Finite element analysis of the effect of epidural adhesions

Nam Lee, Gyu Yeul Ji, Seong Yi, Do Heum Yoon, DongAh Shin, Keung Nyun Kim, Yoon Ha, Chang Hyun Oh

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: It is well documented that epidural adhesion is associated with spinal pain. However, the underlying mechanism of spinal pain generation by epidural adhesion has not yet been elucidated. Objectives: To elucidate the underlying mechanism of spinal pain generation by epidural adhesion using a two-dimensional (2D) non-linear finite element (FE) analysis. Study design: A finite element analysis. Setting: A two-dimensional nonlinear FE model of the herniated lumbar disc on L4/5 with epidural adhesion. Methods: A two-dimensional nonlinear FE model of the lumbar spine was developed, consisting of intervertebral discs, dura, spinal nerve, and lamina. The annulus fibrosus and nucleus pulpous were modeled as hyperelastic using the Mooney-Rivlin equation. The FE mesh was generated and analyzed using Abaqus (ABAQUS 6.13.; Hibbitt, Karlsson & Sorenson, Inc., Providence, RI, USA). Epidural adhesion was simulated as rough contact, in which no slip occurred once two surfaces were in contact, between the dura mater and posterior annulus fibrosus. Results: The FE model of adhesion showed significant stress concentration in the spinal nerves, especially on the dorsal root ganglion (DRG). The stress concentration was caused by the lack of adaptive displacement between the dura mater and posterior annulus fibrosus. The peak von Mises stress was higher in the epidural adhesion model (Adhesion, 0.67 vs. Control, 0.46). In the control model, adaptive displacement was observed with decreased stress in the spinal nerve and DRG (with adhesion, 2.59 vs. without adhesion, 3.58, P < 0.00). Limitations: This study used a 2D non-linear FE model, which simplifies the 3D nature of the human intervertebral disc. In addition, this 2D non-linear FE model has not yet been validated. Conclusion: The current study clearly demonstrated that epidural adhesion causes significantly increased stress in the spinal nerves, especially at the DRG. We believe that the increased stress on the spinal nerve might elicit more pain under similar magnitudes of lumbar disc protrusion.

Original languageEnglish
Pages (from-to)E787-E793
JournalPain Physician
Volume19
Issue number5
Publication statusPublished - 2016 Jan 1

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Spinal Nerves
Finite Element Analysis
Spinal Ganglia
Pain
Dura Mater
Intervertebral Disc
Intervertebral Disc Displacement
Spinal Nerve Roots
Spine
Annulus Fibrosus

All Science Journal Classification (ASJC) codes

  • Anesthesiology and Pain Medicine

Cite this

Lee, N., Ji, G. Y., Yi, S., Yoon, D. H., Shin, D., Kim, K. N., ... Oh, C. H. (2016). Finite element analysis of the effect of epidural adhesions. Pain Physician, 19(5), E787-E793.
Lee, Nam ; Ji, Gyu Yeul ; Yi, Seong ; Yoon, Do Heum ; Shin, DongAh ; Kim, Keung Nyun ; Ha, Yoon ; Oh, Chang Hyun. / Finite element analysis of the effect of epidural adhesions. In: Pain Physician. 2016 ; Vol. 19, No. 5. pp. E787-E793.
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abstract = "Background: It is well documented that epidural adhesion is associated with spinal pain. However, the underlying mechanism of spinal pain generation by epidural adhesion has not yet been elucidated. Objectives: To elucidate the underlying mechanism of spinal pain generation by epidural adhesion using a two-dimensional (2D) non-linear finite element (FE) analysis. Study design: A finite element analysis. Setting: A two-dimensional nonlinear FE model of the herniated lumbar disc on L4/5 with epidural adhesion. Methods: A two-dimensional nonlinear FE model of the lumbar spine was developed, consisting of intervertebral discs, dura, spinal nerve, and lamina. The annulus fibrosus and nucleus pulpous were modeled as hyperelastic using the Mooney-Rivlin equation. The FE mesh was generated and analyzed using Abaqus (ABAQUS 6.13.; Hibbitt, Karlsson & Sorenson, Inc., Providence, RI, USA). Epidural adhesion was simulated as rough contact, in which no slip occurred once two surfaces were in contact, between the dura mater and posterior annulus fibrosus. Results: The FE model of adhesion showed significant stress concentration in the spinal nerves, especially on the dorsal root ganglion (DRG). The stress concentration was caused by the lack of adaptive displacement between the dura mater and posterior annulus fibrosus. The peak von Mises stress was higher in the epidural adhesion model (Adhesion, 0.67 vs. Control, 0.46). In the control model, adaptive displacement was observed with decreased stress in the spinal nerve and DRG (with adhesion, 2.59 vs. without adhesion, 3.58, P < 0.00). Limitations: This study used a 2D non-linear FE model, which simplifies the 3D nature of the human intervertebral disc. In addition, this 2D non-linear FE model has not yet been validated. Conclusion: The current study clearly demonstrated that epidural adhesion causes significantly increased stress in the spinal nerves, especially at the DRG. We believe that the increased stress on the spinal nerve might elicit more pain under similar magnitudes of lumbar disc protrusion.",
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Lee, N, Ji, GY, Yi, S, Yoon, DH, Shin, D, Kim, KN, Ha, Y & Oh, CH 2016, 'Finite element analysis of the effect of epidural adhesions', Pain Physician, vol. 19, no. 5, pp. E787-E793.

