ABSTRACT
Objective To analyze different biomechanical properties between Coflex and X-STOP device in the treatment of lumbar spinal stenosis (LSS), and provide references for design improvement of interspinous process spacer. MethodsFour finite element models, i.e., the L2-5 healthy segment model, the mild degenerated L4/5 segment model, the X-STOP-fixed L4/5 segment model, the Coflex-fixed L4/5 segment model, were constructed based on the normal lumbar CT images of a volunteer, and the models under flexion, extension, lateral bending and axial rotation were simulated to compare range of motion (ROM) changes and stress distributions on the spinous process and interspinous process spacer. ResultsX-STOP and Coflex decreased extension ROM by -48.12% and -75.35%, respectively, and released disc pressure by -58.03% and -80.75%, respectively. Coflex even restricted flexion ROM by -59.58% and reduced flexion disc pressure by -52.84%. No distinct changes appeared in lateral bending and axial rotation ROMs and disc pressure. The largest Von Mises stress appeared at the U-shape place during flexion in Coflex and at connection between left wing and screw during torsion in X-STOP, respectively. The largest contact pressure between Coflex and spinous process was 31.38 MPa during bending, and that between X-STOP and spinous process was 46.86 MPa during torsion. Conclusions Both X-STOP and Coflex are an effective treatment for LSS, and can effectively restrict the ROM of extension and reduce the disc pressure, without affecting the adjacent segments.