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Hybrid cortical bone trajectory and modified cortical bone trajectory techniques in transforaminal lumbar interbody fusion at L4-L5 segment: A finite element analysis – Lumbar Fusion

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The article discusses a study that investigates the biomechanical performance of the hybrid fixation technique using Bilateral Cortical Screws (BCS) and Bilateral Modified Cortical Screws (BMCS) in transforaminal lumbar interbody fusion (TLIF) at the L4-L5 segment. The study utilizes three cadaver specimens to construct lumbar-sacral finite element models and evaluates the biomechanical properties of various fixation technologies. The results show that the BMCS-BCS technique exhibits better biomechanical performance with less range of motion (ROM) and lower stress on the internal fixation system compared to other fixation techniques. The BMCS-BMCS technology is also highlighted as having similar mechanical performance to BMCS-BCS but with more contact area between screws and cortical bone, making it better for patients with severe osteoporosis

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most experienced sugical centre on Harley Street UK

Published article

: The BMCS-BCS technique shows better biomechanical performance with less ROM and lower stress on the internal fixation system compared to other fixation techniques. BMCS-BMCS technology has similar mechanical performance to BMCS-BCS but has more contact area between screws and cortical bone, making it better for patients with severe osteoporosis.

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Heliyon. 2024 Feb 20;10(5):e26294. doi: 10.1016/j.heliyon.2024.e26294. eCollection 2024 Mar 15.ABSTRACTBACKGROUND: The academia has increasingly acknowledged the superior biomechanical performance of the hybrid fixation technique in recent years. However, there is a lack of research on the hybrid fixation technique using BCS (Bilateral Cortical Screws) and BMCS (Bilateral Modified Cortical Screws). This study aims to investigate,

Hellion. 2024 Feb 20;10(5):e26294. doi: 10.1016/j.helion.2024.e26294. eCollection 2024 Mar

ABSTRACT

BACKGROUND: The academia has increasingly acknowledged the superior biomechanical performance of the hybrid fixation technique in recent years. However, there is a lack of research on the hybrid fixation technique using BCS (Bilateral Cortical Screws) and BMCS (Bilateral Modified Cortical Screws). This study aims to investigate the biomechanical performance of the BCS and BMCS hybrid fixation technique in transforaminal lumbar interbody fusion (TLIF) at the L4-L5 segment in a complete lumbar-sacral finite element model.

METHODS: Three cadaver specimens are used to construct three lumbar-sacral finite element models. The biomechanical properties of various fixation technologies (BCS-BCS, BMCS-BMCS, BMCS-BCS, and BCS-BMCS) are evaluated at the L4-5 segment with a TLIF procedure conducted, including the range of motion (ROM) of the L4-5 segment, as well as the stress experienced by the cage, screws, and rods. The testing is conducted under specific loading conditions, including a compressive load of 400 N and a torque of 7.5Nm, subjecting the model to simulate flexion, extension, lateral bending, and rotation.

RESULTS: No significant variations are seen in the ROM at the L4-5 segment when comparing the four fixation procedures during flexion and extension. However, when it comes to lateral bending and rotation, the ROM is ordered in descending order as BCS-BCS, BCS-BMCS, BMCS-BMCS, and BMCS-BCS. The maximum stress experienced by the cage is observed to be highest within the BMCS-BCS technique during movements including flexion, extension, and lateral bending. Conversely, the BMCS-BMCS technique exhibits the highest cage stress levels during rotational movements. The stress applies to the screws and rods order the sequence of BCS-BCS, BCS-BMCS, BMCS-BCS, and BMCS-BMCS throughout all four working conditions.

: The BMCS-BCS technique shows better biomechanical performance with less ROM and lower stress on the internal fixation system compared to other fixation techniques. BMCS-BMCS technology has similar mechanical performance to BMCS-BCS but has more contact area between screws and cortical bone, making it better for patients with severe osteoporosis.

PMID:38434416 | PMC:PMC10906328 | DOI:10.1016/j.heliyon.2024.e26294

The London Spine Unit : most experienced sugical centre on Harley Street UK

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Hybrid cortical bone trajectory and modified cortical bone trajectory techniques in transforaminal lumbar interbody fusion at L4-L5 segment: A finite element analysis

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Heliyon. 2024 Feb 20;10(5):e26294. doi: 10.1016/j.heliyon.2024.e26294. eCollection 2024 Mar 15.ABSTRACTBACKGROUND: The academia has increasingly acknowledged the superior biomechanical performance of the hybrid fixation technique in recent years. However, there is a lack of research on the hybrid fixation technique using BCS (Bilateral Cortical Screws) and BMCS (Bilateral Modified Cortical Screws). This study aims to investigate

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