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Biomechanical evaluation of four different posterior instrumentation techniques for single-level transforaminal lumbar interbody fusion: a finite element analysis.

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机构: [1]The First Institute of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong,China [2]Spine Surgery Department, The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou, Guangdong, China
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关键词: Cortical bone trajectory unilateral translaminar facet screw transforaminal lumbar interbody fusion finite element analysis biomechanical stability

摘要:
This study aims to investigate the fixation strength of unilateral cortical bone trajectory screw fixation (UCBT) and UCBT with contralateral translaminar facet screw fixation (UCBT-TFS) by repeating the verification of three finite element models. Three healthy female models of the lumbosacral spine were constructed. For each of them, four transforaminal lumbar interbody fusion (TLIF) models with the following instruments were created: bilateral traditional trajectory pedicle screw fixation (TT), bilateral cortical bone trajectory screw fixation (CBT), UCBT, and UCBT-TFS. A 150-N compressive load with 10 N/m moments was applied to simulate flexion, extension, lateral bending, and axial rotation. The range of motion (ROM), the stress of the cages, and the stress of the posterior fixations were compared. TT and UCBT-TFS had a similar low ROM compared to the intact models, and CBT showed a higher ROM in lateral bending. UCBT resulted in the highest ROM under all loading conditions, especially in lateral bending (116% and 170% greater than TT in left bending and right bending). UCBT induced a significant increase in the peak stress of cages and instruments, followed by CBT and UCBT-TFS, and the lowest mean values were observed for TT. Among the four different fixation techniques, TT offered the highest fixation strength and lowest implant stress, followed by UCBT-TFS and CBT, while UCBT was the least stable and resulted in increased stress of the screws and cages. UCBT-TFS improved biomechanical stability and appeared to be a less invasive alternative in well-selected patients with single-level TLIF. AJTR Copyright © 2020.

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出版当年[2019]版:
大类 | 3 区 医学
小类 | 3 区 医学:研究与实验 4 区 肿瘤学
最新[2025]版:
大类 | 4 区 医学
小类 | 4 区 医学:研究与实验 4 区 肿瘤学
第一作者:
第一作者机构: [1]The First Institute of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong,China [2]Spine Surgery Department, The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou, Guangdong, China
通讯作者:
通讯机构: [2]Spine Surgery Department, The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou, Guangdong, China [*1]Spine Surgery Department, The First Affiliated Hos-pital of Guangzhou University of Chinese Medicine, 12 Airport Road, Baiyun District, Guangzhou 51-0405, Guangdong, China.
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