Oblique Lumbar Interbody Fusion Combined With 4-Screw Fixation for Treating Two-Level Degenerative Lumbar Diseases:A Finite Element Study
10.3881/j.issn.1000-503X.15878
- VernacularTitle:斜外侧腰椎椎间融合术结合4钉固定法治疗两节段腰椎退变性疾病的有限元分析
- Author:
Ting GE
1
;
Baiwen HU
;
Jin XIAO
;
Qiaolin ZHANG
;
Xiaochuan WU
;
Dongdong XIA
Author Information
1. 宁波大学附属第一医院骨科,浙江宁波 315010
- Keywords:
oblique lumbar interbody fusion;
finite element model;
pedicle screw;
4-screw fixation;
6-screw fixation
- From:
Acta Academiae Medicinae Sinicae
2024;46(3):341-347
- CountryChina
- Language:Chinese
-
Abstract:
Objective To demonstrate the feasibility of oblique lumbar interbody fusion(OLIF)com-bined with 4-screw fixation for treating two-level lumbar degenerative diseases.Methods An intact finite element model of L3-S1(MO)was constructed and validated.Then,we constructed the M1 model by simulating OLIF surgery at L3/4 and L4/5 segments on the MO model.By attachment of posterior 4-screw or 6-screw fixation to the M1 model,three 4-screw fixation models(M2-M4)and one 6-screw fixation model(M5)were established.The segmental and overall range of motion(ROM)and the peak von Mises stresses of superior endplate,cage,and posterior screw-rod were investigated under each implanted condition.Results Under the motion modes of forward flexion,backward extension,bilateral(left and right)flexion,and left and right rotation,the L3/4 ROM of M2 model and L4/5 ROM of M3 model increased,while the L3/4 and L4/5 ROM of M4 and M5 models significantly decreased compared with those of M1 model.Under all motion modes,the L4 superior endplate in M2 model and the L5 superior endplate in M3 model showed the maximum peak von Mises stress,and the peak von Mises stresses of L4 and L5 superior endplates in M4 and M5 models were close.The L3/4 cage in M2 model and the L4/5 cage in M3 model showcased the largest peak von Mises stress,and the peak von Mises stresses of cages in M4 and M5 models were close.The peak stresses of internal fixation in M2-M5 models were close.Conclusion Four-screw fixa-tion can replace 6-screw fixation in the OLIF surgery for treating two-level degenerative lumbar diseases.
