Biomechanical Evaluation of an Oblique Lateral Locking Plate System for Oblique Lumbar Interbody Fusion: A Finite Element Analysis

Wang, Yinge; Wang, Jiajia; Tu, Sha; Li, Shuang; Yi, Jiangpu; Zhao, Haixia; Qiao, Hui; Kang, Yan; Liao, Bo

doi:10.1016/j.wneu.2021.12.105

Cited by 13 publications

(13 citation statements)

References 56 publications

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“…Previous biomechanical tests have mainly focused on a single segment, but in this case, the simulation results might not be solid enough for the other uninvolved segments in the study ( 5 , 7 ). Thus, the current study chose both L2–3 and L4–5 segments for modeling, and the results confirmed the efficacy of this design.…”

Section: Discussionunclassified

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Biomechanical evaluation of a novel anatomical plate for oblique lumbar interbody fusion compared with various fixations: a finite element analysis

Huang¹,

Tian²,

Ma³

et al. 2022

Ann Transl Med

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Background: To build a model of an anatomical plate for oblique lumbar interbody fusion (OLIF) surgery based on previous anatomical parameters and verify the biomechanical effect with finite element analysis. Methods: The anatomical plate model was built with AutoCAD and Solidworks. Finite element models of the L2-3 and L4-5 segments were established with computed tomography images from a 46-year-old asymptomatic male individual. Six fixation technique models were created: (I) stand-alone (SA); (II) bilateral pedicle screws (BPS); (III) lateral rod-screw (LRS); (IV) lateral rod-screw plus facet screw (LRSFS); (V) twoscrew lateral plate (TSLP); (VI) anatomical plate. The range of motion (ROM), the cage stress, and the instrument stress were calculated under different motion states.Results: In the L2-3 and L4-5 segment models, except for a slightly higher maximum cage stress in the extension state of the TSLP model and the right bending and rotation states of the BPS model, the maximum cage stress in each model was smaller than that of the SA model. In the L2-3 and L4-5 segments, each internal fixation limited the ROM in each motion state. The anatomical plate was more effective in reducing the maximum cage stress and vertebral ROM than the two-screw plate. Three-dimensional finite element analysis did not find a higher risk of construct failure for the anatomical plate model compared with the BPS internal fixation model.Conclusions: Anatomical plates can be considered as supplementary fixations using a single incision and position to improve the stability and rigidity of the construction and reduce the risk of complications.

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Section: Discussionunclassified

“…Several previous studies have reported the use of plate and screw fixation systems for OLIF and have demonstrated the biomechanical efficiency of the system ( 7 , 8 ). However, these studies have two noteworthy limitations and could be further improved.…”

Section: Introductionunclassified

Biomechanical evaluation of a novel anatomical plate for oblique lumbar interbody fusion compared with various fixations: a finite element analysis

Huang¹,

Tian²,

Ma³

et al. 2022

Ann Transl Med

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“…A pedicle screw with a diameter of 8 mm and a length of 55 mm and a connecting rod with a diameter of 8 mm and a length of 50 mm was introduced for assembly. [21] Finally, 3-dimensional solid lumbar models of L3-L5 segments with 2 different fixation methods were generated, as shown in Figure 1.…”

Section: Methodsmentioning

confidence: 99%

Biomechanical characteristics of 2 different posterior fixation methods of bilateral pedicle screws: A finite element analysis

Zhang

Song

et al. 2022

Medicine

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Background: To explore the biomechanical characteristics of 2 posterior bilateral pedicle screw fixation methods using finite element analysis.Methods: A normal L3-5 finite element model was established. Based on the verification of its effectiveness, 2 different posterior internal fixation methods were simulated: bilateral pedicle screws (model A) were placed in the L3 and L5 vertebral bodies, and bilateral pedicle screws (model B) were placed in the L3, L4, and L5 vertebral bodies. The stability and stress differences of intervertebral discs, endplates, screws, and rods between models were compared.Results: Compared with the normal model, the maximum stress of the range of motion, intervertebral disc, and endplate of the 2 models decreased significantly. Under the 6 working conditions, the 2 internal fixation methods have similar effects on the stress of the endplate and intervertebral disc, but the maximum stress of the screws and rods of model B is smaller than that of model A.Conclusions: Based on these results, it was found that bilateral pedicle screw fixation in 2 vertebrae L3 and L5 can achieve similar stability as bilateral pedicle screw fixation in 3 vertebrae L3, L4, and L5. However, the maximum stress of the screw and rod in model B is less than that in model A, so this internal fixation method can effectively reduce the risk of fracture. The 3-dimensional finite element model established in this study is in line with the biomechanical characteristics of the spine and can be used for further studies on spinal column biomechanics. This information can serve as a reference for clinicians for surgical selection.

