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Updated: Jan 19, 2026
Multilevel Oblique Lumbar Interbody Fusion in Degenerative Lumbar Disc Disease with Instability
Published on: July 25, 2025
A novel narrow surface cage for full endoscopic oblique lateral lumbar interbody fusion: A finite element study
Qinjie Ling1, Erxing He2, Huanliang Zhang3
1School of Basic Medical Sciences, Guangdong Provincial Key Laboratory of Medical Biomechanics, Southern Medical University, No. 1023, South Shatai Road, Baiyun District, Guangzhou, Guangdong, 510515, China; Dept of Spinal Surgery, The First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiang West Road, Guangzhou, Guangdong, 510120, China.
Objective:
To evaluate the mechanical response of a narrow surface cage that we designed for full endoscopic oblique lateral lumbar interbody fusion (FE-OL-LIF).
Methods:
A finite element (FE) model of lumbar spine was developed and validated. To simulate the FE-OL-LIF, the functional spinal unit (FSU) L4-L5 was assembled with a narrow surface polyetheretherketone (PEEK) cage, two rods and four screws. 500N load combined with 7.5Nm moment was applied to the surgical models. Effect of the cage width on the stress was studied.
Results:
Range of motion (ROM) in the surgical models significantly decreased by 88% in flexion, 91% extension, 85% in right and left lateral bending, 75% in right and left axial rotation as compared to the intact model. Width of the cage slightly decreased the ROM in all loading scenarios. Flexion produced the highest stress in the cages and endplates. In all loading cases, the maximum stresses of cages and endplates were both lower than their yield stress.
Conclusions:
In engineering analysis, the novel narrow-surface cage had a strength to support spine activities. 9 mm width cage was recommended in FE-OL-LIF. This study provided engineering evidence and technical advice to improve the design of minimally invasive cage. Fatigue test and cadaver trial shall be improved.
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