Evaluation of the Stability of a Novel Lateral Plate Internal Fixation: An In Vitro Biomechanical Study

Cai, Zecheng; Ma, Rong; Zhang, Jianqun; Liu, Xiaoyin; Yang, Wenlin; Wang, Zemin; Cai, Baochun; Xü, Xinsheng; Ge, Zhen

doi:10.1016/j.wneu.2021.10.164

Cited by 6 publications

(4 citation statements)

References 31 publications

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“…Therefore, this is consistent with broken nails caused by stress fatigue in some patients after long-term activity. [37][38][39] This experiment verified that the pedicle screw internal fixation system has an obvious effect on the lumbar spine and that role in maintaining stability can reduce the probability of spinal instability. In this experiment, both models produced stress concentration at the root of the screw and the connection of the screw rod, which is consistent with the position of internal fixation failure and fracture commonly observed in the clinic.…”

Section: Discussionmentioning

confidence: 56%

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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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Section: Discussionmentioning

confidence: 56%

“…Therefore, this is consistent with broken nails caused by stress fatigue in some patients after long-term activity. [37–39]…”

Section: Discussionmentioning

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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“…Selection of either posterior or lateral fixation as a supplementary procedure in OLIF surgery has long been disputed. Theoretically, many FE and in vitro studies have shown that the traditional gold standard bipedicle fixation and other kinds of posterior fixation systems indeed provide more stability for the lumbar spine after OLIF surgery than lateral fixation systems (30,42,58,59). However, practically, posterior supplementary instrumentation (1) involves additional use of the prone posture, extra incisions, more blood loss and surgery time and (2) is detrimental to the integrity of the posterior column.…”

Section: Discussionmentioning

confidence: 99%

Biomechanical study of two-level oblique lumbar interbody fusion with different types of lateral instrumentation: a finite element analysis

Zhong,

Wang,

Zhou

et al. 2023

Front. Med.

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ObjectiveThe aim of this study was to verify the biomechanical properties of a newly designed angulated lateral plate (mini-LP) suited for two-level oblique lumbar interbody fusion (OLIF). The mini-LP is placed through the lateral ante-psoas surgical corridor, which reduces the operative time and complications associated with prolonged anesthesia and placement in the prone position.MethodsA three-dimensional nonlinear finite element (FE) model of an intact L1–L5 lumbar spine was constructed and validated. The intact model was modified to generate a two-level OLIF surgery model augmented with three types of lateral fixation (stand-alone, SA; lateral rod screw, LRS; miniature lateral plate, mini-LP); the operative segments were L2–L3 and L3–L4. By applying a 500 N follower load and 7.5 Nm directional moment (flexion-extension, lateral bending, and axial rotation), all models were used to simulate human spine movement. Then, we extracted the range of motion (ROM), peak contact force of the bony endplate (PCFBE), peak equivalent stress of the cage (PESC), peak equivalent stress of fixation (PESF), and stress contour plots.ResultsWhen compared with the intact model, the SA model achieved the least reduction in ROM to surgical segments in all motions. The ROM of the mini-LP model was slightly smaller than that of the LRS model. There were no significant differences in surgical segments (L1–L2, L4–L5) between all surgical models and the intact model. The PCFBE and PESC of the LRS and the mini-LP fixation models were lower than those of the SA model. However, the differences in PCFBE or PESC between the LRS- and mini-LP-based models were not significant. The fixation stress of the LRS- and mini-LP-based models was significantly lower than the yield strength under all loading conditions. In addition, the variances in the PESF in the LRS- and mini-LP-based models were not obvious.ConclusionOur biomechanical FE analysis indicated that LRS or mini-LP fixation can both provide adequate biomechanical stability for two-level OLIF through a single incision. The newly designed mini-LP model seemed to be superior in installation convenience, and equally good outcomes were achieved with both LRS and mini-LP for two-level OLIF.

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“…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: Currently Clinicians Mainly Adopt Two Surgicalmentioning

confidence: 99%

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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Evaluation of the Stability of a Novel Lateral Plate Internal Fixation: An In Vitro Biomechanical Study

Cited by 6 publications

References 31 publications

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

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

Biomechanical study of two-level oblique lumbar interbody fusion with different types of lateral instrumentation: a finite element analysis

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

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