Screws Fixation for Oblique Lateral Lumbar Interbody Fusion (OL-LIF): A Finite Element Study

Overview

Journal Biomed Res Int

Publisher Wiley

Specialties Biomedical Engineering
Biotechnology
General Medicine

Date 2021 May 31

PMID 34055981

Citations 2

Authors

Qinjie Ling

Huanliang Zhang

Erxing He

Affiliations

Soon will be listed here.

Abstract

Background: The combination of screw fixation and cage can provide stability in lumbar interbody fusion (LIF), which is an important technique to treat lumbar degeneration diseases. As the narrow surface cage is developed in oblique lateral lumbar interbody fusion (OL-LIF), screw fixation should be improved at the same time. We used the finite element (FE) method to investigate the biomechanics response by three different ways of screw fixation in OL-LIF.

Methods: Using a validated FE model, OL-LIF with 3 different screw fixations was simulated, including percutaneous transverterbral screw (PTVS) fixation, percutaneous cortical bone trajectory screw (PCBTS) fixation, and percutaneous transpedical screw (PPS) fixation. Range of motion (ROM), vertebral body displacement, cage displacement, cage stress, cortical bone stress, and screw stress were compared.

Results: ROM in FE models significantly decreased by 84-89% in flexion, 91-93% in extension, 78-89% in right and left lateral bending, and 73-82% in right and left axial rotation compared to the original model. The maximum displacement of the vertebral body and the cage in six motions except for the extension of model PTVS was the smallest among models. Meanwhile, the model PTVS had the higher stress of screw-rods system and also the lowest stress of cage. In all moments, the maximum stresses of the cages were lower than their yield stress.

Conclusions: Three screw fixations can highly restrict the surgical functional spinal unit (FSU). PTVS provided the better stability than the other two screw fixations. It may be a good choice for OL-LIF.

Citing Articles

Biomechanical Performances of an Oblique Lateral Interbody Fusion Cage in Models with Different Bone Densities: A Finite Element Analysis.

Xue S, Wu T Indian J Orthop. 2023; 57(1):86-95.

PMID: 36660489 PMC: 9789258. DOI: 10.1007/s43465-022-00775-5.

Pearls and Pitfalls of Oblique Lateral Interbody Fusion: A Comprehensive Narrative Review.

Kim H, Chang B, Chang S Neurospine. 2022; 19(1):163-176.

PMID: 35378589 PMC: 8987540. DOI: 10.14245/ns.2143236.618.

References

Abbasi H, Abbasi A . Oblique Lateral Lumbar Interbody Fusion (OLLIF): Technical Notes and Early Results of a Single Surgeon Comparative Study. Cureus. 2015; 7(10):e351. PMC: 4652919. DOI: 10.7759/cureus.351. View

Orita S, Inage K, Kubota G, Sainoh T, Sato J, Fujimoto K . One-Year Prospective Evaluation of the Technique of Percutaneous Cortical Bone Trajectory Spondylodesis in Comparison with Percutaneous Pedicle Screw Fixation: A Preliminary Report with Technical Note. J Neurol Surg A Cent Eur Neurosurg. 2016; 77(6):531-537. DOI: 10.1055/s-0035-1566118. View

Joseph J, Smith B, La Marca F, Park P . Comparison of complication rates of minimally invasive transforaminal lumbar interbody fusion and lateral lumbar interbody fusion: a systematic review of the literature. Neurosurg Focus. 2015; 39(4):E4. DOI: 10.3171/2015.7.FOCUS15278. View

Nottmeier E, Pirris S . Placement of thoracic transvertebral pedicle screws using 3D image guidance. J Neurosurg Spine. 2013; 18(5):479-83. DOI: 10.3171/2013.2.SPINE12819. View

Huang H, Chen C, Lee H, Chuang H, Chen D, Chu Y . Minimal invasive surgical technique in midline lumbar inter-body fusion: A technique note. J Clin Neurosci. 2018; 55:103-108. DOI: 10.1016/j.jocn.2018.06.033. View

Birkenmaier C, Suess O, Pfeiffer M, Burger R, Schmieder K, Wegener B . The European multicenter trial on the safety and efficacy of guided oblique lumbar interbody fusion (GO-LIF). BMC Musculoskelet Disord. 2010; 11:199. PMC: 2944216. DOI: 10.1186/1471-2474-11-199. View

