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Finite element analysis of implanted lumbar spine: Effects of open laminectomy plus PLF and open laminectomy plus TLIF surgical approaches on L3-L4 FSU – Lumbar Spinal Stenosis

The article discusses a finite element (FE) study comparing the performance of Open Laminectomy plus Posterolateral Fusion (OL-PLF) and Open Laminectomy plus Transforaminal Interbody Fusion (OL-TLIF) surgical approaches for lumbar fusion. The study examined the variations in ranges of motions, stress-strain distributions in the implanted functional spinal unit (FSU), and caudal adjacent soft structures between the two surgical models. The results showed a reduction in ranges of motions for both models, with risks of failure in the implanted FSUs and higher chances of adjacent segment degeneration. This comparative study provides valuable insights for clinicians in choosing the most suitable surgical approach for lumbar fusion

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
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Published article

Several finite element (FE) studies reported performances of various lumbar fusion surgical approaches. However, comparative studies on the performance of Open Laminectomy plus Posterolateral Fusion (OL-PLF) and Open Laminectomy plus Transforaminal Interbody Fusion (OL-TLIF) surgical approaches are rare. In the current FE study, the variation in ranges of motions (ROM), stress-strain distributions in an implanted functional spinal unit (FSU) and caudal adjacent soft structures between OL-PLF and…

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Med Eng Phys. 2024 Jun;128:104178. doi: 10.1016/j.medengphy.2024.104178. Epub 2024 May 7. ABSTRACT Several finite element (FE) studies reported performances of various lumbar fusion surgical approaches. However, comparative studies on the performance of Open Laminectomy plus Posterolateral Fusion (OL-PLF) and Open Laminectomy plus Transforaminal Interbody Fusion (OL-TLIF) surgical approaches are rare. In the current FE study,

Med Eng Phys. 2024 Jun;128:104178. doi: 10.1016/j.medengphy.2024.104178. Epub 2024 May 7.

ABSTRACT

Several finite element (FE) studies reported performances of various lumbar fusion surgical approaches. However, comparative studies on the performance of Open Laminectomy plus Posterolateral Fusion (OL-PLF) and Open Laminectomy plus Transforaminal Interbody Fusion (OL-TLIF) surgical approaches are rare. In the current FE study, the variation in ranges of motions (ROM), stress-strain distributions in an implanted functional spinal unit (FSU) and caudal adjacent soft structures between OL-PLF and OL-TLIF virtual models were investigated. The implanted lumbar spine FE models were developed from subject-specific computed tomography images of an intact spine and solved for physiological loadings such as compression, flexion, extension and lateral bending. Reductions in the ROMs of L1-L5 (49 % to 59 %) and L3-L4 implanted FSUs (91 % to 96 %) were observed for both models. Under all the loading cases, the maximum von Mises strain observed in the implanted segment of both models exceeds the mean compressive yield strain for the vertebra. The maximum von Mises stress and strain observed on the caudal adjacent soft structures of both the implanted models are at least 22 % higher than the natural spine model. The findings indicate the risk of failure in the implanted FSUs and higher chances of adjacent segment degeneration for both models.

PMID:38789215 | DOI:10.1016/j.medengphy.2024.104178

The London Spine Unit : most specialised day surgery hospital in the world

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Finite element analysis of implanted lumbar spine: Effects of open laminectomy plus PLF and open laminectomy plus TLIF surgical approaches on L3-L4 FSU

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Med Eng Phys. 2024 Jun;128:104178. doi: 10.1016/j.medengphy.2024.104178. Epub 2024 May 7. ABSTRACT Several finite element (FE) studies reported performances of various lumbar fusion surgical approaches. However, comparative studies on the performance of Open Laminectomy plus Posterolateral Fusion (OL-PLF) and Open Laminectomy plus Transforaminal Interbody Fusion (OL-TLIF) surgical approaches are rare. In the current FE study

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