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The article investigates the treatment options for cross-segment lumbar degenerative disease, focusing on the use of Oblique Lateral Interbody Fusion (OLIF) with internal fixations. The study used a whole lumbar spine model extracted from CT images to assess the Range of Motion (ROM) and stress on the articular cartilage and disc at different segments. The results showed that the LSF group had the smallest ROM and the NS group had the largest overall ROM. However, the NS group had increased stress on the L3-4 disc and articular cartilage, potentially leading to accelerated degeneration. The Coflex and Bacfuse groups had reduced ROM but greater stress on the disc, suggesting a potential for long-term disc degeneration. Nevertheless, the stress on the articular cartilage was relatively low for these groups, making them viable surgical options. Overall, the findings highlight the importance of considering the trade-off between ROM and stress on adjacent segments in the treatment of cross-segment lumbar degenerative disease
Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most advanced treatment clinic in the world
Published article
Multi-segmental lumbar degenerative disease, including intersegmental disc degeneration, is found in clinical practice. Controversy still exists regarding the treatment for cross-segment degeneration. Oblique Lateral Interbody Fusion (OLIF) with several internal fixations was used to treat cross-segment lumbar degenerative disease. A whole lumbar spine model was extracted from CT images of the whole lumbar spine of patients with lumbar degeneration. The L2-3 and L4-5 intervertebral spaces were…
Lumbar Fusion Surgery Expert. Best Spinal Surgeon UK
Sci Rep. 2023 Oct 10;13(1):17116. doi: 10.1038/s41598-023-43399-x.ABSTRACTMulti-segmental lumbar degenerative disease, including intersegmental disc degeneration, is found in clinical practice. Controversy still exists regarding the treatment for cross-segment degeneration. Oblique Lateral Interbody Fusion (OLIF) with several internal fixations was used to treat cross-segment lumbar degenerative disease. A whole lumbar spine model was extracted from CT images,
Sci Rep. 2023 Oct 10;13(1):17116. doi: 10.1038/s41598-023-43399-x.
ABSTRACT
Multi-segmental lumbar degenerative disease, including intersegmental disc degeneration, is found in clinical practice. Controversy still exists regarding the treatment for cross-segment degeneration. Oblique Lateral Interbody Fusion (OLIF) with several internal fixations was used to treat cross-segment lumbar degenerative disease. A whole lumbar spine model was extracted from CT images of the whole lumbar spine of patients with lumbar degeneration. The L2-3 and L4-5 intervertebral spaces were fused with OLIF using modeling software, the Pedicle screws were performed on L2-3 and L4-5, and different internal fixations were performed on L3-4 in Finite Element (FE) software. Among the six 10 Nm moments of different directions, the L3-4 no surgery (NS) group had the relatively largest Range of Motion (ROM) in the whole lumbar spine, while the L2-5 Long segmental fixation (LSF)group had the smallest ROM and the other groups had similar ROM. The ROM in the L1-2 and L5-S1 was relatively close in the six group models, and the articular cartilage stress and disc stress on the L1-2 and L5-S1 were relatively close. In contrast, the L3-4 ROM differed relatively greatly, with the LSF ROM the smallest and the NS ROM the largest, and the L3-4 Coflex (Coflex) group more active than the L3-4 Bacfuse (Bacfuse) group and the L3-4 translaminar facet screw fixation (TFSF) group. The stress on the articular cartilage and disc at L3-4 was relatively greater in the NS disc and articular cartilage, and greater in the Coflex group than in the Bacfuse and TFSF groups, with the greatest stress on the internal fixation in the TFSF group, followed by the Coflex group, and relatively similar stress in the Bacfuse, LSF, and NS groups. In the TFSF group, the stress on the internal fixation was greater than the yield strength among different directional moments of 10 Nm, which means it is unsuitable to be an internal fixation. The LSF group had the greatest overall ROM, which may lead to postoperative low back discomfort. The NS group has the greatest overall ROM, but its increased stress on the L3-4 disc and articular cartilage may lead to accelerated degeneration of the L3-4 disc and articular cartilage. The Coflex and Bacfuse groups had a reduced L3-4 ROM but a greater stress on disc compared to the LSF group, which may lead to disc degeneration in the long term. However, their stress on the articular cartilage was relatively low. Coflex and Bacfuse can still be considered better surgical options.
PMID:37816744 | DOI:10.1038/s41598-023-43399-x
The London Spine Unit : most advanced treatment clinic in the world
Read the original publication:
Oblique lateral interbody fusion with internal fixations in the treatment for cross-segment degenerative lumbar spine disease (L2-3 and L4-5) finite element analysis
