Finite element analysis of implanted lumbar spine: Effects of open laminectomy plus PLF and open laminectomy plus TLIF surgical approaches on L3-L4 FSU

• Published in: Medical engineering & physics Vol. 128; p. 104178
• Main Authors: Pradeep, Kishore, Pal, Bidyut, Mukherjee, Kaushik, Shetty, Gautam M.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-06-2024
• Subjects: Biomechanical Phenomena; Degenerative disc diseases; Finite Element Analysis; Humans; Laminectomy; Lumbar spine; Lumbar Vertebrae - diagnostic imaging; Lumbar Vertebrae - surgery; Male; Open laminectomy plus posterolateral fusion; Open laminectomy plus transforaminal interbody fusion; Prostheses and Implants; Range of Motion, Articular; Spinal Fusion; Stress, Mechanical; Open laminectomy plus transforaminal interbody fusion; Degenerative disc diseases; Finite element analysis; Lumbar spine; Open laminectomy plus posterolateral fusion
• ISSN: 1350-4533; 1873-4030; 1873-4030
• DOI: 10.1016/j.medengphy.2024.104178

•Comparative finite element study of a fused L3-L4 FSU for physiological loadings.•Open laminectomy plus PLF and open laminectomy plus TLIF surgical approaches.•A follower coordinate system was used for applying loading and boundary conditions.•Maximum strains in the fused FSU are higher than compressive yield strain limit.•Both surgical techniques pose a risk of developing adjacent segment degeneration.
Several finite element (FE) studies reported performances of various lumbar fusion surgical approaches. However, comparative studies on the performance of Open Laminectomy plus Posterolateral Fusion (OL-PLF) and Open Laminectomy plus Transforaminal Interbody Fusion (OL-TLIF) surgical approaches are rare. In the current FE study, the variation in ranges of motions (ROM), stress-strain distributions in an implanted functional spinal unit (FSU) and caudal adjacent soft structures between OL-PLF and OL-TLIF virtual models were investigated. The implanted lumbar spine FE models were developed from subject-specific computed tomography images of an intact spine and solved for physiological loadings such as compression, flexion, extension and lateral bending. Reductions in the ROMs of L1-L5 (49 % to 59 %) and L3-L4 implanted FSUs (91 % to 96 %) were observed for both models. Under all the loading cases, the maximum von Mises strain observed in the implanted segment of both models exceeds the mean compressive yield strain for the vertebra. The maximum von Mises stress and strain observed on the caudal adjacent soft structures of both the implanted models are at least 22 % higher than the natural spine model. The findings indicate the risk of failure in the implanted FSUs and higher chances of adjacent segment degeneration for both models.