ABSTRACT
BACKGROUND:Finite element analysis is a commonly used mathematical modeling method to analyze the biomechanics of the lumbar spine.By constructing finite element models of the complex tissues such as muscles,blood vessels,and nerves in the lumbar region,mechanical analysis is performed to elucidate the pathogenesis of lumbar spine disorders and the mechanical mechanisms of treatment approaches. OBJECTIVE:To review the progress of finite element analysis in understanding the pathogenesis and treatment modalities of lumbar spine disorders,and to propose a new clinical workflow for the implementation of finite element analysis,aiming to provide a reference for future studies and promote the widespread utilization of finite element analysis in clinical diagnosis and treatment. METHODS:The PubMed database was searched using English keywords"finite element analysis,lumbar vertebra",while the WanFang and China National Knowledge Infrastructure(CNKI)databases were searched using Chinese keywords"finite element analysis,lumbar vertebra".A total of 73 articles were included for review. RESULTS AND CONCLUSION:(1)Lumbar spine degeneration in non-slipped patients typically originates from the posterior annulus fibrosus,while in patients with lumbar spine spondylolisthesis,degeneration starts from the lumbar facet joints due to abnormal mechanical mechanisms.(2)Restoring vertebral body height can prevent adjacent-level degeneration,and finite element analysis-measured vertebral compression strength can serve as an effective predictor of fracture risk,replacing bone density measurements.(3)In lumbar spine fusion surgery,selecting fusion devices of appropriate height and placing them transversely can prevent device subsidence.Increased intervertebral strain,circumferential stress,and intervertebral pressure in adjacent segments after fusion surgery may contribute to the occurrence of degenerative changes in neighboring segments.(4)Finite element analysis results suggest that preoperative planning for transforaminal endoscopic surgery should include considerations for osteotomy size to avoid excessive destruction of the articular process,and intraoperatively,preferential selection of a technique that traverses the superior articular process for foraminal dilatation.(5)In percutaneous kyphoplasty,bilateral pedicle screw augmentation should be performed,distributing bone cement on both sides of the pedicle.More advanced non-aluminum glass polyalkenoate cement materials should be selected.(6)Traction therapy should be personalized based on individual patient characteristics,including customized traction angles and forces,to achieve optimal therapeutic effects.(7)Manual therapy can induce relative displacement between the herniated intervertebral disc and the nerve root,thereby reducing compression.(8)The workflow involving CT/MR-AI Plus FEA-AI Plus Surgical robots can enable more precise diagnosis and treatment.
ABSTRACT
Objective To verify the mechanism of Buyang Huanwu decoction in the treatment of spinal cord injury based on network pharmacology and molecular docking.Methods The active ingredients and targets of Buyang Huanwu decoction were screened out by TCMSP,SymMap,PubChem and Swiss Target Prediction databases.Spinal cord injury targets were retrieved from OMIM,GeneCards,TTD,and DrugBank databases.Through venny software,the intersection target of Buyang Huanwu decoction and spinal cord injury was obtained.The active ingredient-target network for the treatment of spinal cord injury was constructed with Cytoscape software.Gene ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analysis of common targets were carried out by DAVID,and the binding ability of drugs and targets was analyzed by molecular docking technology.Results A total of 106 active ingredients and 225 targets of Buyang Huanwu decoction,1315 targets of spinal cord injury and 112 targets of drug-disease intersection were obtained.The active ingredients of Buyang Huanwu decoction were quercetin,kaempferol,ellagic acid,luteolin and hederagenin in the treatment of spinal cord injury.Conclusion Buyang Huanwu decoction can achieve the purpose of treating spinal cord injury through various signal pathways.