Evaluation of Lumbar Spine Stabilization Using Anterior Interbody Fusion Cage

2002 ◽  
Author(s):  
Robert X. Gao ◽  
Mathew E. Mitchell ◽  
R. Scott Cowan
Keyword(s):  
Lumbar Spine ◽  
Interbody Fusion ◽  
Lumbar Fusion ◽  
Healing Process ◽  
Spine Stabilization ◽  
Anterior Interbody Fusion ◽  
Wide Range ◽  
Flexion Extension ◽  
Fusion Cage ◽  
Interbody Fusion Cage

Spinal surgery uses a wide range of instrumentation devices to provide comfort to the patient, stabilize the spine, and enhance the bony healing process after surgery. In order to improve upon the effectiveness of these devices, the interaction between the spine and the implant devices needs to be studied from both medical and engineering perspectives. This paper investigates the effect of an anterior interbody fusion cage on lumbar spine stabilization, by means of numerical analysis using the finite element technique and experimental testing. Specifically, the relative displacement within an intact L4-L5 motion segment has been simulated and measured, under a range of compression, flexion, extension, torsion, and lateral bending loads. Subsequently, the effect of a single anterior lumbar fusion cage implanted into the segment was simulated and experimentally validated, under similar loading conditions. Comparison between the intact and cage-implanted segments indicated varying stabilizing ability of the fusion cage, which is highly dependent upon the cage position and the type of loading.

Design and Research of Interspinous Lumbar Non-Fusion Device

2010 ◽  
Author(s):  
Lei Li ◽  
Zhaohua Chang ◽  
Xuelian Gu ◽  
Chengli Song
Keyword(s):  
Stress Concentration ◽  
Vertebral Body ◽  
Interbody Fusion ◽  
Lumbar Fusion ◽  
Pedicle Screws ◽  
Adjacent Level ◽  
Flexion Extension ◽  
Fusion Cage ◽  
Adjacent Level Degeneration ◽  
Interbody Fusion Cage

Objective: Long term clinical data showed that lumbar fusion for Lumbar spinal stenosis (LSS) and lumbar disc degeneration (LDD) therapy could change the loads of disc and articular facet and increase the motion of adjacent segments which lead to facet arthropathy and adjacent level degeneration. This study is to design and analyze an interspinous process device (IPD) that could prevent adjacent level degeneration in the LSS and LDD therapy. Method: The IPD was designed based on anatomical parameters measured from 3D CT images directly. The IPD was inserted at the validated finite element model of the mono-segmental L3/L4. The biomechanical performance of a pair of interbody fusion cages and a paired pedicel screws were studied to compare with the IPD. The model was loaded with the upper body weight and muscle forces to simulate five loading cases including standing, compression, flexion, extension, lateral bending and axial rotation. Results: The interbody fusion cage induced serious stress concentration on the surface of vertebral body, has the worst biomechanical performance among the three systems. Pedicle screws and interbody fusion cage could induce stress concentration within vertebral body which leads to vertebral compression fracture or screw loosening. Regarding to disc protection, the IPD had higher percentage to share the load of posterior lumbar structure than the pedicel screws and interbody fusion cage. Conclusion: IPD has the same loads as pedicle screw-rod which suggests it has a good function in the posterior stability. While the IPD had much less influence on vertebral body. Furthermore, IPD could share the load of intervertebral discs and facet joints to maintain the stability of lumbar spine.

scholarly journals An Ultrasensitive Immunoassay Strip for Simultaneously Detectingcyproheptadinehydrochloride and Six Phenothiazinesin Feedstuffs Based on a Monoclonal Antibody

2020 ◽  
Author(s):  
changjun Chen ◽  
Xianlei Gao ◽  
Hao Li ◽  
Xin Pan ◽  
Songgang Wang
Keyword(s):  
Interbody Fusion ◽  
The Elderly ◽  
Good Alternative ◽  
Stage Iii ◽  
Column Height ◽  
Modified Technique ◽  
Spine Stabilization ◽  
Surgical Methods ◽  
Fusion Cage ◽  
Interbody Fusion Cage

Abstract Background: Kümmell disease usually occurs in the elderly osteoporosis population and develops gradually into symptomatic, progressive kyphosis of the spine. Several alternative surgical procedures, including vertebroplasty, kyphoplasty, and osteotomy, can be chose for the treatment of the disease. However, current surgical methods to deal with stage III Kümmell disease are less satisfying.Method: Amodified technique of intravertebral insertion of interbody fusion cage with posterior spine stabilization was applied to treat stage III Kümmell disease.Results:This study details a modified technique applied in a patient with stage III Kümmell disease, showing significant improvement in pain relief, anterior column height recovery, and kyphotic angle correction. And nocomplications was reported during ourfollow-up.Conclusions: Intravertebral insertion of interbody fusion cage via transpedicular approach provides advantages of acceptable correctionof kyphosis, bony fusion, minimal invasion. Thus, our method was a good alternative choice for stage III Kümmell disease.

scholarly journals Intravertebral insertion of Interbody fusion cage via transpedicular approach for the treatment of stage III Kümmell disease：a technical note and case presentation

2020 ◽  
Author(s):  
changjun Chen ◽  
Xianlei Gao ◽  
Hao Li ◽  
Xin Pan ◽  
Songgang Wang
Keyword(s):  
Interbody Fusion ◽  
Technical Note ◽  
Stage Iii ◽  
Column Height ◽  
Modified Technique ◽  
Transpedicular Approach ◽  
Spine Stabilization ◽  
Surgical Methods ◽  
Fusion Cage ◽  
Interbody Fusion Cage

