RT Journal Article ID 1904c2d77cdaf427 A1 Srinivas, Gunti Ranga A1 Kumar, Malhar N. A1 Deb, Anindya A1 Saha, Subrata T1 CAE-Driven Evaluations of Surgical Fixations on Lumbar Spine: An Option for Aiding Ethics in Orthopedics JF Ethics in Biology, Engineering and Medicine: An International Journal JO EBEM YR 2014 FD 2015-11-20 VO 5 IS 4 SP 313 OP 322 K1 Lumbar spine fusion K1 Adjacent segment degeneration K1 Adjacent disc stresses K1 Explicit finite element analysis K1 Computer-Aided Engineering (CAE). AB Segmental spinal fusion−posterior, anterior, and combined−has been widely employed in the management of degenerative disc disease of the lumbar spine and for surgical stabilization of spine during vertebral body fractures. The surgeon may often resort to more invasive and expensive procedures that have long-term negative effects on the patient. Commercial motivations may also drive the propensity to extend the use of instrumentation as much as possible. The surgeon should inform the patients of the possible long-term effects of surgical fixations. However, due to the lack of long-term controlled studies proving the efficacy of various surgical spinal fixations, the treating surgeon may face ethical challenges in selecting the best treatment for the patient. In the present study, a computer-aided engineering (CAE)−based approach was followed using explicit finite element analysis (FEA) to predict the maximum stresses in the adjacent lumbar discs during the following conditions: intervertebral disc without fusion and disc adjacent to instrumented circumferential fusion at one-, two-, and three-level fusions. The insights obtained from the numerical simulations could be useful in avoiding unnecessary extension of the instrumentation to healthy disc segments. The study provides quantitative data which would be useful for clinicians to understand the effects of their choice of surgical intervention. PB Begell House LK https://www.dl.begellhouse.com/journals/6ed509641f7324e6,1e4e51bf2376b66b,1904c2d77cdaf427.html