Oblique, Unilateral, or Bilateral Rods Configurations for Single-Level Interbody Fusion and Posterior Spinal Fixation: A Finite Element Study

被引:0
作者
Redaelli, Andrea [1 ]
Panico, Matteo [1 ,2 ]
Cecchinato, Riccardo [1 ]
Damilano, Marco [1 ]
Vanni, Daniele [1 ]
Ponzo, Matteo [1 ]
Galbusera, Fabio [3 ]
Langella, Francesco [1 ]
机构
[1] IRCCS Ist Ortoped Galeazzi, Milan, Italy
[2] Politecn Milan, Dept Chem, Mat & Chem Engn Giulio Natta, Milan, Italy
[3] Schulthess Klin, Spine Ctr, Zurich, Switzerland
关键词
Single Rod fixation; Range of motion; von Mises stress; Degenerative disc disease; Anterior spinal approach; IN-VIVO; LUMBAR;
D O I
10.5137/1019-5149.JTN.42502-22.2
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
AIM: To compare three different posterior mono-segmental instrumented models with a Lateral Lumbar Interbody Fusion (LLIF) cage in L4-L5 based on finite element (FE) analysis. MATERIAL and METHODS: Three different configurations of posterior instrumentation were created: 1. Bilateral posterior screws with 2 rods: Bilateral (B); 2. Left posterior rod and left pedicle screws in L4-L5: Unilateral (U); 3. Oblique posterior rod, left pedicle screw in L4, and right pedicle screw in L5: Oblique (O). The models were compared regarding the range of motion (ROM), stresses in the L4 and L5 pedicle screws, and posterior rods.RESULTS: The Oblique and Unilateral models showed a lower decrease in ROM than the Bilateral model (O vs U vs B; 92% vs 95% vs 96%). In the L4 screw, a higher stress level was identified in the O than in the B model. Still, lower if compared to U. In the L5 screw, the highest stress values were observed with the O model in extension and flexion and the U model in lateral bending and axial rotation. The highest stress values for the rods were observed for the O model in extension, flexion, and axial rotation and the U model in lateral bending.CONCLUSION: The FE analysis showed that the three configurations significantly reduced the ROM. The stress analysis identified a substantially higher value for the rod and pedicle screws in oblique or unilateral configuration systems compared to the standard bilateral one. In particular, the oblique configuration has stress properties similar to the unilateral in lateral bending and axial rotation but is significantly higher in flexion-extension.
引用
收藏
页码:584 / 590
页数:7
相关论文
共 24 条
  • [1] HEALTH OUTCOME ASSESSMENT BEFORE AND AFTER ADULT DEFORMITY SURGERY - A PROSPECTIVE-STUDY
    ALBERT, TJ
    PURTILL, J
    MESA, J
    MCINTOSH, T
    BALDERSTON, RA
    [J]. SPINE, 1995, 20 (18) : 2002 - 2004
  • [2] Caprara S, 2021, THESIS, DOI [10.3929/ethz-b-000475269, DOI 10.3929/ETHZ-B-000475269]
  • [3] Pedicle screw insertion with patient-specific 3D-printed guides based on low-dose CT scan is more accurate than free-hand technique in spine deformity patients: a prospective, randomized clinical trial
    Cecchinato, Riccardo
    Berjano, Pedro
    Zerbi, Alberto
    Damilano, Marco
    Redaelli, Andrea
    Lamartina, Claudio
    [J]. EUROPEAN SPINE JOURNAL, 2019, 28 (07) : 1712 - 1723
  • [4] Clinical and radiographic performance of indirect foraminal decompression with anterior retroperitoneal lumbar approach for interbody fusion (ALIF)
    Cofano, Fabio
    Langella, Francesco
    Petrone, Salvatore
    Baroncini, Alice
    Cecchinato, Riccardo
    Redaelli, Andrea
    Garbossa, Diego
    Berjano, Pedro
    [J]. CLINICAL NEUROLOGY AND NEUROSURGERY, 2021, 209
  • [5] Extraction of broken pedicle screws: Technical note
    Duncan, JD
    MacDonald, JD
    [J]. NEUROSURGERY, 1998, 42 (06) : 1399 - 1400
  • [6] Lumbar Transpedicular Implant Failure: A Clinical and Surgical Challenge and Its Radiological Assessment
    Eldin, Mohamed M. Mohi
    Ali, Abdel Mohsen Arafa
    [J]. ASIAN SPINE JOURNAL, 2014, 8 (03) : 281 - 297
  • [7] Early complications of spinal pedicle screw
    Faraj A.A.
    Webb J.K.
    [J]. European Spine Journal, 1997, 6 (5) : 324 - 326
  • [8] Biomechanics of sacropelvic fixation: a comprehensive finite element comparison of three techniques
    Galbusera, Fabio
    Casaroli, Gloria
    Chande, Ruchi
    Lindsey, Derek
    Villa, Tomaso
    Yerby, Scott
    Mesiwala, Ali
    Panico, Matteo
    Gallazzi, Enrico
    Brayda-Bruno, Marco
    [J]. EUROPEAN SPINE JOURNAL, 2020, 29 (02) : 295 - 305
  • [9] Transforaminal lumbar interbody fusion - The effect of various instrumentation techniques on the flexibility of the lumbar spine
    Harris, BM
    Hilibrand, AS
    Savas, PE
    Pellegrino, A
    Vaccaro, AR
    Siegler, S
    Albert, TJ
    [J]. SPINE, 2004, 29 (04) : E65 - E70
  • [10] Prone single-position extreme lateral interbody fusion (Pro-XLIF): preliminary results
    Lamartina, Claudio
    Berjano, Pedro
    [J]. EUROPEAN SPINE JOURNAL, 2020, 29 (SUPPL 1) : 6 - 13