Department of Orthopaedics, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou City of Henan, Zhengzhou, China.
Department of Orthopaedics, General Hospital of Ningxia Medical University, Yinchuan City of Ningxia, China.
Sci Rep. 2024 Nov 27;14(1):29432. doi: 10.1038/s41598-024-80631-8.
Oblique lateral interbody fusion (OLIF) is a minimally invasive surgery for the treatment of lumbar degenerative diseases (LDD). Under normal bone mass(NB), supplemental with lateral plate (LP) fixation has been proven to provide stability and reduce complications. However, it is unclear whether OLIF combined with LP fixation can achieve satisfactory fixation effects in cases of osteoporosis(OP) or osteopenia (OS)? In this study, Eighteen L3-5 spinal specimens from 3 to 6 months old fresh calves were equally divided into 3 groups: group A (NB), group B (OS) and group C (OP). A load control scheme was adopted and evaluated using multidirectional nondestructive moments (± 7.5 N·m). An electronic universal tester and a tensile/torsion tester were simulated to generate 6 degrees of freedom of motion, and a VIC-3D three-dimensional optical full-field strain measurement system dynamically tracked the surgical segmental displacement. Each spine was evaluated under the following conditions at the L4-5 level: intact (INT); OLIF stand-alone (SA); cage supplemented with LP, cage supplemented with unilateral pedicle screws (UPS), and cage supplemented with bilateral pedicle screws (BPS). The current data show that With NB and OS models, LP fixation significantly reduced ROM in the LB and AR directions, with slightly less stability than BPS fixation and comparable to UPS. In the case of OP, LP fixation may increase the risk of internal fixation failure, and it is more preferable to choose BPS fixation with stronger stability.
斜外侧腰椎间融合术（OLIF）是一种治疗腰椎退行性疾病（LDD）的微创手术。在正常骨量（NB）下，附加侧板（LP）固定已被证明可以提供稳定性并减少并发症。然而，OLIF 联合 LP 固定在骨质疏松症（OP）或骨量减少（OS）的情况下是否能达到满意的固定效果尚不清楚？在这项研究中，将 3 至 6 个月大的新鲜小牛的 18 个 L3-5 脊柱标本等分为 3 组：A 组（NB）、B 组（OS）和 C 组（OP）。采用负载控制方案，并使用多向无损力矩（±7.5 N·m）进行评估。采用电子万能试验机和拉伸/扭转试验机模拟产生 6 自由度运动，并采用 VIC-3D 三维光学全场应变测量系统动态跟踪手术节段位移。在 L4-5 水平下，对每个脊柱进行以下条件的评估：完整（INT）；OLIF 独立（SA）；笼补 LP、笼补单侧椎弓根螺钉（UPS）、笼补双侧椎弓根螺钉（BPS）。目前的数据显示，在 NB 和 OS 模型中，LP 固定显著降低了 LB 和 AR 方向的 ROM，稳定性略低于 BPS 固定，与 UPS 相当。在 OP 的情况下，LP 固定可能会增加内固定失败的风险，选择稳定性更强的 BPS 固定更为可取。
