Journal of Shandong University (Health Sciences) ›› 2022, Vol. 60 ›› Issue (1): 55-64.doi: 10.6040/j.issn.1671-7554.0.2021.0609

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Afinite element analysis of three different fusion methods of lumbar internal fixation

LI Mingbo1, HUANG Yanbo1, REN Dongcheng2, LIU Juncheng1, TAN Chengshuang3, XU Jixi4, DING Jinyong4   

  1. 1. The First Clinical Medical College of Guangzhou University of Traditional Chinese Medicine, Guangzhou 510405, Guangdong, China;
    2. Department of Orthopedics, The Third Peoples Hospital of Shenzhen, Shenzhen 518112, Guangdong, China;
    3. Department of Orthopedics, The Second Peoples Hospital of Panyu Guangzhou, Guangzhou 511400, Guangdong, China;
    4. Department of Spinal Surgery, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong, China
  • Published:2022-01-08

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Abstract: Objective To observe the biomechanical differences between the operative segments and adjacent segments of three different lumbar internal fixation and fusion methods. Methods Three models of L4-5 internal fixation fusion mode were constructed, including oblique lateral interbody fusion(OLIF)model, unilateral minimally invasive surgery-transforaminal lumbar interbody fusion(MIS-TLIF)model, and bilateral MIS-TLIF model. Six stress states as normal body were simulated, including forward flexion, extension, left flexion, right flexion, left rotation and right rotation. The changes of the peak stress of the intervertebral disc, the maximum displacement of the vertebral body, the peak stress of the cage, the peak stress of the internal fixation, the peak stress of the endplate under L3 and the peak stress of the endplate on L4 in each model under 6 different motion states were observed and analyzed. Results Among the three models, the OLIF model was significantly lower than the other two models in terms of the peak stress in the intervertebral disc at L3-4, the maximum displacement of the vertebral body at L3, the peak stress of internal fixation and the peak stress of the endplate under L3. In comparison of the stress peak of the cage, the stress peak of the OLIF internal fixation model was significantly lower than that of the unilateral MIS-TLIF model, but in most cases, it was greater than that of the bilateral MIS-TLIF model. However, the stress peak of the cage in the unilateral MIS-TLIF internal fixation model was significantly higher than that in the bilateral MIS-TLIF model. In comparison of internal fixed stress peak, the OLIF model had the best biomechanics, followed by the bilateral MIS-TLIF, and the unilateral MIS-TLIF. Conclusion Among the three finite element research models, OLIF model has the best biomechanical effect and relatively small surgical injury, which provides a reference value for clinicians in the choice of surgery.

Key words: Lumbar internal fixation and fusion, Oblique lateral interbody fusion, Minimally invasive surgery-transforaminal lumbar interbody fusion, Finite element, Biomechanics

CLC Number: 

  • R681.5
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