A Review of Finite Element Analysis in Spine Surgery Decision-Making

Area of Science:

• Biomechanical Engineering
• Spinal Surgery
• Computational Modeling

Background:

• Finite element analysis (FEA) is crucial for understanding spinal biomechanics and evaluating surgical interventions.
• FEA models allow for controlled variations in alignment, fixation, and implant design to analyze stress redistribution and motion changes.
• A review of FEA studies in spine surgery from 2018-2024 focuses on interbody fusion, adjacent segment mechanics, and implant stress.

Purpose of the Study:

• To review and synthesize findings from finite element analysis studies focused on spinal surgery techniques published between 2018 and 2024.
• To emphasize interbody fusion techniques, adjacent segment biomechanics, and implant stress behavior.
• To highlight the evolving role of FEA in surgical planning and implant development.

Main Methods:

• Systematic review of finite element analysis studies in spinal surgery.
• Analysis of models focusing on lumbar and cervical spine fusion techniques.
• Evaluation of implant-specific stress behavior and adjacent segment mechanics under various loading conditions.

Main Results:

• In lumbar fusion, anterior column support constructs show lower posterior instrumentation stress compared to posterior-only methods.
• Lateral lumbar interbody fusion techniques demonstrate reduced rod and screw stresses versus posterior lumbar interbody or posterolateral fusion.
• Cervical spine studies indicate zero-profile anterior cervical discectomy and fusion devices result in less adjacent-level motion and intradiscal pressure increase, but higher fixation interface stress.

Conclusions:

• Finite element analysis is increasingly vital for supporting surgical planning and optimizing implant design in spine surgery.
• Advances in FEA validation and patient-specific modeling are enhancing its clinical relevance.
• FEA provides valuable insights into biomechanical outcomes of different spinal fusion strategies.