Biomechanical support for the physician's decision when choosing a treatment option based on quantitative success criteria

D. V. Ivanov

Izvestiya of Saratov University. Mathematics. Mechanics. Informatics, Tome 22 (2022) no. 1, pp. 62-89.

Résumé

Preoperative planning for the treatment of the consequences of diseases and injuries of the spino-pelvic complex surgical treatment is a mandatory procedure and should ensure the selection of implants, modes and techniques for their installation, as well as the reconstruction of the optimal biomechanics of the operated segment. For each individual patient, the surgeon chooses a treatment variant based on his qualitative and quantitative individual parameters. Therefore, the task of developing some measurable characteristics (criteria) seems to be urgent, with the help of which it would be possible to choose a successful variant for each specific patient. In surgery of the spino-pelvic complex pathologies, it is customary to use questionnaires of the patient's quality of life to assess the long-term treatment results. During preoperative planning, surgeons also calculate geometric parameters to assess the degree of deformity and select the necessary correction. At the same time, a geometrically and anatomically correctly planned operation may not be successful in terms of assessing the strength of implanted structures and the “bone-implant” system as a whole. This paper presents the results of the development and testing of criteria for assessing the success of surgical reconstructive treatment of the consequences of the spino-pelvic complex diseases and injuries. Three groups of criteria have been identified: geometric, biomechanical, and clinical. Geometric and biomechanical criteria make it possible to obtain short-term postoperative prognosis. The use of clinical success criteria makes it possible to formulate long-term postoperative prognosis. The criteria for assessing success do not offer the surgeon any new treatment variant, but only provide a tool for quantitative comparison of the treatment variants that are considered by him and the choice of successful ones among them. The criteria for evaluating the success of treatment are implemented in the Smart Plan Ortho preoperative planning system developed at Saratov University, which provides a full cycle of preoperative planning in accordance with the planning–modeling–forecast methodology.

Bibliographie

[1] R. M. Tikhilov, I. I. Shubnyakov, D. G. Pliev (eds.), Guide to Hip Surgery, in 2 vols., v. 2, RNIITO im. R. R. Vredena, St. Petersburg, 2015, 356 pp. (in Russian)

[2] Dictionary of the Russian Language (Ozhegov) online (in Russian) (accessed 04 August 2021)

[3] Werner D. A. T., Grotle M., Gulati S., Austevoll I. M., Madsbu M. A., Lønne G., Solberg T. K., Can a Successful Outcome After Surgery for Lumbar Disc Herniation Be Defined by the Oswestry Disability Index Raw Score?, Global Spine Journal, 10:1 (2020), 47–54 | DOI

[4] Mjåset C., Zwart J. A., Goedmakers C. M. W., Smith T. R., Solberg T. K., Grotle M., “Criteria for success after surgery for cervical radiculopathy-estimates for a substantial amount of improvement in core outcome measures”, The Spine Journal, 20:9 (2020), 1413–1421 | DOI

[5] Alhaug O. K., Dolatowski F. C., Solberg T. K., Lønne G., “Criteria for failure and worsening after surgery for lumbar spinal stenosis: A prospective national spine registry observational study”, The Spine Journal, 21:9 (2021), 1489–1496 | DOI

[6] Duval-Beaupére G., Schmidt C., Cosson P., “A barycentremetric study of the sagittal shape of spine and pelvis: The conditions required for an economic standing position”, Annals of Biomedical Engineering, 20:4 (1992), 451–462 | DOI

[7] Le Huec J. C., Hasegawa K., “Normative values for the spine shape parameters using 3D standing analysis from a database of 268 asymptomatic Caucasian and Japanese subjects”, European Spine Journal, 25:11 (2016), 3630–3637 | DOI

[8] Schwab F., Lafage V., Patel A., Farcy J.-P., “Sagittal plane considerations and the pelvis in the adult patient”, Spine, 34:17 (2009), 1828–1833 | DOI