Finite element analysis of the effect of epidural adhesions. / Lee, Nam; Ji, Gyu Yeul; Yi, Seong; Yoon, Do Heum; Shin, DongAh; Kim, Keung Nyun; Ha, Yoon; Oh, Chang Hyun.

In: Pain Physician, Vol. 19, No. 5, 01.01.2016, p. E787-E793.

Research output: Contribution to journalArticle

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T1 - Finite element analysis of the effect of epidural adhesions

AU - Lee, Nam

AU - Ji, Gyu Yeul

AU - Yi, Seong

AU - Yoon, Do Heum

AU - Shin, DongAh

AU - Kim, Keung Nyun

AU - Ha, Yoon

AU - Oh, Chang Hyun

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N2 - Background: It is well documented that epidural adhesion is associated with spinal pain. However, the underlying mechanism of spinal pain generation by epidural adhesion has not yet been elucidated. Objectives: To elucidate the underlying mechanism of spinal pain generation by epidural adhesion using a two-dimensional (2D) non-linear finite element (FE) analysis. Study design: A finite element analysis. Setting: A two-dimensional nonlinear FE model of the herniated lumbar disc on L4/5 with epidural adhesion. Methods: A two-dimensional nonlinear FE model of the lumbar spine was developed, consisting of intervertebral discs, dura, spinal nerve, and lamina. The annulus fibrosus and nucleus pulpous were modeled as hyperelastic using the Mooney-Rivlin equation. The FE mesh was generated and analyzed using Abaqus (ABAQUS 6.13.; Hibbitt, Karlsson & Sorenson, Inc., Providence, RI, USA). Epidural adhesion was simulated as rough contact, in which no slip occurred once two surfaces were in contact, between the dura mater and posterior annulus fibrosus. Results: The FE model of adhesion showed significant stress concentration in the spinal nerves, especially on the dorsal root ganglion (DRG). The stress concentration was caused by the lack of adaptive displacement between the dura mater and posterior annulus fibrosus. The peak von Mises stress was higher in the epidural adhesion model (Adhesion, 0.67 vs. Control, 0.46). In the control model, adaptive displacement was observed with decreased stress in the spinal nerve and DRG (with adhesion, 2.59 vs. without adhesion, 3.58, P < 0.00). Limitations: This study used a 2D non-linear FE model, which simplifies the 3D nature of the human intervertebral disc. In addition, this 2D non-linear FE model has not yet been validated. Conclusion: The current study clearly demonstrated that epidural adhesion causes significantly increased stress in the spinal nerves, especially at the DRG. We believe that the increased stress on the spinal nerve might elicit more pain under similar magnitudes of lumbar disc protrusion.

AB - Background: It is well documented that epidural adhesion is associated with spinal pain. However, the underlying mechanism of spinal pain generation by epidural adhesion has not yet been elucidated. Objectives: To elucidate the underlying mechanism of spinal pain generation by epidural adhesion using a two-dimensional (2D) non-linear finite element (FE) analysis. Study design: A finite element analysis. Setting: A two-dimensional nonlinear FE model of the herniated lumbar disc on L4/5 with epidural adhesion. Methods: A two-dimensional nonlinear FE model of the lumbar spine was developed, consisting of intervertebral discs, dura, spinal nerve, and lamina. The annulus fibrosus and nucleus pulpous were modeled as hyperelastic using the Mooney-Rivlin equation. The FE mesh was generated and analyzed using Abaqus (ABAQUS 6.13.; Hibbitt, Karlsson & Sorenson, Inc., Providence, RI, USA). Epidural adhesion was simulated as rough contact, in which no slip occurred once two surfaces were in contact, between the dura mater and posterior annulus fibrosus. Results: The FE model of adhesion showed significant stress concentration in the spinal nerves, especially on the dorsal root ganglion (DRG). The stress concentration was caused by the lack of adaptive displacement between the dura mater and posterior annulus fibrosus. The peak von Mises stress was higher in the epidural adhesion model (Adhesion, 0.67 vs. Control, 0.46). In the control model, adaptive displacement was observed with decreased stress in the spinal nerve and DRG (with adhesion, 2.59 vs. without adhesion, 3.58, P < 0.00). Limitations: This study used a 2D non-linear FE model, which simplifies the 3D nature of the human intervertebral disc. In addition, this 2D non-linear FE model has not yet been validated. Conclusion: The current study clearly demonstrated that epidural adhesion causes significantly increased stress in the spinal nerves, especially at the DRG. We believe that the increased stress on the spinal nerve might elicit more pain under similar magnitudes of lumbar disc protrusion.

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Lee N, Ji GY, Yi S, Yoon DH, Shin D, Kim KN et al. Finite element analysis of the effect of epidural adhesions. Pain Physician. 2016 Jan 1;19(5):E787-E793.