Cargando…

Biomechanical evaluation of the hybrid pedicle screw—cortical bone trajectory technique in transforaminal lumbar interbody fusion to adjacent segment degeneration—finite element analysis

BACKGROUND: Transforaminal lumbar interbody fusion is an effective surgical treatment of intervertebral disk herniation. However, its clinical efficacy for adjacent segment disk degeneration (ASDD) after hybrid bilateral pedicle screw - bilateral cortical screw (pedicle screw at L4 and cortical bone...

Descripción completa

Detalles Bibliográficos
Autores principales: Zhang, Rui, Kahaer, Alafate, Niu, Hanqian, Wang, Jingwen, Jumahan, Ayididaer, Qiu, Yanning, Rexiti, Paerhati, Guo, Hailong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10204234/
https://www.ncbi.nlm.nih.gov/pubmed/37221546
http://dx.doi.org/10.1186/s12891-023-06411-z
_version_ 1785045791443779584
author Zhang, Rui
Kahaer, Alafate
Niu, Hanqian
Wang, Jingwen
Jumahan, Ayididaer
Qiu, Yanning
Rexiti, Paerhati
Guo, Hailong
author_facet Zhang, Rui
Kahaer, Alafate
Niu, Hanqian
Wang, Jingwen
Jumahan, Ayididaer
Qiu, Yanning
Rexiti, Paerhati
Guo, Hailong
author_sort Zhang, Rui
collection PubMed
description BACKGROUND: Transforaminal lumbar interbody fusion is an effective surgical treatment of intervertebral disk herniation. However, its clinical efficacy for adjacent segment disk degeneration (ASDD) after hybrid bilateral pedicle screw - bilateral cortical screw (pedicle screw at L4 and cortical bone trajectory screw at L5) and hybrid bilateral cortical screw - bilateral pedicle screw (bilateral cortical screw at L4 and bilateral pedicle screw at L5) remains undiscovered. Therefore, the aim of this study is to evaluate the effect of the hybrid bilateral pedicle screw - bilateral cortical screw and hybrid bilateral cortical screw - bilateral pedicle screw on the adjacent segment via a 3-dimensional (3D) finite element (FE) analysis. METHODS: Four human cadaveric lumbar spine specimens were provided by the anatomy teaching and research department of Xinjiang Medical University. Four finite element models of L1-S1 lumbar spine segment were generated. For each of these, four lumbar transforaminal lumbar interbody fusion models at L4-L5 segment with the following instruments were created: hybrid bilateral pedicle screw - bilateral cortical screw, bilateral cortical screw - bilateral cortical screw (bilateral cortical screw at both L4 and L5 segments), bilateral pedicle screw - bilateral pedicle screw (bilateral pedicle screw at both L4 and L5 segments), and hybrid bilateral cortical screw - bilateral pedicle screw. A 400-N compressive load with 7.5 Nm moments was applied for the simulation of flexion, extension, lateral bending, and rotation. The range of motion of L3-L4 and L5-S1 segments and von Mises stress of the intervertebral disc at the adjacent segment were compared. RESULTS: Hybrid bilateral pedicle screw - bilateral cortical screw has the lowest range of motion at L3-L4 segment in flexion, extension, and lateral bending, and the highest disc stress in all motions, while the range of motion at L5-S1 segment and disc stress was lower than bilateral pedicle screw - bilateral pedicle screw in flexion, extension, and lateral bending, and higher than bilateral cortical screw - bilateral cortical screw in all motions. The range of motion of hybrid bilateral cortical screw - bilateral pedicle screw at L3-L4 segment was lower than bilateral pedicle screw - bilateral pedicle screw and higher than bilateral cortical screw - bilateral cortical screw in flexion, extension, and lateral bending, and the range of motion at L5-S1 segment was higher than bilateral pedicle screw - bilateral pedicle screw in flexion, lateral bending, and axial rotation. The disc stress at L3-L4 segment was lowest and more dispersed in all motions, and the disc stress at L5-S1 segment was higher than bilateral pedicle screw - bilateral pedicle screw in lateral bending and axial rotation, but more dispersed. CONCLUSION: Hybrid bilateral cortical screw - bilateral pedicle screw decreases the impact on adjacent segments after spinal fusion, reduces the iatrogenic injury to the paravertebral tissues, and provides throughout decompression of the lateral recess.
format Online
Article
Text
id pubmed-10204234
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-102042342023-05-24 Biomechanical evaluation of the hybrid pedicle screw—cortical bone trajectory technique in transforaminal lumbar interbody fusion to adjacent segment degeneration—finite element analysis Zhang, Rui Kahaer, Alafate Niu, Hanqian Wang, Jingwen Jumahan, Ayididaer Qiu, Yanning Rexiti, Paerhati Guo, Hailong BMC Musculoskelet Disord Research BACKGROUND: Transforaminal lumbar interbody fusion is an effective surgical treatment of intervertebral disk herniation. However, its clinical efficacy for adjacent segment disk degeneration (ASDD) after hybrid bilateral pedicle screw - bilateral cortical screw (pedicle screw at L4 and cortical bone trajectory screw at L5) and hybrid bilateral cortical screw - bilateral pedicle screw (bilateral cortical screw at L4 and bilateral pedicle screw at L5) remains undiscovered. Therefore, the aim of this study is to evaluate the effect of the hybrid bilateral pedicle screw - bilateral cortical screw and hybrid bilateral cortical screw - bilateral pedicle screw on the adjacent segment via a 3-dimensional (3D) finite element (FE) analysis. METHODS: Four human cadaveric lumbar spine specimens were provided by the anatomy teaching and research