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Stepwise reduction of bone mineral density increases the risk of cage subsidence in oblique lumbar interbody fusion patients biomechanically: an in-silico study.
Yang, Zhi-Qiang; Cai, Ping; Li, Jing-Chi; Wang, Xian-Di; Xie, Tian-Hang; Pu, Xing-Xiao; Lin, Run; Zeng, Jian-Cheng; Song, Yue-Ming.
Afiliação
  • Yang ZQ; Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, 37# Wuhou Guoxue road, Chengdu, 610041, Sichuan Province, People's Republic of China.
  • Cai P; Department of Orthopedics, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, People's Republic of China.
  • Li JC; Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, 37# Wuhou Guoxue road, Chengdu, 610041, Sichuan Province, People's Republic of China.
  • Wang XD; Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, 37# Wuhou Guoxue road, Chengdu, 610041, Sichuan Province, People's Republic of China.
  • Xie TH; Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, 37# Wuhou Guoxue road, Chengdu, 610041, Sichuan Province, People's Republic of China.
  • Pu XX; Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, 37# Wuhou Guoxue road, Chengdu, 610041, Sichuan Province, People's Republic of China.
  • Lin R; Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, 37# Wuhou Guoxue road, Chengdu, 610041, Sichuan Province, People's Republic of China.
  • Zeng JC; Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, 37# Wuhou Guoxue road, Chengdu, 610041, Sichuan Province, People's Republic of China. tomzeng5@126.com.
  • Song YM; Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, 37# Wuhou Guoxue road, Chengdu, 610041, Sichuan Province, People's Republic of China. sym_cd@163.com.
BMC Musculoskelet Disord ; 23(1): 1083, 2022 Dec 12.
Article em En | MEDLINE | ID: mdl-36503614
ABSTRACT

BACKGROUND:

Cage subsidence causes poor prognoses in patients treated by oblique lumbar interbody fusion (OLIF). Deterioration of the biomechanical environment initially triggers cage subsidence, and patients with low bone mineral density (BMD) suffer a higher risk of cage subsidence. However, whether low BMD increases the risk of cage subsidence by deteriorating the local biomechanical environment has not been clearly identified.

METHODS:

OLIF without additional fixation (stand-alone, S-A) and with different additional fixation devices (AFDs), including anterolateral single rod screws (ALSRs) and bilateral pedicle screws (BPSs) fixation, was simulated in the L4-L5 segment of a well-validated finite element model. The biomechanical effects of different BMDs were investigated by adjusting the material properties of bony structures. Biomechanical indicators related to cage subsidence were computed and recorded under different directional moments.

RESULTS:

Overall, low BMD triggers stress concentration in surgical segment, the highest equivalent stress can be observed in osteoporosis models under most loading conditions. Compared with the flexion-extension loading condition, this variation tendency was more pronounced under bending and rotation loading conditions. In addition, AFDs obviously reduced the stress concentration on both bony endplates and the OLIF cage, and the maximum stress on ALSRs was evidently higher than that on BPSs under almost all loading conditions.

CONCLUSIONS:

Stepwise reduction of BMD increases the risk of a poor local biomechanical environment in OLIF patients, and regular anti-osteoporosis therapy should be considered an effective method to biomechanically optimize the prognosis of OLIF patients.
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Texto completo: 1 Bases de dados: MEDLINE Assunto principal: Osteoporose / Fusão Vertebral / Parafusos Pediculares Tipo de estudo: Etiology_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: BMC Musculoskelet Disord Assunto da revista: FISIOLOGIA / ORTOPEDIA Ano de publicação: 2022 Tipo de documento: Article

Texto completo: 1 Bases de dados: MEDLINE Assunto principal: Osteoporose / Fusão Vertebral / Parafusos Pediculares Tipo de estudo: Etiology_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: BMC Musculoskelet Disord Assunto da revista: FISIOLOGIA / ORTOPEDIA Ano de publicação: 2022 Tipo de documento: Article