Journal of spinal disorders & techniques
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J Spinal Disord Tech · Jun 2008
Internal and external responses of anterior lumbar/lumbosacral fusion: nonlinear finite element analysis.
Determination of external and internal responses of the human lumbosacral spine using a validated 3-dimensional finite element model. ⋯ At the fused level, the caudal fusion imparted additional rigidity under flexion to the lumbosacral joint. Both fusion masses added flexibility to the adjacent segment. Under both fusion masses, increased facet joint pressure in the lumbosacral joint indicates the susceptibility of this transitional joint to long-term biomechanics-induced consequences. Increased facet joint pressures with the rostral fusion indicate that the posterior complex responds with increased load sharing, and may predispose the spine to facet-related arthropathy. Increased stresses in the adjacent disc with the caudal fusion under both modes of loading imply the potential to disc-related changes owing to long-term physiologic loading.
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Retrospective study of consecutive patients that were struck by motor vehicles and sustained spinal injuries over a 6-year period from 1997 to 2003. ⋯ Spinal injuries in pedestrians struck by motor vehicles are more evenly distributed throughout the spinal column and more often coexist with injuries to remote organs compared with car occupants and motorcyclists where regional tendencies and isolated spinal injuries are more frequent. A systematic approach to both diagnosis and treatment is, therefore, necessary. Helical truncal CT, performed to evaluate visceral injury, effectively screens for TL fractures.