Abstract Background Kümmell disease usually occurs in the elderly osteoporosis population and develops gradually into symptomatic, progressive kyphosis of the spine. Several alternative surgical procedures, including vertebroplasty, kyphoplasty, and osteotomy, can be chose for the treatment of the disease. However, current surgical methods to deal with stage III Kümmell disease are less satisfying. Method A modified technique of intravertebral insertion of interbody fusion cage with posterior spine stabilization was applied to treat stage III Kümmell disease. Results This study details a modified technique applied in a patient with stage III Kümmell disease, showing significant improvement in pain relief, anterior column height recovery, and kyphotic angle correction. And no complications was reported during our follow-up. Conclusions Intravertebral insertion of interbody fusion cage via transpedicular approach provides advantages of acceptable correction of kyphosis, bony fusion, minimal invasion. Thus, our method was a good alternative choice for stage III Kümmell disease.

scholarly journals Imaging anatomy and clinical significance of percutaneous endoscopic transforaminal oblique fixation from posterior corner in lumbar spine

2020 ◽  
Author(s):  
Feifei Chen ◽  
Xiaoyang Liu ◽  
Jianmin Sun ◽  
Jun Xin ◽  
Cheng Su ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Interbody Fusion ◽  
Axial Plane ◽  
Minor Trauma ◽  
Lumbar Interbody Fusion ◽  
Significant Difference ◽  
One Stop ◽  
Anatomic Basis ◽  
Fusion Cage ◽  
Interbody Fusion Cage

Abstract BackgroundPercutaneous endoscopic transforaminal lumbar interbody fusion (PE-TLIF) has been widely discussed due to its advantages of less trauma, less bleeding, quick recovery, high safety, and relatively fewer complications, as well as other adverse factors such as incomplete decompression, steep learning curve, low fusion rate, and high radiation risk. It can keep the posterior structure of spine intact to the greatest extent, ensure the stability of spine after surgery, and achieve decompression with minor trauma. However, posterior percutaneous pedicle screws are often needed for fusion and fixation after decompression, and additional posterior trauma, postural changes and anesthesia methods are often required. Interbody fixation and fusion are often independent and not one-stop completion. The authors consider whether the percutaneous spinal endoscopy can be used to achieve complete decompression and fusion under a single minimally invasive channel, while achieving one-stop endoscopic decompression, fusion and fixation. The purpose of this paper is to provide the anatomic feasibility for oblique fixation by measuring the imaging anatomic parameters, especially to provide the anatomic basis for the design of new endoscopic lumbar interbody fusion cage.Methods Sixty volunteers (22 men and 38 women) who underwent lumbar CT scans were collected and sent to the GEAW4.4 workstation. The distances from posterior corner in the lumbar spine to the corresponding targets of the contralateral anterior corner and the included angles between each path line in sagittal and axial plane were measured and analyzed statistically.Results In the medium group, PC path was the shortest, PA path and PB path had little difference (P=0.123), with no statistical significance. In the full-length group, PF path was the shortest, and there was no significant difference between PD path and PE path (P =0.177). PE was the optimal path. The included angles a1, a2, a3, b1, b2, and b3 in sagittal plane and c1, c2 and c3 in axial plane were significantly different (P=0.000), namely, a1 >a2>a3, b1>b2>b3, and c1<c2<c3. Conclusions This study provides anatomic feasibility for percutaneous endoscopic transforaminal oblique fixation from posterior corner in lumbar spine and particularly provides anatomic basis for the design of new endoscopic lumbar interbody fusion cage.

scholarly journals Porous Biodegradable Lumbar Interbody Fusion Cage Design and Fabrication Using Integrated Global-Local Topology Optimization With Laser Sintering

2013 ◽  
Vol 135 (10) ◽  
Author(s):  
Heesuk Kang ◽  
Scott J. Hollister ◽  
Frank La Marca ◽  
Paul Park ◽  
Chia-Ying Lin
Keyword(s):  
Topology Optimization ◽  
Lumbar Spine ◽  
Interbody Fusion ◽  
Optimization Technique ◽  
Stress Shielding ◽  
Interconnected Porosity ◽  
Human Lumbar Spine ◽  
Fusion Cage ◽  
Material Layout ◽  
Interbody Fusion Cage

Biodegradable cages have received increasing attention for their use in spinal procedures involving interbody fusion to resolve complications associated with the use of nondegradable cages, such as stress shielding and long-term foreign body reaction. However, the relatively weak initial material strength compared to permanent materials and subsequent reduction due to degradation may be problematic. To design a porous biodegradable interbody fusion cage for a preclinical large animal study that can withstand physiological loads while possessing sufficient interconnected porosity for bony bridging and fusion, we developed a multiscale topology optimization technique. Topology optimization at the macroscopic scale provides optimal structural layout that ensures mechanical strength, while optimally designed microstructures, which replace the macroscopic material layout, ensure maximum permeability. Optimally designed cages were fabricated using solid, freeform fabrication of poly(ε-caprolactone) mixed with hydroxyapatite. Compression tests revealed that the yield strength of optimized fusion cages was two times that of typical human lumbar spine loads. Computational analysis further confirmed the mechanical integrity within the human lumbar spine, although the pore structure locally underwent higher stress than yield stress. This optimization technique may be utilized to balance the complex requirements of load-bearing, stress shielding, and interconnected porosity when using biodegradable materials for fusion cages.

Current status of bone graft options for anterior interbody fusion of the cervical and lumbar spine

2013 ◽  
Vol 37 (1) ◽  
pp. 23-37 ◽  
Author(s):  
Anthony Minh Tien Chau ◽  
Lileane Liang Xu ◽  
Johnny Ho-Yin Wong ◽  
Ralph Jasper Mobbs
Keyword(s):  
Lumbar Spine ◽  
Bone Graft ◽  
Interbody Fusion ◽  
Current Status ◽  
Anterior Interbody Fusion
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