Viscoelastic properties of adjacent segments under prolonged flexion after anterior intervertebral fusion

Objective: To analyze the viscoelastic properties of adjacent segments after anterior fusion under prolonged flexion, and further reveal the mechanism of accelerated adjacent segment degeneration after intervertebral fusion. Methods: The same prolonged flexion lasted 30 minutes was applied on the two-level ovine lumbar specimen before and after anterior fusion respectively, and the moment relaxation and viscoelastic deformation of adjacent segments were measured. The moment relaxation curves from two groups were then fitted to obtain the quantitative viscoelastic results. Results: After fusion, the initial and final moment in two groups significantly increased by 30.68% and 34.34%, and the viscoelastic deformation of the adjacent segments increased by 28.21%. The Prony model could perfectly fit the moment relaxation curves (R²=99.50%). The integral stiffness significantly increased by 47.82% and 31.14% for two groups, while the viscoelasticity significantly decreased by 27.19% and 28.16%, respectively(P<0.05). Conclusions: After intervertebral fusion, to maintain the same posture with the same time, the joints should bear larger loads than before. The viscoelastic deformation of adjacent segments becomes larger, which increases the risk of instability or injury, and further leads to the accelerated degeneration of adjacent segments. The mechanism of quasi-static daily loading on adjacent segment degeneration should be focused in clinical research.