Effect of cage insertion orientation on stress profiles and subsidence phenomenon in posterior lumbar interbody fusion
Posterior lumbar interbody fusion has been widely accepted as one of the surgical procedure to treat clinical problems. However, vertebral endplate subsidence failure has been detected as one of its major problems that might increase the potential of pain and mechanical instability. Therefore, poste...
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| Main Authors: | , , , |
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| Format: | Conference or Workshop Item |
| Published: |
2015
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| Subjects: | |
| Online Access: | http://eprints.uthm.edu.my/7340/ http://eprints.uthm.edu.my/7340/1/16KL0014.pdf |
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| Summary: | Posterior lumbar interbody fusion has been widely accepted as one of the surgical procedure to treat clinical problems. However, vertebral endplate subsidence failure has been detected as one of its major problems that might increase the potential of pain and mechanical
instability. Therefore, posterior instrumentation (PI) has been introduced alongside with double
fusion cages implant to limit segmental movement and to facilitate fusion. Nevertheless, the use of
two interbody fusion cages will be likely to incur higher cost and more risky. Hence, single oblique
cage insertion surgical procedure has been reported as one of the reliable solution. In the present
study, an image-based finite element analysis was used to evaluate a subsidence phenomenon based
on the fracture risks evaluation and the stress profiles at cage-endplate interface in two different cage
insertion orientations namely as double cages and single oblique cage. Apparently, the single oblique
inserted cage with PI has significantly produced lower stress than the double inserted cages at the
cage-endplate interfaces. At higher impact loading (2000N), the total number of compressive
deformations of the double cages outnumbered the single oblique cage at the cage-endplate interface
junctions and the deformations were more uniformly distributed. Obviously, there was a trade-off
between the stress generation, the implant stability and the risk of vertebral bone failures. The single
oblique cage insertion method could be considered as one of the best alternative for the posterior
lumbar interbody fusion surgical procedure due its structural symmetry that could provide similar
stability as two cages did |
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