Mok, J.M. orcid.org/0000-0001-9781-0699, Lin, Y. orcid.org/0000-0001-8195-9042, Tafur, J.C. orcid.org/0000-0002-7492-4973 et al. (2 more authors) (2023) Biomechanical Comparison of Multilevel Stand-Alone Lumbar Lateral Interbody Fusion With Posterior Pedicle Screws: An In Vitro Study. Neurospine, 20 (2). pp. 478-486. ISSN 2586-6583
Abstract
Objective Lumbar lateral interbody fusion (LLIF) allows placement of large interbody cages while preserving ligamentous structures important for stability. Multiple clinical and biomechanical studies have demonstrated the feasibility of stand-alone LLIF in single-level fusion. We sought to compare the stability of 4-level stand-alone LLIF utilizing wide (26 mm) cages with bilateral pedicle screw and rod fixation. Methods Eight human cadaveric specimens of L1–5 were included. Specimens were attached to a universal testing machine (MTS 30/G). Flexion, extension, and lateral bending were attained by applying a 200 N load at a rate of 2 mm/sec. Axial rotation of ±8° of the specimen was performed at 2°/sec. Three-dimensional specimen motion was recorded using an optical motion-tracking device. Specimens were tested in 4 conditions: (1) intact, (2) bilateral pedicle screws and rods, (3) 26-mm stand-alone LLIF, (4) 26-mm LLIF with bilateral pedicle screws and rods. Results Compared to the stand-alone LLIF, bilateral pedicle screws and rods had 47% less range of motion in flexion-extension (p < 0.001), 21% less in lateral bending (p < 0.05), and 20% less in axial rotation (p = 0.1). The addition of bilateral posterior instrumentation to the stand-alone LLIF resulted in decreases of all 3 planes of motion: 61% in flexion-extension (p < 0.001), 57% in lateral bending (p < 0.001), 22% in axial rotation (p = 0.002). Conclusion Despite the biomechanical advantages associated with the lateral approach and 26 mm wide cages, stand-alone LLIF for 4-level fusion is not equivalent to pedicle screws and rods.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2023 by the Korean Spinal Neurosurgery Society. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0). |
Keywords: | Stand-alone; Lateral interbody fusion; Multilevel; Extreme lateral interbody fu-sion; Lumbar lateral interbody fusion; Biomechanics |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Engineering & Physical Sciences (Leeds) > School of Mechanical Engineering (Leeds) > Institute of Medical and Biological Engineering (iMBE) (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 21 Aug 2023 12:54 |
Last Modified: | 21 Aug 2023 12:54 |
Status: | Published |
Publisher: | The Korean Spinal Neurosurgery Society |
Identification Number: | 10.14245/ns.2244734.367 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:202575 |