Medicine in Novel Technology and Devices (Dec 2022)

Biomechanical evaluation of two fusion techniques based on finite element analysis: Percutaneous endoscopic and minimally invasive transforaminal lumbar interbody fusion

  • Yang Yan,
  • Jiarui Li,
  • Jianhao Yu,
  • Yan Wang,
  • Hao Dong,
  • Yuqin Sun,
  • Xiaogang Wu,
  • Liming He,
  • Weiyi Chen,
  • Haoyu Feng

Journal volume & issue
Vol. 16
p. 100138

Abstract

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As a novel minimally invasive technique, percutaneous endoscopic transforaminal lumbar interbody fusion (PE-TLIF) has been widely used in the treatment of lumbar degenerative diseases. The purpose of this study was to analyze these two operation types’ biomechanical performances of PE-TLIF and traditional minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) using the finite element (FE) method. The intact FE models of L4-L5 were established and validated based on the CT images. On this basis, the FE models of MIS-TLIF and PE-TLIF were established and analyzed. It is demonstrated that for lumbar interbody fusion with the oblique asymmetrically implanted cage under bilateral pedicle screws and rods fixation, such as MIS-TLIF and PE-TLIF, different degrees of articular process resection have no significant effect on the cage subsidence, and the surgical segment can achieve similar stability. In addition, the maximum stress of the L4 inferior endplate of MIS-TLIF and PE-TLIF is greater than that of the L5 superior endplate, which indicates that MIS-TLIF and PE-TLIF can cause cage subsidence in the L4 inferior endplate.

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