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Elucidation of the Mechanism of Occasional Anterior Longitudinal Ligament Rupture with Posterior Correction Procedure for Adult Spinal Deformity Using LLIF–Finite Element Analysis of the Impact of the Lordotic Angle of Intervertebral LLIF Cage

Background and Objectives: There are several advantages of using lateral lumbar interbody fusion (LLIF) for correction surgeries for adult spinal deformity (ASD); however, we currently have unresolved new issues, including occasional anterior longitudinal ligament (ALL) rupture during the posterior...

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Autores principales: Takeda, Hiroki, Abe, Yuichiro, Imai, Takaya, Rashid, Mohd Zaim Mohd, Ikeda, Daiki, Kawabata, Soya, Nagai, Sota, Hachiya, Kurenai, Fujita, Nobuyuki, Kaneko, Shinjiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10532993/
https://www.ncbi.nlm.nih.gov/pubmed/37763688
http://dx.doi.org/10.3390/medicina59091569
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author Takeda, Hiroki
Abe, Yuichiro
Imai, Takaya
Rashid, Mohd Zaim Mohd
Ikeda, Daiki
Kawabata, Soya
Nagai, Sota
Hachiya, Kurenai
Fujita, Nobuyuki
Kaneko, Shinjiro
author_facet Takeda, Hiroki
Abe, Yuichiro
Imai, Takaya
Rashid, Mohd Zaim Mohd
Ikeda, Daiki
Kawabata, Soya
Nagai, Sota
Hachiya, Kurenai
Fujita, Nobuyuki
Kaneko, Shinjiro
author_sort Takeda, Hiroki
collection PubMed
description Background and Objectives: There are several advantages of using lateral lumbar interbody fusion (LLIF) for correction surgeries for adult spinal deformity (ASD); however, we currently have unresolved new issues, including occasional anterior longitudinal ligament (ALL) rupture during the posterior correction procedure. When LLIF was initially introduced, only less lordotic cages were available and ALL rupture was more frequently experienced compared with later periods when more lordotic cages were available. We performed finite element analysis (FEA) regarding the mechanism of ALL rupture during a posterior correction procedure. Methods: A spring (which mimics ALL) was introduced at the location of ALL in the FEA and an LLIF cage with two different lordotic angles, 6 and 12 degrees (6DC/12DC), was employed. To assess the extent of burden on the ALL, the extension length of the spring during the correction procedure was measured and the location of the rotation center was examined. Results: We observed a significantly higher degree of length extension of the spring during the correction procedure in the FEA model with 6DC compared with that of 12DC. We also observed that the location of the rotation center was shifted posteriorly in the FEA model with 6DC compared with that of 12DC. Conclusions: It is considered that the posterior and rostral edge of the less lordotic angle cage became a hinge, and the longer lever arm increased the burden on ALL as the principle of leverage. It is important to use an LLIF cage with a sufficient lordotic angle, that is compatible with the degree of posterior osteotomy in ASD correction.
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spelling pubmed-105329932023-09-28 Elucidation of the Mechanism of Occasional Anterior Longitudinal Ligament Rupture with Posterior Correction Procedure for Adult Spinal Deformity Using LLIF–Finite Element Analysis of the Impact of the Lordotic Angle of Intervertebral LLIF Cage Takeda, Hiroki Abe, Yuichiro Imai, Takaya Rashid, Mohd Zaim Mohd Ikeda, Daiki Kawabata, Soya Nagai, Sota Hachiya, Kurenai Fujita, Nobuyuki Kaneko, Shinjiro Medicina (Kaunas) Article Background and Objectives: There are several advantages of using lateral lumbar interbody fusion (LLIF) for correction surgeries for adult spinal deformity (ASD); however, we currently have unresolved new issues, including occasional anterior longitudinal ligament (ALL) rupture during the posterior correction procedure. When LLIF was initially introduced, only less lordotic cages were available and ALL rupture was more frequently experienced compared with later periods when more lordotic cages were available. We performed finite element analysis (FEA) regarding the mechanism of ALL rupture during a posterior correction procedure. Methods: A spring (which mimics ALL) was introduced at the location of ALL in the FEA and an LLIF cage with two different lordotic angles, 6 and 12 degrees (6DC/12DC), was employed. To assess the extent of burden on the ALL, the extension length of the spring during the correction procedure was measured and the location of the rotation center was examined. Results: We observed a significantly higher degree of length extension of the spring during the correction procedure in the FEA model with 6DC compared with that of 12DC. We also observed that the location of the rotation center was shifted posteriorly in the FEA model with 6DC compared with that of 12DC. Conclusions: It is considered that the posterior and rostral edge of the less lordotic angle cage became a hinge, and the longer lever arm increased the burden on ALL as the principle of leverage. It is important to use an LLIF cage with a sufficient lordotic angle, that is compatible with the degree of posterior osteotomy in ASD correction. MDPI 2023-08-29 /pmc/articles/PMC10532993/ /pubmed/37763688 http://dx.doi.org/10.3390/medicina59091569 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Takeda, Hiroki
Abe, Yuichiro
Imai, Takaya
Rashid, Mohd Zaim Mohd
Ikeda, Daiki
Kawabata, Soya
Nagai, Sota
Hachiya, Kurenai
Fujita, Nobuyuki
Kaneko, Shinjiro
Elucidation of the Mechanism of Occasional Anterior Longitudinal Ligament Rupture with Posterior Correction Procedure for Adult Spinal Deformity Using LLIF–Finite Element Analysis of the Impact of the Lordotic Angle of Intervertebral LLIF Cage
title Elucidation of the Mechanism of Occasional Anterior Longitudinal Ligament Rupture with Posterior Correction Procedure for Adult Spinal Deformity Using LLIF–Finite Element Analysis of the Impact of the Lordotic Angle of Intervertebral LLIF Cage
title_full Elucidation of the Mechanism of Occasional Anterior Longitudinal Ligament Rupture with Posterior Correction Procedure for Adult Spinal Deformity Using LLIF–Finite Element Analysis of the Impact of the Lordotic Angle of Intervertebral LLIF Cage
title_fullStr Elucidation of the Mechanism of Occasional Anterior Longitudinal Ligament Rupture with Posterior Correction Procedure for Adult Spinal Deformity Using LLIF–Finite Element Analysis of the Impact of the Lordotic Angle of Intervertebral LLIF Cage
title_full_unstemmed Elucidation of the Mechanism of Occasional Anterior Longitudinal Ligament Rupture with Posterior Correction Procedure for Adult Spinal Deformity Using LLIF–Finite Element Analysis of the Impact of the Lordotic Angle of Intervertebral LLIF Cage
title_short Elucidation of the Mechanism of Occasional Anterior Longitudinal Ligament Rupture with Posterior Correction Procedure for Adult Spinal Deformity Using LLIF–Finite Element Analysis of the Impact of the Lordotic Angle of Intervertebral LLIF Cage
title_sort elucidation of the mechanism of occasional anterior longitudinal ligament rupture with posterior correction procedure for adult spinal deformity using llif–finite element analysis of the impact of the lordotic angle of intervertebral llif cage
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10532993/
https://www.ncbi.nlm.nih.gov/pubmed/37763688
http://dx.doi.org/10.3390/medicina59091569
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