scholarly journals Biomechanical effect of cage position combined with bilateral pedicle screw fixation in the osteoporotic lumbar spine of oblique lumbar interbody fusion: a finite element analysis

2021 ◽  
Author(s):  
Yichuan Qin ◽  
Bin Zhao ◽  
Jie Yuan ◽  
Chaojian Xu ◽  
Junqiang Su ◽  
...  
Keyword(s):  
Finite Element ◽  
Lumbar Spine ◽  
Pedicle Screw ◽  
Interbody Fusion ◽  
Screw Fixation ◽  
Pedicle Screw Fixation ◽  
Lumbar Interbody Fusion ◽  
Cage Subsidence ◽  
Oblique Lumbar Interbody Fusion ◽  
Bilateral Pedicle Screw

Abstract Background: The influence of cage position on postoperative cage subsidence has been paid increasing attention. The best cage position in oblique lumbar interbody fusion (OLIF) is still unclear. This study aimed to evaluate the biomechanical effects of different cage positions with stand-alone (SA) methods and bilateral pedicle screw fixation (BPSF) in the osteoporotic lumbar spine after OLIF.Methods: A finite element (FE) model of an intact L3-L5 lumbar spine was constructed. After validation, an osteoporosis model (OP) was constructed by assigning osteoporotic material properties. SA models (SA1, SA2, SA3) and BPSF models (BPSF1, BPSF2, BPSF3) in which a cage was placed in the anterior, middle and posterior third of the L5 superior endplate (SEP) were constructed at the L4-L5 segment of the OP. The L4-L5 range of motion (ROM), the stress of the L5 SEP, the stress of the cage and the stress of fixation were compared among the different models.Results: According to the degree of ROM of L4-L5, the stress of the L5 SEP and the stress of the cage for most physiological motions, the SA and BPSF models were ranked as follows: SA2＜SA1＜SA3, BPSF2＜BPSF1＜BPSF3. In BPSF2, the stress of fixation was minimal in most motions. At the same cage position, the ROM of L4-L5, the stress of the L5 SEP and the stress of the cage in the BPSF models were significantly reduced compared with those in SA models; compared with SA2, BPSF2 had a maximum reduction of 83.24%, 70.71% and 73.52% in these parameters, respectively.Conclusions: Placing the cage in the middle third of the L5 SEP for OLIF could reduce the maximum stresses of the L5 SEP, the cage and the fixation, which may reduce the risk of postoperative cage subsidence, endplate collapse and fixation fracture in the osteoporotic lumbar spine. Compared with SA OLIF, BPSF could provide sufficient stability for the surgical segment and may reduce the incidence of the aforementioned complications.

scholarly journals Bilateral pedicle screw fixation provides superior biomechanical stability in transforaminal lumbar interbody fusion: a finite element study

2015 ◽  
Vol 15 (8) ◽  
pp. 1812-1822 ◽  
Author(s):  
Divya V. Ambati ◽  
Edward K. Wright ◽  
Ronald A. Lehman ◽  
Daniel G. Kang ◽  
Scott C. Wagner ◽  
...  
Keyword(s):  
Finite Element ◽  
Pedicle Screw ◽  
Interbody Fusion ◽  
Screw Fixation ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Pedicle Screw Fixation ◽  
Lumbar Interbody Fusion ◽  
Biomechanical Stability ◽  
Bilateral Pedicle Screw ◽  
Element Study

scholarly journals Biomechanical Evaluation of Anterolateral Screw Fixation for Oblique Lumbar Interbody Fusion Surgery – A Finite Element Analysis

2020 ◽  
Author(s):  
gufang Fang ◽  
SG Chen ◽  
wda zhuang ◽  
WH Huang ◽  
Hongxun Sang
Keyword(s):  
Finite Element ◽  
Interbody Fusion ◽  
Screw Fixation ◽  
Upper Body ◽  
Lumbar Interbody Fusion ◽  
Element Analysis ◽  
Flexion Extension ◽  
Cage Subsidence ◽  
Oblique Lumbar Interbody Fusion ◽  
Maximum Stresses

Abstract Background: The most common complication of oblique lumbar interbody fusion (OLIF) is cage subsidence. OLIF combined with internal fixation could help decrease the cage subsidence and increase the fusion rate. The aim of this study was to evaluate the biomechanical feasibility and safety in the patients undergoing OLIF surgery with anterolateral screw fixation (ASF). Methods: Based on our previous validated model , L4-L5 functional surgical models corresponding to the ASF and Bilateral pedicle screw fixation(BPSF) methods were created. A 500 N compression force was applied to the superior surface of the model to represent the upper body weight, and a 7.5 Nm moment was applied to simulate the six movement directions of the lumbar spinal model: flexion/extension, right/left lateral bending and right/left axial rotation. Finite element (FE) models were developed to compare the biomechanics of the ASF and BPSF groups. Results: Compared to the range of motion (ROM) of the intact lumbar model, that of the ASF model was decreased by 82.0% in flexion, 60.0% in extension, and the BPSF model was decreased by 86.7% in flexion, 77.3% in extension. Compared to the BPSF model, the maximum stresses of the L4 inferior endplate (IEP) and L5 superior endplate (SEP) were greatly increased in the ASF model; The contact surface between vertebrae and screw (CSVS) in the ASF model produced nearly100% more stresses than the BPSF model in all moment .Conclusions: OLIF surgery with ASF could not reduce the maximum stresses on the endplate and CSVS, which may be a potential risk factor for cage subsidence and screw loosening.

scholarly journals A Meta-Analysis of Unilateral versus Bilateral Pedicle Screw Fixation in Minimally Invasive Lumbar Interbody Fusion

PLoS ONE ◽  
2014 ◽  
Vol 9 (11) ◽  
pp. e111979 ◽  
Author(s):  
Zheng Liu ◽  
Qi Fei ◽  
Bingqiang Wang ◽  
Pengfei Lv ◽  
Cheng Chi ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Pedicle Screw ◽  
Interbody Fusion ◽  
Screw Fixation ◽  
Meta Analysis ◽  
Pedicle Screw Fixation ◽  
Lumbar Interbody Fusion ◽  
Bilateral Pedicle Screw
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