[9] Krutko A. V., Sagittal Balance. Harmony in Formulas, Background Information for Practical Calculations, ANO “Klinika NIITO”, Novosibirsk, 2016, 67 pp. (in Russian)

[10] Tikhilov R. M., Nikolaev N. S., Shubnyakov I. I., Myasoedov A. A., Boyarov A. A., Efimov A. V., Syundyukov A. R., “Difficulties of total hip replacement in patients with ankylosing spondylitis (case report)”, Traumatology and Orthopedics of Russia, 22:2 (2016), 70–79 (in Russian) | DOI

[11] Makirov S. K., Yuz A. A., Jahaf M. T., “Method of assessing the parameters of the sagittal spinal pelvic balance”, Hirurgiâ pozvonočnika (Spine Surgery), 12:3 (2015), 55–63 (in Russian) | DOI

[12] Kudyashev A. L., Hominets V. V., Teremshonok A. V., Korostelev K. E., Nagorny E. B., Dol A. V., Ivanov D. V., Kirillova I. V., Kossovich L. Yu., “Biomechanical background for the formation of proximal junctional kyphosis after the transpedicular fixation of the lumbarian spine”, Russian Journal of Biomechanics, 21:3 (2017), 270–279 | DOI

[13] Kim Y. J., Lenke L. G., Bridwell K. H., Kim J., Cho S. K., Cheh G., Yoon J., “Proximal junctional kyphosis in adolescent idiopathic scoliosis after 3 different types of posterior segmental spinal instrumentation and fusions: Incidence and risk factor analysis of 410 cases”, Spine, 32:24 (2007), 2731–2738 | DOI

[14] Le Huec J. C., Charosky S., Barrey C., Rigal J., Aunoble S., “Sagittal imbalance cascade for simple degenerative spine and consequences: Algorithm of decision for appropriate treatment”, European Spine Journal, 20, suppl. 5 (2011), 699–703 | DOI

[15] Johnson R. D., Valore A., Villaminar A., Comisso M., Balsano M., “Sagittal balance and pelvic parameters — a paradigm shift in spinal surgery”, Journal of Clinical Neuroscience, 20:2 (2013), 191–196 | DOI

[16] Kotelnikov A. O., Riabykh S. O., Burtsev A. V., “Hip-spine syndrome: The problem from the biomechanical point of view”, Genij Ortopedii, 25:4 (2019), 541–549 (in Russian) | DOI

[17] Burtsev A. V., Ryabykh S. O., Kotelnikov A. O., Gubin A. V., “Clinical issues of the sagittal balance in adults”, Genij Ortopedii, 23:2 (2017), 228–235 (in Russian) | DOI

[18] Ivanov D. V., Kirillova I. V., Kossovich L. Yu., Likhachev S. V., Polienko A. V., Kharlamov A. V., Shulga A. E., “Comparative analysis of the SpinoMeter mobile application and Surgimap system for measuring the sagittal balance parameters: Inter-observer reliability test”, Genij Ortopedii, 27:1 (2021), 74–79 (in Russian) | DOI

[19] Pan C., Wang G., Sun J., “Correlation between the apex of lumbar lordosis and pelvic incidence in asymptomatic adult”, European Spine Journal, 29:3 (2020), 420–427 | DOI

[20] Legaye J., Duval-Beaupére G., “Sagittal plane alignment of the spine and gravity: A radiological and clinical evaluation”, Acta Orthopaedica Belgica, 71:2 (2005), 213–220

[21] Vialle R., Levassor N., Rillardon L., Templier A., Skalli W., Guigui P., “Radiographic analysis of the sagittal alignment and balance of the spine in asymptomatic subjects”, Journal of Bone Joint Surgery, 87:2 (2005), 260–267 | DOI

