Hao Jiayu, Tang XianSheng, Jiang Nizhou, Wang Hong, Jiang Jian
Department of Spine Surgery, Dalian Municipal Central Hospital, Dalian University of Technology, Dalian, China.
Department of Engineering Mechanics, Dalian University of Technology, Dalian, China.
Front Bioeng Biotechnol. 2023 Sep 25;11:1260693. doi: 10.3389/fbioe.2023.1260693. eCollection 2023.
Using finite element analysis to identify the optimal internal fixation method for oblique lateral lumbar interbody fusion (OLIF), providing guidance for clinical practice. A finite element model of the L4 - L5 segment was created. Five types of internal fixations were simulated in the generated L4-L5 finite element (FE) model. Then, six loading scenarios, i.e., flexion, extension, left-leaning, right-leaning, rotate left, and rotate right, were simulated in the FE models with different types of fixations. The biomechanical stability of the spinal segment after different fixations was investigated. Regarding the range of motion (ROM) of the fused segment, OLIF + Bilateral Pedicle Screws (BPS) has a maximum ROM of 1.82° during backward bending and the smallest ROM in all directions of motion compared with other models. In terms of the von Mises stress distribution on the cage, the average stress on every motion direction of OLIF + BPS is about 17.08MPa, and of OLIF + Unilateral Vertebral Screw - Pedicle Screw (UVS-PS) is about 19.29 MPa. As for the von Mises stress distribution on the internal fixation, OLIF + BPS has the maximum internal fixator stress in left rotation (31.85 MPa) and OLIF + Unilateral Pedicle Screw (UPS) has the maximum internal fixator stress in posterior extension (76.59 MPa). The data of these two models were smaller than those of other models. OLIF + BPS provides the greatest biomechanical stability, OLIF + UPS has adequate biomechanical stability, OLIF + UVS-PS is inferior to OLIF + UPS synthetically, and OLIF + Double row vertical screw (DRVS) and Individual OLIF (IO) do not present significant obvious advantages.
采用有限元分析确定斜外侧腰椎椎间融合术（OLIF）的最佳内固定方法，为临床实践提供指导。建立了L4-L5节段的有限元模型。在生成的L4-L5有限元（FE）模型中模拟了五种类型的内固定。然后，在具有不同类型固定的有限元模型中模拟了六种加载情况，即前屈、后伸、左侧倾、右侧倾、左旋和右旋。研究了不同固定后脊柱节段的生物力学稳定性。关于融合节段的活动范围（ROM），与其他模型相比，OLIF+双侧椎弓根螺钉（BPS）在后伸时的最大活动范围为1.82°，在所有运动方向上的活动范围最小。就椎间融合器上的von Mises应力分布而言，OLIF+BPS在每个运动方向上的平均应力约为17.08MPa，OLIF+单侧椎体螺钉-椎弓根螺钉（UVS-PS）约为19.29MPa。至于内固定上的von Mises应力分布，OLIF+BPS在左旋时的内固定器应力最大（31.85MPa），OLIF+单侧椎弓根螺钉（UPS）在后伸时的内固定器应力最大（76.59MPa）。这两个模型的数据均小于其他模型。OLIF+BPS提供了最大的生物力学稳定性，OLIF+UPS具有足够的生物力学稳定性，OLIF+UVS-PS综合性能不如OLIF+UPS，OLIF+双排垂直螺钉（DRVS）和单纯OLIF（IO）没有明显优势。
