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초록· 키워드

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The artificial disc replacement (ADR) technique for the lumbar spine, with the “joint motion preservation” concept, aims to replicate the natural disc dynamics and load transfer through the lumbar motion segments. However, ADR designs vary greatly in their approaches to restore the normal disc function. In this study, Prodisc II, a most-widely used ADR type in Korea, was chosen. A validated three-dimensional intact osteoligamentous L2-L4 FE model was modified to simulate the ADR by Prodisc II, via anterior approach at L3-L4 level. The models were loaded with a combination of compressive preload 400N and 10Nm flexion/extension moments. The lumbar range of motion and facet loads, contact area (CAREA) and total contact forces (TCF) across the implant articulation surfaces was evaluated. We found that the flexion motions across surgical level L3-L4 and its adjacent level L2-L3 remain unchanged. In extension, at surgical level, the Prodisc model had a 91.4% increase and L2-L3 a decrease of 6.8%. The facet loads through L3-L4 increased by 33.2% in flexion and 36.3% in extension. CAREA/TCF was 41.47㎜2/723N for flexion and 11.68㎜2/324.6N for extension. The major CAREA was located posteriorly in extension and more evenly distributed in flexion. The lumbar segment mobility in flexion was retained after Prodisc replacement, but extension motion at the surgical level became more flexible and more stresses was imposed to the facet joint. The CAREA/TCF can be used as an indicator for the prediction of the wearing properties of the Prodisc in clinical service.

목차

Abstract
1. INTRODUCTION
2. Material and Methods
3. RESULTS
4. Discussion & Conclusions
ACKNOWLEDGEMNETS
References

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UCI(KEPA) : I410-ECN-0101-2009-550-016782336