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Biomechanical investigation of the hybrid lumbar fixation technique with traditional and cortical bone trajectories in transforaminal lumbar interbody fusion: finite element analysis
OBJECTIVE: To compare the biomechanical performance of the hybrid lumbar fixation technique with the traditional and cortical bone trajectory techniques using the finite element method. METHODS: Four adult wet lumbar spine specimens were provided by the Department of Anatomy and Research of Xinjiang...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2023
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10388474/ https://www.ncbi.nlm.nih.gov/pubmed/37525283 http://dx.doi.org/10.1186/s13018-023-04027-6 |
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author | Huang, Ying Maimaiti, Abulikemu Tian, Yiming Li, Zhengrong Kahaer, Alafate Rexiti, Paerhati |
author_facet | Huang, Ying Maimaiti, Abulikemu Tian, Yiming Li, Zhengrong Kahaer, Alafate Rexiti, Paerhati |
author_sort | Huang, Ying |
collection | PubMed |
description | OBJECTIVE: To compare the biomechanical performance of the hybrid lumbar fixation technique with the traditional and cortical bone trajectory techniques using the finite element method. METHODS: Four adult wet lumbar spine specimens were provided by the Department of Anatomy and Research of Xinjiang Medical University, and four L1–S1 lumbar spine with transforaminal lumbar interbody fusion (TLIF) models at L4–L5 segment and four different fixation techniques were established: bilateral traditional trajectory screw fixation (TT–TT), bilateral cortical bone trajectory screw fixation (CBT–CBT), hybrid CBT–TT (CBT screws at L4 and TT screws at L5) and TT–CBT (TT screws at L4 and CBT screws at L5). The range of motion (ROM) of the L4–L5 segment, von Mises stress of cage, internal fixation, and rod were compared in flexion, extension, left and right bending, and left and right rotation. RESULTS: Compared with the TT–TT group, the TT–CBT group exhibited lower ROM of L4–L5 segment, especially in left-sided bending; the CBT–TT group had the lowest ROM of L4–L5 segment in flexion and extension among the four fixation methods. Compared with the CBT–CBT group, the peak cage stress in the TT–CBT group was reduced by 9.9%, 18.1%, 21.5%, 23.3%, and 26.1% in flexion, left bending, right bending, left rotation, and right rotation conditions, respectively, but not statistically significant (P > 0.05). The peak stress of the internal fixation system in the TT–CBT group was significantly lower than the other three fixation methods in all five conditions except for extension, with a statistically significant difference between the CBT–TT and TT–CBT groups in the left rotation condition (P = 0.017). In addition, compared with the CBT–CBT group, the peak stress of the rod in the CBT–TT group decreased by 34.8%, 32.1%, 28.2%, 29.3%, and 43.0% under the six working conditions of flexion, extension, left bending, left rotation, and right rotation, respectively, but not statistically significant (P > 0.05). CONCLUSIONS: Compared with the TT–TT and CBT–CBT fixation methods in TLIF, the hybrid lumbar fixation CBT–TT and TT–CBT techniques increase the biomechanical stability of the internal fixation structure of the lumbar fusion segment to a certain extent and provide a corresponding theoretical basis for further development in the clinic. |
format | Online Article Text |
id | pubmed-10388474 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-103884742023-08-01 Biomechanical investigation of the hybrid lumbar fixation technique with traditional and cortical bone trajectories in transforaminal lumbar interbody fusion: finite element analysis Huang, Ying Maimaiti, Abulikemu Tian, Yiming Li, Zhengrong Kahaer, Alafate Rexiti, Paerhati J Orthop Surg Res Research Article OBJECTIVE: To compare the biomechanical performance of the hybrid lumbar fixation technique with the traditional and cortical bone trajectory techniques using the finite element method. METHODS: Four adult wet lumbar spine specimens were provided by the Department of Anatomy and Research of Xinjiang Medical University, and four L1–S1 lumbar spine with transforaminal lumbar interbody fusion (TLIF) models at L4–L5 segment and four different fixation techniques were established: bilateral traditional trajectory screw fixation (TT–TT), bilateral cortical bone trajectory screw fixation (CBT–CBT), hybrid CBT–TT (CBT screws at L4 and TT screws at L5) and TT–CBT (TT screws at L4 and CBT screws at L5). The range of motion (ROM) of the L4–L5 segment, von Mises stress of cage, internal fixation, and rod were compared in flexion, extension, left and right bending, and left and right rotation. RESULTS: Compared with the TT–TT group, the TT–CBT group exhibited lower ROM of L4–L5 segment, especially in left-sided bending; the CBT–TT group had the lowest ROM of L4–L5 segment in flexion and extension among the four fixation methods. Compared with the CBT–CBT group, the peak cage stress in the TT–CBT group was reduced by 9.9%, 18.1%, 21.5%, 23.3%, and 26.1% in flexion, left bending, right bending, left rotation, and right rotation conditions, respectively, but not statistically significant (P > 0.05). The peak stress of the internal fixation system in the TT–CBT group was significantly lower than the other three fixation methods in all five conditions except for extension, with a statistically significant difference between the CBT–TT and TT–CBT groups in the left rotation condition (P = 0.017). In addition, compared with the CBT–CBT group, the peak stress of the rod in the CBT–TT group decreased by 34.8%, 32.1%, 28.2%, 29.3%, and 43.0% under the six working conditions of flexion, extension, left bending, left rotation, and right rotation, respectively, but not statistically significant (P > 0.05). CONCLUSIONS: Compared with the TT–TT and CBT–CBT fixation methods in TLIF, the hybrid lumbar fixation CBT–TT and TT–CBT techniques increase the biomechanical stability of the internal fixation structure of the lumbar fusion segment to a certain extent and provide a corresponding theoretical basis for further development in the clinic. BioMed Central 2023-07-31 /pmc/articles/PMC10388474/ /pubmed/37525283 http://dx.doi.org/10.1186/s13018-023-04027-6 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This 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 Article Huang, Ying Maimaiti, Abulikemu Tian, Yiming Li, Zhengrong Kahaer, Alafate Rexiti, Paerhati Biomechanical investigation of the hybrid lumbar fixation technique with traditional and cortical bone trajectories in transforaminal lumbar interbody fusion: finite element analysis |
title | Biomechanical investigation of the hybrid lumbar fixation technique with traditional and cortical bone trajectories in transforaminal lumbar interbody fusion: finite element analysis |
title_full | Biomechanical investigation of the hybrid lumbar fixation technique with traditional and cortical bone trajectories in transforaminal lumbar interbody fusion: finite element analysis |
title_fullStr | Biomechanical investigation of the hybrid lumbar fixation technique with traditional and cortical bone trajectories in transforaminal lumbar interbody fusion: finite element analysis |
title_full_unstemmed | Biomechanical investigation of the hybrid lumbar fixation technique with traditional and cortical bone trajectories in transforaminal lumbar interbody fusion: finite element analysis |
title_short | Biomechanical investigation of the hybrid lumbar fixation technique with traditional and cortical bone trajectories in transforaminal lumbar interbody fusion: finite element analysis |
title_sort | biomechanical investigation of the hybrid lumbar fixation technique with traditional and cortical bone trajectories in transforaminal lumbar interbody fusion: finite element analysis |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10388474/ https://www.ncbi.nlm.nih.gov/pubmed/37525283 http://dx.doi.org/10.1186/s13018-023-04027-6 |
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