Biomechanical analysis of lateral lumbar interbody fusion constructs with various fixation options: Based on a validated finite element model.

Biomechanical analysis of lateral lumbar interbody fusion constructs with various fixation options: Based on a validated finite element model.

World Neurosurg. 2018 Mar 30;:

Authors: Zhang Z, Fogel GR, Liao Z, Sun Y, Liu W

Abstract
BACKGROUND: Lateral lumbar interbody fusion using cage supplemented with fixation has been widely used in the treatment of lumbar disease. A combined fixation of lateral plate and spinous process plate may provide multiplanar stability similar to that of bilateral pedicle screws, and may reduce morbidity. The biomechanical influence of the combined fixation on cage subsidence and facet joint stress has not been well described. The aim of this study was to compare biomechanics of various fixation options and to verify biomechanical effects of the combined fixation.
METHODS: The surgical finite element (FE) models with various fixation options were constructed based on CT images. The lateral plate and posterior spinous process plate were applied (combined fixation, CF). The six motion modes were simulated. Range of motion (ROM), cage stress, endplate stress, and facet joint stress (FJS) were compared.
RESULTS: For the CF model, ROM, cage stress, and endplate stress were the minimum in almost all motion modes. When compared with bilateral pedicle screws (BPS), the CF reduced ROM, cage stress and endplate stress in all motion modes. The ROM was reduced by more than 10% in all motion modes except for flexion; cage stress and endplate stress was reduced more than 10% in all motion modes except for rotation-left. After interbody fusion, FJS was substantially reduced compared to the intact conditions in all motion modes except for flexion.
CONCLUSIONS: The combined plate fixation may offer an alternative to bilateral pedicle screw fixation in lateral lumbar interbody fusion.

PMID: 29609081 [PubMed - as supplied by publisher]

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