Ayturk U, Puttlitz C . Parametric convergence sensitivity and validation of a finite element model of the human lumbar spine. Comput Methods Biomech Biomed Engin. 2011; 14(8):695-705. DOI: 10.1080/10255842.2010.493517. View

Lu Y, Hutton W, Gharpuray V . Do bending, twisting, and diurnal fluid changes in the disc affect the propensity to prolapse? A viscoelastic finite element model. Spine (Phila Pa 1976). 1996; 21(22):2570-9. DOI: 10.1097/00007632-199611150-00006. View

Yeung A, Tsou P . Posterolateral endoscopic excision for lumbar disc herniation: Surgical technique, outcome, and complications in 307 consecutive cases. Spine (Phila Pa 1976). 2002; 27(7):722-31. DOI: 10.1097/00007632-200204010-00009. View

10.

Logroscino C, Tamburrelli F, Scaramuzzo L, Schiro G, Sessa S, Proietti L . Transdiscal L5-S1 screws for the treatment of adult spondylolisthesis. Eur Spine J. 2012; 21 Suppl 1:S128-33. PMC: 3325400. DOI: 10.1007/s00586-012-2229-8. View

11.

Dreischarf M, Zander T, Shirazi-Adl A, Puttlitz C, Adam C, Chen C . Comparison of eight published static finite element models of the intact lumbar spine: predictive power of models improves when combined together. J Biomech. 2014; 47(8):1757-66. DOI: 10.1016/j.jbiomech.2014.04.002. View

12.

Collados-Maestre I, Lizaur-Utrilla A, Bas-Hermida T, Pastor-Fernandez E, Gil-Guillen V . Transdiscal screw versus pedicle screw fixation for high-grade L5-S1 isthmic spondylolisthesis in patients younger than 60 years: a case-control study. Eur Spine J. 2016; 25(6):1806-12. DOI: 10.1007/s00586-016-4550-0. View

13.

Inamasu J, Guiot B . Vascular injury and complication in neurosurgical spine surgery. Acta Neurochir (Wien). 2005; 148(4):375-87. DOI: 10.1007/s00701-005-0669-1. View

14.

Abdu W, Wilber R, Emery S . Pedicular transvertebral screw fixation of the lumbosacral spine in spondylolisthesis. A new technique for stabilization. Spine (Phila Pa 1976). 1994; 19(6):710-5. DOI: 10.1097/00007632-199403001-00011. View

15.

Tsitsopoulos P, Serhan H, Voronov L, Carandang G, Havey R, Ghanayem A . Would an anatomically shaped lumbar interbody cage provide better stability? An in vitro cadaveric biomechanical evaluation. J Spinal Disord Tech. 2012; 25(8):E240-4. DOI: 10.1097/BSD.0b013e31824c820c. View

16.

Belytschko T, Andriacchi T, Schultz A, Galante J . Analog studies of forces in the human spine: computational techniques. J Biomech. 1973; 6(4):361-71. DOI: 10.1016/0021-9290(73)90096-1. View

17.

Akpolat Y, Inceoglu S, Kinne N, Hunt D, Cheng W . Fatigue Performance of Cortical Bone Trajectory Screw Compared With Standard Trajectory Pedicle Screw. Spine (Phila Pa 1976). 2015; 41(6):E335-41. DOI: 10.1097/BRS.0000000000001233. View

18.

Ling Q, He E, Zhang H, Lin H, Huang W . A novel narrow surface cage for full endoscopic oblique lateral lumbar interbody fusion: A finite element study. J Orthop Sci. 2019; 24(6):991-998. DOI: 10.1016/j.jos.2019.08.013. View

19.

Wu A, Harris J, Hao J, Jenkins S, Chi Y, Bucklen B . Biomechanical properties of posterior transpedicular-transdiscal oblique lumbar screw fixation with novel trapezoidal lateral interbody spacer: an in vitro human cadaveric model. Eur Spine J. 2017; 26(11):2873-2882. DOI: 10.1007/s00586-017-5050-6. View

20.

Mobbs R, Phan K, Malham G, Seex K, Rao P . Lumbar interbody fusion: techniques, indications and comparison of interbody fusion options including PLIF, TLIF, MI-TLIF, OLIF/ATP, LLIF and ALIF. J Spine Surg. 2016; 1(1):2-18. PMC: 5039869. DOI: 10.3978/j.issn.2414-469X.2015.10.05. View