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“… 12 The finite element biomechanical study showed that BPS provides the best biomechanical properties for OLIF, 10 , 13 and the lateral locking plate system and UPS can be used as alternatives to BPS in OLIF. 13 , 14 However, most OLIF biomechanical studies are limited to a single segment. There is a lack of literature evaluating the need for supplementary instrumentation after double‐level OLIF.…”

Section: Introductionmentioning

confidence: 99%

“…With the increase in the degree of osteoporosis, stand‐alone OLIF increased the potential risk of implant subsidence 12 . The finite element biomechanical study showed that BPS provides the best biomechanical properties for OLIF, 10,13 and the lateral locking plate system and UPS can be used as alternatives to BPS in OLIF 13,14 . However, most OLIF biomechanical studies are limited to a single segment.…”

Section: Introductionmentioning

confidence: 99%

Biomechanical Analysis of Double‐Level Oblique Lumbar Fusion with Different Types of Fixation: A Finite Element‐Based Study

Fan

Zhang

Xue

et al. 2023

Orthopaedic Surgery

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Objective One well‐liked less invasive procedure is oblique lumbar interbody fusion (OLIF). The biomechanical characteristics of double‐level oblique lumbar interbody fusion in conjunction with various internal fixations are poorly understood. The purpose of this study was to clarify the biomechanical characteristics of double‐level oblique lumbar interbody fusion for osteoporosis spines using various internal fixation techniques. Methods Based on CT scans of healthy male volunteers, a complete finite element model of osteoporosis in L1–S1 was established. After validation, L3–L5 was selected as the surgical segment to construct four surgical models: (a) two stand‐alone cages (SA); (b) two cages with unilateral pedicle screws (UPS); (c) two cages with bilateral pedicle screws (BPS); and (d) two cages with bilateral cortical bone trajectory screws (CBT). Segmental range of motion (ROM), cage stress, and internal fixation stress were studied in all surgical models and compared with the intact osteoporosis model. Results The SA model had a minimal reduction in all motions. The CBT model had the most noticeable reduction in flexion and extension activities, while the reduction in the BPS model was slightly less than that in the CBT model but larger than that in the UPS model. The BPS model had the greatest limitation in left–right bending and rotation, which was greater than the UPS and CBT models. CBT had the smallest limitation in left–right rotation. The cage stress of the SA model was the highest. The cage stress in the BPS model was the lowest. Compared with the UPS model, the cage stress in the CBT model was larger in terms of flexion and LB and LR but slightly smaller in terms of RB and RR. In the extension, the cage stress in the CBT model is significantly smaller than in the UPS model. The CBT internal fixation was subjected to the highest stress of all motions. The BPS group had the lowest internal fixation stress in all motions. Conclusions Supplemental internal fixation can improve segmental stability and lessen cage stress in double‐level OLIF surgery. In limiting segmental mobility and lowering the stress of cage and internal fixation, BPS outperformed UPS and CBT.

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Biomechanical Evaluation of an Oblique Lateral Locking Plate System for Oblique Lumbar Interbody Fusion: A Finite Element Analysis

Cited by 13 publications

References 56 publications

Biomechanical evaluation of a novel anatomical plate for oblique lumbar interbody fusion compared with various fixations: a finite element analysis

Biomechanical evaluation of a novel anatomical plate for oblique lumbar interbody fusion compared with various fixations: a finite element analysis

Biomechanical characteristics of 2 different posterior fixation methods of bilateral pedicle screws: A finite element analysis

Biomechanical Analysis of Double‐Level Oblique Lumbar Fusion with Different Types of Fixation: A Finite Element‐Based Study

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