The effect of polymethylmethacrylate augmentation on the primary stability of stand-alone implant construct versus posterior stabilization in oblique lumbar interbody fusion with osteoporotic bone quality– a finite element study

医学 斜格 植入 口腔正畸科 融合 外科 牙科 语言学 哲学
作者
Ferenc Bereczki,Máté Turbucz,Ágoston Jakab Pokorni,Benjámin Hajnal,Marton Rónai,István Klemencsics,Áron Lazáry,Péter Endre Éltes
出处
期刊:The Spine Journal [Elsevier]
标识
DOI:10.1016/j.spinee.2024.01.021
摘要

Background ContextOblique lumbar interbody fusion (OLIF) can provide an ideal minimally invasive solution for achieving spinal fusion in an older, more frail population where decreased bone quality can be a limiting factor. Stabilization can be achieved with bilateral pedicle screws (BPS), which require additional incisions and longer operative time. Alternatively, a novel self-anchoring stand-alone lateral plate system (SSA) can be used, where no additional incisions are required. Based on the relevant literature, BPS constructs provide greater primary biomechanical stability compared to lateral plate constructs, including SSA. This difference is further increased by osteoporosis. Screw augmentation in spinal fusion surgeries is commonly used; however, in the case of OLIF, it is a fairly new concept, lacking a consensus-based guideline.PurposeThis comparative study aimed to investigate the effect of PMMA screw augmentation on the primary stability of a stand-alone implant construct versus posterior stabilization in oblique lumbar interbody fusion with osteoporotic bone quality.Study DesignThe biomechanical effect of screw augmentation was studied inside an in-silico environment using computer-aided finite element analysis.MethodsA previously validated and published L2-L4 finite element model with normal and osteoporotic bone material properties was used. Geometries based on the OLIF implants (BPS, SSA) were created and placed inside the L3-L4 motion segment with increasing volumes (1 cm3 – 6 cm3) of PMMA augmentation. A 400 N follower load and 10 Nm bending moment (in the three anatomical planes) were applied to the surgical finite element models with different bone material properties. The operated L3-L4 segmental range of motion (ROM), the inserted cage's maximal caudal displacements, and L4 cranial bony endplate principal stress values were measured.ResultsThe non-augmented values for the BPS construct were generally lower compared to SSA, and the difference was increased by osteoporosis. In osteoporotic bone, PMMA augmentation gradually decreased the investigated values and the difference between the two constructs as well. Between 3 cm3 and 4 cm3of injected PMMA volume per screw, the difference between augmented SSA and standard BPS became comparable.ConclusionsBased on this study, augmentation can enhance the primary stability of the constructs and decrease the difference between them. Considering leakage as a possible complication, between 3 cm3 and 4 cm3 of injected PMMA per screw can be an adequate amount for SSA augmentation. However, further in silico, and possibly in vitro and clinical testing is required to thoroughly understand the investigated biomechanical aspects.Clinical SignificanceThis study sheds light on the possible biomechanical advantage offered by augmented OLIF implants and provides a theoretical augmentation amount for the SSA construct. Based on the findings, the concept of an SSA device with PMMA augmentation capability is desirable.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
大幅提高文件上传限制,最高150M (2024-4-1)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
刚刚
刚刚
Giraffe发布了新的文献求助20
1秒前
852应助小纸人采纳,获得10
2秒前
英俊的铭应助宋莱文采纳,获得10
3秒前
wisdom发布了新的文献求助10
3秒前
岁月静好完成签到,获得积分10
3秒前
欢喜初雪发布了新的文献求助10
4秒前
吕春雨发布了新的文献求助10
4秒前
刘宇完成签到,获得积分20
5秒前
5秒前
5秒前
wanci应助小冰棍采纳,获得10
5秒前
adiam发布了新的文献求助10
5秒前
5秒前
研友_VZG7GZ应助dujinjun采纳,获得10
5秒前
开放丸子完成签到,获得积分20
6秒前
Jinnel发布了新的文献求助10
7秒前
科研通AI2S应助慈祥的翠桃采纳,获得10
8秒前
科研通AI2S应助慈祥的翠桃采纳,获得10
8秒前
yatou5651应助慈祥的翠桃采纳,获得10
8秒前
斯文败类应助样子采纳,获得10
8秒前
Rylynn完成签到,获得积分10
8秒前
8秒前
迷路初兰发布了新的文献求助10
9秒前
从容曲奇发布了新的文献求助10
9秒前
水悟子完成签到,获得积分10
10秒前
10秒前
月月发布了新的文献求助10
10秒前
11秒前
法外潮湿宝贝完成签到 ,获得积分10
11秒前
DAOXIAN发布了新的文献求助10
12秒前
皮皮发布了新的文献求助10
12秒前
阿瓦隆的蓝胖子完成签到,获得积分10
12秒前
Akim应助思思采纳,获得10
13秒前
不配.应助花椒小透明采纳,获得10
14秒前
上官若男应助徐辉采纳,获得10
15秒前
乌龙茶完成签到 ,获得积分10
15秒前
15秒前
15秒前
高分求助中
The late Devonian Standard Conodont Zonation 2000
The Lali Section: An Excellent Reference Section for Upper - Devonian in South China 1500
Nickel superalloy market size, share, growth, trends, and forecast 2023-2030 1000
Smart but Scattered: The Revolutionary Executive Skills Approach to Helping Kids Reach Their Potential (第二版) 1000
Mantiden: Faszinierende Lauerjäger Faszinierende Lauerjäger 800
PraxisRatgeber: Mantiden: Faszinierende Lauerjäger 800
A new species of Coccus (Homoptera: Coccoidea) from Malawi 500
热门求助领域 (近24小时)
化学 医学 生物 材料科学 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 基因 遗传学 催化作用 物理化学 免疫学 量子力学 细胞生物学
热门帖子
关注 科研通微信公众号,转发送积分 3245398
求助须知:如何正确求助?哪些是违规求助? 2889057
关于积分的说明 8256709
捐赠科研通 2557392
什么是DOI,文献DOI怎么找? 1386090
科研通“疑难数据库(出版商)”最低求助积分说明 650285
邀请新用户注册赠送积分活动 626541