[22] Hyun S.-J., Han S., Kim Y. B., Kim Y. J., Kang G.-B., Cheong J.-Y., “Predictive formula of ideal lumbar lordosis and lower lumbar lordosis determined by individual pelvic incidence in asymptomatic elderly population”, European Spine Journal, 28:9 (2019), 1906–1913 | DOI

[23] Sullivan T. B., Marino N., Reighard F. G., Newton P. O., “Relationship between lumbar lordosis and pelvic incidence in the adolescent patient: Normal cohort analysis and literature comparison”, Spine Deformity, 6:5 (2018), 529–536 | DOI

[24] Manoharan S. R., Joshi D., Owen M., Theiss S. M., Deinlein D., “Relationship of Cervical Sagittal Vertical Alignment After Sagittal Balance Correction in Adult Spinal Deformity: A Retrospective Radiographic Study”, International Journal of Spine Surgery, 12:2 (2018), 269–275 | DOI

[25] Yeh K.-T., Lee R.-P., Chen I.-H., Yu T.-C., Liu K.-L., Peng C.-H., Wang J.-H., Wu W.-T., “Correlation of Functional Outcomes and Sagittal Alignment After Long Instrumented Fusion for Degenerative Thoracolumbar Spinal Disease”, Spine, 43:19 (2018), 1355–1362 | DOI

[26] Than K. D., Park P., Fu K.-M., Nguyen S., Wang M. Y., Chou D., Nunley P. D., Anand N., Fessler R. G., Shaffrey C. I., Bess S., Akbarnia B. A., Deviren V., Uribe J. S., La Marca F., Kanter A. S., Okonkwo D. O., Mundis G. M., Mummaneni P. V., “Clinical and radiographic parameters associated with best versus worst clinical outcomes in minimally invasive spinal deformity surgery”, Journal of Neurosurgery, 25:1 (2016), 21–25 | DOI

[27] Kao F.-C., Huang Y.-J., Chiu P.-Y., Hsieh M.-K., Tsai T.-T., “Factors Predicting the Surgical Risk of Osteoporotic Vertebral Compression Fractures”, Journal of Clinical Medicine, 8:4 (2019), 501 | DOI

[28] Kornilov N. V., Voitovich A. V., Mashkov V. M., Einstein G. G., Surgical Treatment of Degenerative-Dystrophic Lesions of the Hip Joint, LITO Sintez, St. Petersburg, 1997, 292 pp. (in Russian)

[29] Tian J.-L., Sun L., Hu R. Y., Han W., Tian X.-B., “Correlation of Cup Inclination Angle with Liner Wear for Metal-on-polyethylene in Hip Primary Arthroplasty”, Orthopaedic Surgery, 9:2 (2017), 186–190 | DOI

[30] Más Y., Gracia L., Ibarz E., Gabarre S., Peña D., Herrera A., “Finite element simulation and clinical follow-up of lumbar spine biomechanics with dynamic fixations”, PLoS ONE, 12:11 (2017), e0188328 | DOI

[31] Chun K., Yang I., Kim N., Cho D., “Effect of Device Rigidity and Physiological Loading on Spinal Kinematics after Dynamic Stabilization: An In-Vitro Biomechanical Study”, Journal of Korean Neurosurgical Society, 58:5 (2015), 412–418 | DOI

[32] Clair S. St., Tan J. S., Lieberman I., “Oblique lumbar interbody fixation: A biomechanical study in human spines”, Journal of Spinal Disorders and Techniques, 25:4 (2012), 183–189 | DOI

[33] Niosi C. A., Zhu Q. A., Wilson D. C., Keynan O., Wilson D. R., Oxland T. R., “Biomechanical characterization of the three-dimensional kinematic behaviour of the Dynesys dynamic stabilization system: An in vitro study”, European Spine Journal, 15:6 (2006), 913–922 | DOI

[34] White III A. A., Panjabi M. M., Clinical Biomechanics of the Spine, 2nd ed., J. B. LIPPINCOTT Company, New York, 1990, 722 pp.

