Biomechanical changes of oblique lumbar interbody fusion with different fixation techniques in degenerative spondylolisthesis lumbar spine: a finite element analysis

BMC Musculoskeletal Disorders, 2024 · DOI: https://doi.org/10.1186/s12891-024-07796-1 · Published: August 19, 2024

Simple Explanation

This study uses computer models to compare how different surgical techniques affect the stability of the spine when treating a condition called degenerative lumbar spondylolisthesis (DLS). DLS is a common spinal problem that causes lower back pain and leg issues. The researchers compared six different ways of fixing the spine after a specific type of surgery called Oblique Lumbar Interbody Fusion (OLIF). They looked at how much each technique limited movement and how much stress it put on the spine. The study found that a technique called Bilateral Cortical Bone Trajectory (BCBT) provided the best stability with the least amount of stress. The Stand-Alone (S-A) OLIF method showed the least stability and the most stress.

Study Duration

Not specified

Participants

Data for a 62 years old female patient (L4 degenerative lumbar spondylolisthesis)

Evidence Level

Not specified

Key Findings

1
The S-A model had the highest average ROM of six motion modes, followed by LSR, UPS, UCBT, BPS and BCBT.
2
The BCBT model had a relatively lower cage stress than the others.
3
The maximum peak von Mises stress of the fixation constructs was found in the LSR model.

Research Summary

The study aimed to assess biomechanical changes resulting from OLIF combined with six different internal fixation methods for degenerative spondylolisthesis in the lumbar spine using finite element analysis. BCBT exhibited superior biomechanical stability and minimal stress on the cage-endplate interface compared to BPS, UCBT, UPS, and LSR. S-A OLIF demonstrated the least stability and resulted in increased stress on both the cage and endplates.

Practical Implications

Surgical Planning

BCBT fixation technique may be considered as a less invasive alternative to BPS for patients with degenerative lumbar spondylolisthesis.

Risk Assessment

S-A OLIF should be carefully evaluated due to its potential for increased stress and instability.

Patient Selection

LSR may be suitable for carefully selected patients with good bone quality and normal body mass index.

Study Limitations

1
The simulated material properties are oversimplified and idealized.
2
The study did not observe the biomechanical properties of adjacent segments after OLIF.
3
This finite element analysis was conducted on patients with normal bone density and therefore cannot fully reflect the biomechanical changes occurring at the fixed segment under conditions of osteopenia.

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