department of Xinjiang Medical University. Four finite element models of L1-S1 lumbar spine segment were generated. For each of these, four lumbar transforaminal lumbar interbody fusion models at L4-L5 segment with the following instruments were created: hybrid bilateral pedicle screw - bilateral cortical screw, bilateral cortical screw - bilateral cortical screw (bilateral cortical screw at both L4 and L5 segments), bilateral pedicle screw - bilateral pedicle screw (bilateral pedicle screw at both L4 and L5 segments), and hybrid bilateral cortical screw - bilateral pedicle screw. A 400-N compressive load with 7.5 Nm moments was applied for the simulation of flexion, extension, lateral bending, and rotation. The range of motion of L3-L4 and L5-S1 segments and von Mises stress of the intervertebral disc at the adjacent segment were compared. RESULTS: Hybrid bilateral pedicle screw - bilateral cortical screw has the lowest range of motion at L3-L4 segment in flexion, extension, and lateral bending, and the highest disc stress in all motions, while the range of motion at L5-S1 segment and disc stress was lower than bilateral pedicle screw - bilateral pedicle screw in flexion, extension, and lateral bending, and higher than bilateral cortical screw - bilateral cortical screw in all motions. The range of motion of hybrid bilateral cortical screw - bilateral pedicle screw at L3-L4 segment was lower than bilateral pedicle screw - bilateral pedicle screw and higher than bilateral cortical screw - bilateral cortical screw in flexion, extension, and lateral bending, and the range of motion at L5-S1 segment was higher than bilateral pedicle screw - bilateral pedicle screw in flexion, lateral bending, and axial rotation. The disc stress at L3-L4 segment was lowest and more dispersed in all motions, and the disc stress at L5-S1 segment was higher than bilateral pedicle screw - bilateral pedicle screw in lateral bending and axial rotation, but more dispersed. CONCLUSION: Hybrid bilateral cortical screw - bilateral pedicle screw decreases the impact on adjacent segments after spinal fusion, reduces the iatrogenic injury to the paravertebral tissues, and provides throughout decompression of the lateral recess. BioMed Central 2023-05-23 /pmc/articles/PMC10204234/ /pubmed/37221546 http://dx.doi.org/10.1186/s12891-023-06411-z Text en © The Author(s) 2023, corrected publication 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Zhang, Rui
Kahaer, Alafate
Niu, Hanqian
Wang, Jingwen
Jumahan, Ayididaer
Qiu, Yanning
Rexiti, Paerhati
Guo, Hailong
Biomechanical evaluation of the hybrid pedicle screw—cortical bone trajectory technique in transforaminal lumbar interbody fusion to adjacent segment degeneration—finite element analysis
title Biomechanical evaluation of the hybrid pedicle screw—cortical bone trajectory technique in transforaminal lumbar interbody fusion to adjacent segment degeneration—finite element analysis
title_full Biomechanical evaluation of the hybrid pedicle screw—cortical bone trajectory technique in transforaminal lumbar interbody fusion to adjacent segment degeneration—finite element analysis
title_fullStr Biomechanical evaluation of the hybrid pedicle screw—cortical bone trajectory technique in transforaminal lumbar interbody fusion to adjacent segment degeneration—finite element analysis
title_full_unstemmed Biomechanical evaluation of the hybrid pedicle screw—cortical bone trajectory technique in transforaminal lumbar interbody fusion to adjacent segment degeneration—finite element analysis
title_short Biomechanical evaluation of the hybrid pedicle screw—cortical bone trajectory technique in transforaminal lumbar interbody fusion to adjacent segment degeneration—finite element analysis
title_sort biomechanical evaluation of the hybrid pedicle screw—cortical bone trajectory technique in transforaminal lumbar interbody fusion to adjacent segment degeneration—finite element analysis
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10204234/
https://www.ncbi.nlm.nih.gov/pubmed/37221546
http://dx.doi.org/10.1186/s12891-023-06411-z
work_keys_str_mv AT zhangrui biomechanicalevaluationofthehybridpediclescrewcorticalbonetrajectorytechniqueintransforaminallumbarinterbodyfusiontoadjacentsegmentdegenerationfiniteelementanalysis
AT kahaeralafate biomechanicalevaluationofthehybridpediclescrewcorticalbonetrajectorytechniqueintransforaminallumbarinterbodyfusiontoadjacentsegmentdegenerationfiniteelementanalysis
AT niuhanqian biomechanicalevaluationofthehybridpediclescrewcorticalbonetrajectorytechniqueintransforaminallumbarinterbodyfusiontoadjacentsegmentdegenerationfiniteelementanalysis
AT wangjingwen biomechanicalevaluationofthehybridpediclescrewcorticalbonetrajectorytechniqueintransforaminallumbarinterbodyfusiontoadjacentsegmentdegenerationfiniteelementanalysis
AT jumahanayididaer biomechanicalevaluationofthehybridpediclescrewcorticalbonetrajectorytechniqueintransforaminallumbarinterbodyfusiontoadjacentsegmentdegenerationfiniteelementanalysis
AT qiuyanning biomechanicalevaluationofthehybridpediclescrewcorticalbonetrajectorytechniqueintransforaminallumbarinterbodyfusiontoadjacentsegmentdegenerationfiniteelementanalysis
AT rexitipaerhati biomechanicalevaluationofthehybridpediclescrewcorticalbonetrajectorytechniqueintransforaminallumbarinterbodyfusiontoadjacentsegmentdegenerationfiniteelementanalysis
AT guohailong biomechanicalevaluationofthehybridpediclescrewcorticalbonetrajectorytechniqueintransforaminallumbarinterbodyfusiontoadjacentsegmentdegenerationfiniteelementanalysis