[35] Brown T., Hansen R. J., Yorra A. J., “Some mechanical tests on the lumbosacral spine with particular reference to the intervertebral discs; A preliminary report”, The Journal of Bone and Joint Surgery. American volume, 39-A:5 (1957), 1135–1164 | DOI

[36] Inoue N., Espinoza Orías A. A., “Biomechanics of intervertebral disk degeneration”, Orthopedic Clinics of North America, 42:4 (2011), 487–499 | DOI

[37] Hansson T. H., Keller T. S., Panjabi M. M., “A study of the compressive properties of lumbar vertebral trabeculae: Effects of tissue characteristics”, Spine, 12:1 (1987), 56–62 | DOI

[38] Baikov E. S., Baikalov A. A., “Relationship between biomechanical and biochemical parameters of spinal motion segments and recurrent lumbar disc herniation”, Hirurgiâ pozvonočnika (Spine Surgery), 14:4 (2017), 61–68 (in Russian) | DOI

[39] Natarajan R. N., Watanabe K., Hasegawa K., “Biomechanical analysis of a long-segment fusion in a lumbar spine — a finite element model study”, Journal of Biomechanical Engineering, 140:9 (2018), 1–7 | DOI

[40] Shin J. K., Lim B. Y., Goh T. S., Son S. M., Kim H.-S., Lee J. S., Lee C.–S., “Effect of the screw type (S2-alar-iliac and iliac), screw length, and screw head angle on the risk of screw and adjacent bone failures after a spinopelvic fixation technique: A finite element analysis”, PLoS ONE, 13:8 (2018), 296–301 | DOI

[41] Duan Y., Wang H. H., Jin A. M., Zhang L., Min S. X., Liu C. L., Qiu S. J., Shu X. Q., “Finite element analysis of posterior cervical fixation”, Orthopaedics Traumatology: Surgery Research, 101:1 (2015), 23–29 | DOI

[42] Kudiashev A. L., Khominets V. V., Teremshonok A. V., Nagorny E. B., Stadnichenko S. Yu., Dol A. V., Ivanov D. V., Kirillova I. V., Kossovich L. Yu., Kovtun A. L., “Biomechanical modeling in surgical treatment of a patient with true lumbar spondylolisthesis”, Hirurgiâ pozvonočnika (Spine Surgery), 15:4 (2018), 87–94 (in Russian) | DOI

[43] La Barbera L., Galbusera F., Villa T., Costa F., Wilke H.-J., ASTM F1717 standard for the preclinical evaluation of posterior spinal fixators: Can we improve it?, Journal of Engineering in Medicine, 228:10 (2014), 1014–1026 | DOI

[44] Su Y.-S., Ren D., Wang P.-S., “Comparison of biomechanical properties of single- and two-segment fusion for denis type B spinal fractures”, Orthopaedic Surgery, 5:4 (2013), 266–273 | DOI

[45] Vessels and apparatus. Norms and methods of strength calculation. General requirements, Standartinform, M., 2008, 26 pp. (in Russian)

[46] 316LS/316LVM Surgical Stainless Steel Bar — ASTM F138 (accessed 17 August 2018) https://www.upmet.com/products/stainless-steel/316lslvm

[47] Ti6Al4V ELI Titanium Alloy (accessed 17 August 2018) https://www.arcam.com/wp-content/uploads/Arcam-Ti6Al4V-ELI-Titanium-Alloy.pdf

[48] Havaldar R., Pilli S. C., Putti B. B., “Insights into the effects of tensile and compressive loadings on human femur bone”, Advanced Biomedical Research, 3 (2014), 101 | DOI

[49] Karlov A. V., Shakhov V. P., External Fixation Systems and Regulatory Mechanisms for Optimal Biomechanics, STT, Tomsk, 2001, 477 pp. (in Russian)

