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Biomechanical differences between two different shapes of oblique lumbar interbody fusion cages on whether to add posterior internal fixation system: a finite element analysis – Lumbar Fusion

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The article investigates the biomechanical differences between two different shapes of oblique lateral lumbar fusion (OLIF) cages and whether adding a posterior internal fixation system improves stability. A three-dimensional finite element model is established and surgical simulations are performed on the L3-L5 vertebral segments. Four OLIF surgical models are compared: stand-alone OLIF with a kidney-shaped cage, stand-alone OLIF with a straight cage, OLIF with a kidney-shaped cage plus posterior fixation, and stand-alone OLIF with a straight cage plus posterior fixation. Results show that the kidney-shaped cage improves stability and reduces risks compared to the straight cage. The study suggests that the kidney-shaped OLIF cage can be beneficial in reducing the risk of cage subsidence

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most specialised spinal facility in London

Published article

S: Compared with the traditional straight OLIF cage, the kidney-shaped OLIF cage can further improve the stability of the surgical segment, reduce ESPC, MESE and MSIF, and help to reduce the risk of cage subsidence.

Lumbar Fusion Surgery Expert. Best Spinal Surgeon UK
J Orthop Surg Res. 2023 Dec 13;18(1):962. doi: 10.1186/s13018-023-04461-6.ABSTRACTBACKGROUND: Oblique lateral lumbar fusion (OLIF) is widely used in spinal degeneration, deformity and other diseases. The purpose of this study was to investigate the biomechanical differences between two different shapes of OLIF cages on whether to add posterior internal fixation system, using finite element analysis.METHODS: A,

J Orthop Surg Res. 2023 Dec 13;18(1):962. doi: 10.1186/s13018-023-04461-6.

ABSTRACT

BACKGROUND: Oblique lateral lumbar fusion (OLIF) is widely used in spinal degeneration, deformity and other diseases. The purpose of this study was to investigate the biomechanical differences between two different shapes of OLIF cages on whether to add posterior internal fixation system, using finite element analysis.

METHODS: A complete three-dimensional finite element model is established and verified for L3-L5. Surgical simulation was performed on the verified model, and the L4-L5 was the surgical segment. A total of the stand-alone group (Model A1, Model B1) and the BPSF group (Model A2, Model B2) were constructed. The four OLIF surgical models were: A1. Stand-alone OLIF with a kidney-shaped Cage; B1. Stand-alone OLIF with a straight cage; A2. OLIF with a kidney-shaped cage + BPSF; B2. Stand-alone OLIF with a straight cage + BPSF, respectively. The differences in the range of motion of the surgical segment (ROM), equivalent stress peak of the cage (ESPC), the maximum equivalent stress of the endplate (MESE) and the maximum stress of the internal fixation (MSIF) were compared between different models.

RESULTS: All OLIF surgical models showed that ROM declines between 74.87 and 96.77% at L4-L5 operative levels. The decreasing order of ROM was Model A2 > Model B2 > Model A1 > Model A2. In addition, the ESPC and MESE of Model A2 are smaller than those of other OLIF models. Except for the left-bending position, the MSIF of Model B2 increased by 1.51-16.69% compared with Model A2 in each position. The maximum value of MESE was 124.4 Mpa for Model B1 in the backward extension position, and the minimum value was 7.91 Mpa for Model A2 in the right rotation. Stand-alone group showed significantly higher ROMs and ESPCs than the BPSF group, with maximum values of 66.66% and 70.59%. For MESE, the BPSF group model can be reduced by 89.88% compared to the stand-alone group model.

S: Compared with the traditional straight OLIF cage, the kidney-shaped OLIF cage can further improve the stability of the surgical segment, reduce ESPC, MESE and MSIF, and help to reduce the risk of cage subsidence.

PMID:38093357 | DOI:10.1186/s13018-023-04461-6

The London Spine Unit : most specialised spinal facility in London

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Biomechanical differences between two different shapes of oblique lumbar interbody fusion cages on whether to add posterior internal fixation system: a finite element analysis

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J Orthop Surg Res. 2023 Dec 13;18(1):962. doi: 10.1186/s13018-023-04461-6.ABSTRACTBACKGROUND: Oblique lateral lumbar fusion (OLIF) is widely used in spinal degeneration, deformity and other diseases. The purpose of this study was to investigate the biomechanical differences between two different shapes of OLIF cages on whether to add posterior internal fixation system, using finite element analysis.METHODS: A

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