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Three-dimensional Navigation-guided, Prone, Single-position, Lateral Lumbar Interbody Fusion Technique
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The Biomechanical Study of Extraforaminal Lumbar Interbody Fusion: A Three-Dimensional Finite-Element Analysis
Mingjie Yang1, Guixin Sun2, Song Guo1
1Department of Spine, Shanghai East Hospital, Tongji University School of Medicine, No. 150 Jimo Road, Shanghai 200120, China.
Journal of Healthcare Engineering
|October 31, 2017
Summary
Extraforaminal lumbar interbody fusion (ELIF) with unilateral fixation offers better stability than transforaminal lumbar interbody fusion (TLIF) with unilateral fixation. Adding a translaminar facet screw further enhances ELIF stability.
Area of Science:
- Spine biomechanics
- Orthopedic surgery
- Finite element analysis
Background:
- Lumbar interbody fusion is a common surgical procedure for spinal instability.
- Different internal fixation techniques aim to optimize biomechanical stability and fusion rates.
- Comparing extraforaminal lumbar interbody fusion (ELIF) with transforaminal lumbar interbody fusion (TLIF) is crucial for surgical decision-making.
Purpose of the Study:
- To evaluate and compare the biomechanical stability of ELIF with various internal fixation methods.
- To assess the stability of ELIF against different TLIF configurations using finite-element analysis.
Main Methods:
- A three-dimensional finite-element model of the L3-L5 lumbar spine was created.
- Simulations involved decompression and internal fixation at the L4-L5 segment.
- The model was subjected to physiological loads to calculate range of motion (ROM) under different fixation conditions.
Main Results:
- All internal fixation methods demonstrated increased stability compared to the intact model.
- ELIF with unilateral pedicle screw fixation (UPS) showed greater stability than TLIF with UPS.
- ELIF with UPS and translaminar facet screw (TLFS) fixation exhibited superior stability, comparable to TLIF with bilateral pedicle screw fixation (BPS).
Conclusions:
- ELIF with unilateral pedicle screw fixation provides superior biomechanical stability compared to TLIF with unilateral pedicle screw fixation.
- Supplementing ELIF with a translaminar facet screw significantly enhances its stability, making it a viable alternative to bilateral fixation techniques.
