Skip to main content

ORIGINAL RESEARCH article

Front. Bioeng. Biotechnol.
Sec. Biomechanics
Volume 12 - 2024 | doi: 10.3389/fbioe.2024.1508385
This article is part of the Research Topic Biomechanical and Biomaterial Advances in Degenerative Diseases of Bone and Joint View all 6 articles

The effects of cage on endplate collapse after Stand-Alone OLIF:Based on finite element analysis and invitro mechanics experiments

Provisionally accepted
Hao Li Hao Li 1*Jiarui Liu Jiarui Liu 1Huifei Cui Huifei Cui 1*Nana Shen Nana Shen 1*Futong Wu Futong Wu 1Zhihao Zhang Zhihao Zhang 1*Zhongze Zhu Zhongze Zhu 1*Chensheng Qiu Chensheng Qiu 2Hongfei Xiang Hongfei Xiang 1*
  • 1 Department of Spinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, China
  • 2 Qingdao Municipal Hospital, Qingdao, Shandong Province, China

The final, formatted version of the article will be published soon.

    Background: Lumbar degenerative diseases are an important factor in disability worldwide, and they are also common among the elderly population.Stand-Alone Oblique Lumbar Interbody Fusion (Stand-Alone OLIF) is a novel surgical approach for treating lumbar degenerative diseases. However, long-term follow-up after surgery has revealed the risk of endplate collapse associated with Stand-Alone OLIF procedures.This study aimed to investigate the effect of the cage factor on endplate collapse after Stand-Alone OLIF.Methods: Finite element(FE) models and calf lumbar functional units were established separately and used to simulate Stand-Alone OLIF surgery.On the L5 endplate of the FE model and the calf lumbar functional unit, 12 cage positions from anterior to posterior, 16 cage inclination angles from 0°to 15°, and 4 cage heights were selected to simulate surgical models with different cage positions.Compression loads of 400N were applied to the upper surface of the superior vertebral body of the cage, and 10Nm torques in four directions were used to simulate four different physiological movements of the lumbar spine: flexion, extension, lateral curvature and torsion, in order to compare the range of motion of the surgical segment and the endplate stress.Results: When the cage is placed closer to the anterior and posterior edges of the endplate and when the height of the cage exceeds 12mm, the intervertebral range of motion at the surgical segment is greater and the stress on the endplate is higher during various lumbar spine activities.When the cage is inclined at an angle within 15°, there are no significant differences in the corresponding endplate stress and the range of motion.For Stand-Alone OLIF surgery, inserting the cage in the central anterior-posterior position of the intervertebral space and selecting a cage with a height not exceeding 12mm can reduce the stress on the endplate after surgery, which is more conducive to the stability of the lumbar spine postoperatively and reduces the risk of postoperative endplate collapse. The inclination angle of the cage placement does not significantly affect postoperative endplate stress or lumbar stability.

    Keywords: Stand-alone OLIF, CAGE, endplate collapse, Biomechanics, Finite Element Analysis

    Received: 09 Oct 2024; Accepted: 15 Nov 2024.

    Copyright: © 2024 Li, Liu, Cui, Shen, Wu, Zhang, Zhu, Qiu and Xiang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Hao Li, Department of Spinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, 266000, Shandong Province, China
    Huifei Cui, Department of Spinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, 266000, Shandong Province, China
    Nana Shen, Department of Spinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, 266000, Shandong Province, China
    Zhihao Zhang, Department of Spinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, 266000, Shandong Province, China
    Zhongze Zhu, Department of Spinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, 266000, Shandong Province, China
    Hongfei Xiang, Department of Spinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, 266000, Shandong Province, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.