What question did this study set out to answer?

To investigate the biomechanical effects of superior articular process resection on lumbar stability during surgery.

March 23, 2026Open Access

Biomechanical study on the correlation between the extent of lumbar superior articular process resection and segmental stability

Key Points

To investigate the biomechanical effects of superior articular process resection on lumbar stability during surgery.
Developed a finite element model of the L4-L5 lumbar spine based on CT scans
Created surgical simulation models for partial (50%) and complete (100%) SAP resection
Assessed range of motion and stress distribution under various loading conditions using finite element analysis
Complete SAP resection (100%) significantly increased range of motion (333% higher left rotation)
Intervertebral disc stress increased by up to 800% in extension with complete SAP resection
Partial SAP resection (50%) maintained better segmental stability and lower stress in posterior elements

Abstract

Full-endoscopic transforaminal lumbar surgery is effective for lumbar disc herniation (LDH), but the biomechanical relationship between superior articular process (SAP) resection extent and postoperative segmental stability remains unclear. To establish a lumbar spine finite element model and evaluate the effect of SAP resection extent in the surgery on lumbar range of motion (ROM) and posterior element stress distribution via finite element analysis (FEA). A validated L4-L5 finite element model (M0, intact) was built from a healthy volunteer's CT images, and surgical simulation models were subdivided into M2(F, 50% lateral SAP resection) and M2(G, 100% complete SAP resection). Under six loading conditions, ROM and maximum Von Mises stress of the intervertebral disc, facet joints and pars interarticularis were compared across all models. SAP resection increased L4-L5 ROM and posterior element stress vs M0: M2(G) induced far greater elevations than M2(F), with 333% higher left rotation ROM and up to 800% higher intervertebral disc stress in extension; M2(G) also raised facet joint stress significantly, and left pars interarticularis stress increased in flexion for both M2(F) and M2(G). In percutaneous endoscopic transforaminal discectomy (PETD), partial SAP resection (≤50%) is preferable and complete resection should be avoided, as it causes severe lumbar segmental instability. Preserving facet joint integrity is critical for maintaining lumbar segmental stability in the surgery.

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