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Three-dimensional Navigation-guided, Prone, Single-position, Lateral Lumbar Interbody Fusion Technique
Published on: July 15, 2021
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Biomechanical Evaluation of Rigid Interspinous Process Fixation Combined With Lumbar Interbody Fusion Using Hybrid
Wei Fan1, Chi Zhang1, Dong-Xiang Zhang1
1School of Mechanical Engineering and Automation, Northeastern University, Shenyang 110819, China.
Journal of Biomechanical Engineering
|January 25, 2023
Summary
Rigid interspinous process fixation (RIPF) may reduce adjacent segment degeneration compared to pedicle screw fixation (PSF) in lumbar interbody fusion. However, RIPF may initially decrease surgical segment stability and increase subsidence risk, which improves with bony fusion.
Area of Science:
- Spine Biomechanics
- Orthopedic Surgery
- Finite Element Analysis
Background:
- Rigid interspinous process fixation (RIPF) is an emerging alternative to pedicle screw fixation (PSF) for lumbar interbody fusion (LIF).
- Understanding the biomechanical implications of RIPF is crucial for its clinical adoption.
Purpose of the Study:
- To investigate the biomechanics of the lumbar spine with RIPF.
- To compare biomechanical differences between RIPF and PSF.
- To evaluate RIPF biomechanics before and after bony fusion.
Main Methods:
- Development of finite-element models of the lumbosacral spine.
- Modeling single-level LIF with RIPF and conventional PSF.
- Simulation of biomechanical responses to physiological motion using a hybrid testing protocol.
Main Results:
- RIPF showed reduced range of motion (ROM), intradiscal pressure (IDP), and facet joint forces (FJF) at adjacent segments compared to PSF.
- RIPF demonstrated increased ROM and endplate stress at the surgical segment versus PSF.
- Bony fusion in RIPF significantly decreased surgical segment ROM and endplate stress.
Conclusions:
- RIPF may lower the risk of adjacent segment degeneration but could compromise surgical segment stability and increase cage subsidence risk.
- Achieving bony fusion with RIPF enhances surgical segment stability and reduces the risk of bone-cage contact failure.
