Biomechanical Evaluation of Oblique Lateral Interbody Fusion Combined with Different Internal Fixation Methods for Treating Degenerative Lumbar Scoliosis:A Finite Element Analysis
10.16156/j.1004-7220.2023.01.07
- VernacularTitle:斜外侧椎间融合结合不同内固定方式治疗退变性腰椎侧凸的有限元分析
- Author:
Shulong YANG
1
,
2
;
Rong MA
3
;
Zhiqiang WANG
1
;
Simin LIANG
3
;
Zhen CHEN
3
;
Xiaoyin LIU
3
;
Jianqun ZHANG
3
;
Zhaohui GE
3
Author Information
1. College of Clinical Medicine, Ningxia Medical University
2. Department of Orthopaedic Surgery, Wuhai People’s Hospital
3. Department of Orthopaedic Surgery, General Hospital of Ningxia Medical University
- Publication Type:Journal Article
- Keywords:
oblique lumbar interbody fusion ( OLIF);
degenerative lumbar scoliosis ( DLS);
finite element analysis
- From:
Journal of Medical Biomechanics
2023;38(1):E052-E058
- CountryChina
- Language:Chinese
-
Abstract:
Objective To verify the biomechanical stability of oblique lateral interbody fusion ( OLIF) combinedwith different fixation methods for treating degenerative lumbar scoliosis (DLS) by three-dimensional (3D) finite element analysis. Methods The L1-S1 3D finite element DLS model ( Model 1) was established, and then the OLIF (L2-5) at 3 contiguous levels of fusion and its combination with different internal fixation methods were simulated, namely, stand-alone OLIF model ( Model 2), vertebral screw fixation model ( Model 3), unilateral pedicle screw fixation model (Model 4) and bilateral pedicle screw fixation model (Model 5) were established,respectively. Under upright, flexion, extension, lateral bending and axial rotation states, range of motion (ROM) of fusion segments, as well as cage stress, internal fixation stress, and stress distribution were recorded and analyzed. Results Under six motion states, the overall ROM of fusion segments in Models 2-5 was smaller than that of Model 1. Compared with Model 1, the overall ROM reduction of Model 3 and Model 4 was larger than that of Model 2 and smaller than that of Model 5. Under flexion and extension, the overall ROM reduction of Model 4 and Model 5 was basically equal. Under left and right lateral bending, the overall ROM reduction of Model 3 and Model 5 was basically equal. Under all motion states, the peak stress of Model 3 and Model 4 fusion cage was larger than that of Model 5 and smaller than that of Model 2. The peak stresses of L2-3, L3-4 and L4-5 fusion cages in Model 3 increased by 5. 52% , 10. 96% and 7. 99% respectively compared with Model 5 under left lateral bending, and the peak stresses of L2-3, L3-4 and L4-5 fusion cages in Model 4 increased by 8. 70% , 7. 00% and 6. 99% respectively under flexion. Under all motion states, the peak stress of screw rod in Model 5 was smaller than that of Model 3 and Model 4, and the peak stresses of screw rod in Models 3-5 were the smallest in upright state. Conclusions The OLIF with unilateral pedicle screw fixation or vertebral screw fixation can provide favorable biomechanical stability of the fusion segment. The results provide some references for clinical application of OLIF technology in the treatment of DLS.
