded Facetectomy on Lumbar Biomechanics

1Spine Division of Orthopaedic Department, Tongji Hospital, Tongji University School of Medicine, 389 Xincun Road, Shanghai 200065, China
2Department of Histology and Embryology, Tongji University School of Medicine, 1239 Siping Road, Shanghai 200092, China

Correspondence should be addressed to Rui Zhu; moc.liamtoh@80iuruhz

Received 21 November 2016; Revised 8 January 2017; Accepted 23 January 2017; Published 19 February 2017

Academic Editor: Jie Yao

Copyright © 2017 Zhi-li Zeng et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Facetectomy is an important intervention for spinal stenosis but may lead to spinal instability. Biomechanical knowledge for facetectomy can be beneficial when deciding whether fusion is necessary. Therefore, the aim of this study was to investigate the biomechanical effect of different grades of facetectomy. A three-dimensional nonlinear finite element model of L3–L5 was constructed. The mobility of the model and the intradiscal pressure (IDP) of L4-L5 for standing were inside the data from the literature. The effect of graded facetectomy on intervertebral rotation, IDP, facet joint forces, and maximum von Mises equivalent stresses in the annuli was analyzed under flexion, extension, left/right lateral bending, and left/right axial rotation. Compared with the intact model, under extension, unilateral facetectomy increased the range of intervertebral rotation (IVR) by 11.7% and IDP by 10.7%, while the bilateral facetectomy increased IVR by 40.7% and IDP by 23.6%. Under axial rotation, the unilateral facetectomy and the bilateral facetectomy increased the IVR by 101.3% and 354.3%, respectively, when turned to the right and by 1.1% and 265.3%, respectively, when turned to the left. The results conclude that, after unilateral and bilateral facetectomy, care must be taken when placing the spine into extension and axial rotation posture from the biomechanical point of view.