ArticleFrontiers in bioengineering and biotechnology2026
Effect of body mass index and disc degeneration on lumbar biomechanics after unilateral biportal endoscopy-unilateral laminectomy bilateral decompression for lumbar spinal stenosis: a finite element study.
Article in Frontiers in bioengineering and biotechnology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: To evaluate the effects of body mass index (BMI) and disc degeneration on lumbar biomechanics following unilateral biportal endoscopy-unilateral laminectomy bilateral decompression (UBE-ULBD) for lumbar spinal stenosis (LSS). Methods: Computed tomography data from a 32-year-old healthy male volunteer (height: 1.75 m, weight: 70 kg, BMI: 22.86 kg/m Results: Compared with the intact model, the UBE-ULBD model showed a stable and consistent pattern of biomechanical variation across motion directions under different BMI levels and disc degeneration grades. Single-factor analyses showed that within the same degeneration grade, increasing BMI generally increased ROM, IDP, and FJS at the L4-L5 segment. At a fixed BMI, progressive disc degeneration was associated with decreased ROM and IDP but stepwise increases in FJS, indicating posterior column overload. Mixed-effects analyses revealed that in degenerated discs, a higher BMI partially offset the degeneration-related decreases in ROM and IDP; however, ROM remained lower than that of the intact model, whereas IDP values only shifted from decreased to slightly increased in severe degeneration cases. FJS exhibited a cumulative and amplifying response to BMI and disc degeneration, especially during extension and rotation. The combination of severe disc degeneration and high BMI produced peak posterior element loading under multidirectional loading, suggesting that weight gain with disc degeneration globally amplifies spinal loading and markedly aggravates posterior column overload. Conclusion: FE analysis showed that disc degeneration primarily alters load distribution (i.e., reduced ROM and IDP but increased FJS), whereas BMI increases the overall load magnitude (i.e., simultaneous increases in ROM, IDP, and FJS at any given grade of degeneration). Their interaction produces a peak posterior column overload pattern under the severe degeneration + high BMI condition. Clinically, body weight and disc degeneration status should be simultaneously considered. During UBE-ULBD, posterior stabilizing structures should be preserved as much as possible, and weight management along with postoperative core muscle rehabilitation should be emphasized.
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