[50] Misch C. E., Qu Z., Bidez M. W., “Mechanical properties of trabecular bone in the human mandible: Implications for dental implant treatment planning and surgical placement”, Journal of Oral and Maxillofacial Surgery, 57:6 (1999), 700–706 | DOI

[51] Goldstein S. A., “The mechanical properties of trabecular bone: Dependence on anatomic location and function”, Journal of Biomechanics, 20:11 (1987), 1055–1061 | DOI

[52] Gushcha A. O., Yusupova A. R., “Evaluation of outcomes of surgical treatment for degenerative diseases of the spine”, Hirurgiâ pozvonočnika (Spine Surgery), 14:4 (2017), 85–94 (in Russian) | DOI

[53] Byvaltsev V. A., Belykh E. G., Alekseeva N. V., Sorokovikov V. A., The Use of Scales and Questionnaires in the Examination of Patients with Degenerative Lesions of the Lumbar Spine, Guidelines, FGBU “NTsRVKh” SO RAMN, Irkutsk, 2013, 32 pp. (in Russian)

[54] Cao P., Hao W., Zhang L., Zhang Q., Liu X., Li M., “Safety and Efficacy Studies of Vertebroplasty with Dual Injections for the Treatment of Osteoporotic Vertebral Compression Fractures: Preliminary Report”, Academic Radiology, 27:8 (2020), e224–e231 | DOI

[55] Cook C. E., Learman K. E., O'Halloran B. J., Showalter C. R., Kabbaz V. J., Goode A. P., Wright A. A., Which Prognostic Factors for Low Back Pain Are Generic Predictors of Outcome Across a Range of Recovery Domains?, PTJ: Physical Therapy Rehabilitation Journal, 93:1 (2013), 32–40 | DOI

[56] Cheng L., Cai H., Yu Y., Li W., Li Q., Liu Z., “Modified Full-Endoscopic Interlaminar Discectomy via an Inferior Endplate Approach for Lumbar Disc Herniation: Retrospective 3-Year Results from 321 Patients”, World Neurosurgery, 141 (2020), e537–e544 | DOI

[57] Marouby S., Coulomb R., Maury E., Assi C., Mares O., Kouyoumdjian P., “Prospective Evaluation of Spino-Pelvic Parameters with Clinical Correlation in Patients Operated with an Anterior Lumbar Interbody Fusion”, Asian Spine Journal, 14:1 (2020), 88–96 | DOI

[58] Staartjes V. E., Vergroesen P. A., Zeilstra D. J., Schröder M. L., “Identifying subsets of patients with single-level degenerative disc disease for lumbar fusion: The value of prognostic tests in surgical decision making”, The Spine Journal, 18:4 (2018), 558–566 | DOI

[59] Vieli M., Staartjes V. E., Eversdjik H. A. J., De Wispelaere M. P., Oosterhuis J. W. A., Schröder M. L., “Safety and Efficacy of Anterior Lumbar Interbody Fusion for Discogenic Chronic Low Back Pain in a Short-stay Setting: Data From a Prospective Registry”, Cureus, 11:8 (2019), e5332 | DOI

[60] Ertzgaard P., Nene A., Kiekens C., Burns A. S., “A review and evaluation of patient-reported outcome measures for spasticity in persons with spinal cord damage: Recommendations from the Ability Network — an international initiative”, The Journal of Spinal Cord Medicine, 43:6 (2020), 813–823 | DOI

[61] Amirdjanova V. N., Goryachev D. V., Korshunov N. I., Rebrov A. P., Sorotskaya V. N., “SF-36 questionnaire population quality of life indices”, Rheumatology Science and Practice, 46:1 (2008), 36–48 (in Russian)

[62] Gary K. W., Cao Y., Burns S. P., McDonald S. D., Krause J. S., “Employment, health outcomes, and life satisfaction after spinal cord injury: Comparison of veterans and nonveterans”, Spinal Cord, 58:1 (2020), 3–10 | DOI

