Tang Shujie
Jinan University, Medical School, Department of Traditional Chinese Medicine, Guangzhou, China.
Turk Neurosurg. 2012;22(3):324-8. doi: 10.5137/1019-5149.JTN.5284-11.1.
To determine whether transforaminal lumbar interbody fusion aggravate adjacent segmental degeneration more adversely than anterior lumbar interbody fusion.
A normal finite element model, an anterior lumbar interbody fusion model and a transforaminal lumbar interbody fusion model of L3-5 were developed. 800 N compressive loading plus 10 Nm moments simulating flexion, extension, lateral bending and axial rotation were imposed on L3 superior endplate. The intradiscal pressure, intersegmental rotation and tresca stress in L3-4 were investigated.
Under all loading directions, the values of three parameters in transforaminal lumbar interbody fusion model were the highest and those in normal model were the lowest, and the values in the ALIF model were higher than the normal model while lower than the TLIF model. In the ALIF and normal models, the values of the three parameters on left lateral bending and axial rotation were equal to those on right lateral bending and axial rotation. However, in the TILF model, the values on right lateral bending and axial rotation were larger than those on left lateral bending and axial rotation.
Transforaminal lumbar interbody fusion aggravates adjacent segmental degeneration more adversely than anterior lumbar interbody fusion.
确定经椎间孔腰椎椎间融合术（TLIF）是否比前路腰椎椎间融合术（ALIF）更不利地加重相邻节段退变。
建立L3 - 5节段的正常有限元模型、前路腰椎椎间融合模型和经椎间孔腰椎椎间融合模型。在L3上终板施加800 N压缩载荷加10 Nm模拟前屈、后伸、侧屈和轴向旋转的力矩。研究L3 - 4节段的椎间盘内压力、节段间旋转和最大剪应力。
在所有加载方向下，经椎间孔腰椎椎间融合模型中三个参数的值最高，正常模型中最低，前路腰椎椎间融合模型中的值高于正常模型但低于经椎间孔腰椎椎间融合模型。在前路腰椎椎间融合模型和正常模型中，左侧侧屈和轴向旋转时三个参数的值与右侧侧屈和轴向旋转时相等。然而，在经椎间孔腰椎椎间融合模型中，右侧侧屈和轴向旋转时的值大于左侧侧屈和轴向旋转时的值。
经椎间孔腰椎椎间融合术比前路腰椎椎间融合术更不利地加重相邻节段退变。