[63] Kolesnikov S. V., Diachkova G. V., Kamshilov B. V., Kolesnikova E. S., “Evaluation of clinical and functional status of patients following total hip replacement”, Genij Ortopedii, 25:1 (2019), 32–37 (in Russian) | DOI

[64] Wright J. G., Rudicel S., Feinstein A. R., “Ask patients what they want. Evaluation of individual complaints before total hip replacement”, The Journal of Bone and Joint Surgery, 76:2 (1994), 229–234 | DOI

[65] Dulaev A. K., Kazhanov I. V., Presnov R. A., Mikityuk S. I., “Triangular osteosynthesis of fractures of the sacrum in vertically unstable pelvic ring injuries”, Polytrauma, 2018, no. 2, 17–34 (in Russian)

[66] Fairbank J. C., Pynsent P. B., “The Oswestry Disability Index”, Spine, 25:22 (2000), 2940–2952 | DOI

[67] Solberg T., Johnsen L. G., Nygaard Ø. P., Grotle M., “Can we define success criteria for lumbar disc surgery? Estimates for a substantial amount of improvement in core outcome measures”, Acta Orthopaedica, 84:2 (2013), 196–201 | DOI

[68] Jaeschke R., Singer J., Guyatt G. H., “Measurement of health status: Ascertaining the minimal clinically important difference”, Controlled Clinical Trials, 10:4 (1989), 407–415 | DOI

[69] Copay A. G., Subach B. R., Glassman S. D., Polly D. W., Schuler T. C., “Understanding the minimum clinically important difference: A review of concepts and methods”, The Spine Journal, 7:5 (2007), 541–546 | DOI

[70] Donnik A. M., Ivanov D. V., Kossovich L. Yu., Levchenko K. K., Kireev S. I., Morozov K. M., Ostrovsky N. V., Zaretskov V. V., Likhachev S. V., “Creation of Three-Dimensional Solid-State Models of a Spine with Transpedicular Fixation Using a Specialized Software”, Izvestiya of Saratov University. Mathematics. Mechanics. Informatics, 19:4 (2019), 424–438 (in Russian) | DOI | MR

[71] Donnik A. M., Ivanov D. V., Kireev S. I., Kossovich L. Yu., Ostrovsky N. V., Norkin I. A., Levchenko K. K., Likhachev S. V., “Extracting Clinically Relevant Data from Biomechanical Modeling of Surgical Treatment Options for Spinal Injury in Damaged Vertebrae Th10, Th11”, Izvestiya of Saratov University. Mathematics. Mechanics. Informatics, 19:4 (2019), 439–453 (in Russian) | DOI | MR

[72] Dol A. V., Dol E. S., Ivanov D. V., “Biomechanical modeling of surgical reconstructive treatment of spinal spondylolisthesis at L4–L5 level”, Russian Journal of Biomechanics, 22:1 (2018), 25–36 | DOI | DOI

[73] Beskrovny A. S., Bessonov L. V., Golyadkina A. A., Dol A. V., Ivanov D. V., Kirillova I. V., Kossovich L. Yu., Sidorenko D. A., “Development of a decision support system in traumatology and orthopedics. Biomechanics as a tool for preoperative planning”, Russian Journal of Biomechanics, 25:2 (2021), 99–112 | DOI | DOI

[74] Dol A. V., Ivanov D. V., Kazhanov I. V., Kirillova I. V., Kossovich L. Yu., Mikityuk S. I., Petrov A. V., “Biomechanical modeling of surgical reconstructive treatment options for unilateral sacral fractures”, Russian Journal of Biomechanics, 23:4 (2019), 459–468 | DOI | DOI

[75] Denisov A. O., Shilnikov V. A., Barns S. A., “Coxa-vertebral syndrome and its significance in hip arthroplasty (review)”, Traumatology and Orthopedics of Russia, 18:1 (2012), 121–127 (in Russian) | DOI