Biomechanical changes at the adjacent segments induced by a lordotic porous interbody fusion cage

Zhang, Ning-Ze; Xiong, Qisheng; Yao, Jie; Liu, Bolun; Zhang, Min; Cheng, Cheng‐Kung

doi:10.1016/j.compbiomed.2022.105320

Cited by 13 publications

(6 citation statements)

References 59 publications

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“…Collagen fibers were simulated using tension-only truss elements (T3D2) and embedded in the ground substance of the intervertebral disc with an average angle of ±30° to the endplates to form the annulus fibrosus. The ground substance was composed of eight layers 1.0 mm thick ( Zhang et al, 2022 ). The volume ratio of the annulus fibrosus and nucleus pulposus was 3:7 ( Goto et al, 2002 ).…”

Section: Methodsmentioning

confidence: 99%

Biomechanical evaluation of a short-rod technique for lumbar fixation surgery

Huang

Nie

Zhang

et al. 2022

Front. Bioeng. Biotechnol.

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Objective: The purpose of this study was to analyze the stability and instrument-related complications associated with fixation of the lumbar spine using the Short-Rod (SR) technique.Methods: Using finite element analysis, this study assessed the stability of a bilateral lumbar fixation system when inserting the pedicle screws at angles of 10°, 15°, and 20° to the endplate in the sagittal plane. Using the most stable construct with a screw angle, the model was then assessed with different rod lengths of 25, 30, 35, and 45 mm. The optimal screw inclination angle and rod length were incorporated into the SR model and compared against traditional parallel screw insertion (pedicle screws in parallel to the endplate, PPS) in terms of the stability and risk of instrument-related complications. The following parameters were evaluated using the validated L4–L5 lumbar finite element model: axial stiffness, range of motion (ROM), stress on the endplate and facet joint, von-Mises stress on the contact surface between the screw and rod (CSSR), and screw displacement.Results: The results showed that the SR model with a 15° screw inclination angle and 35 mm rod length was superior in terms of construct stability and risk of complications. Compared to the PPS model, the SR model had lower stiffness, lower ROM, less screw displacement, and lower stress on the facet cartilage, the CSSR, and screws. However, the SR model also suffered more stress on the endplate in flexion and lateral bending.Conclusion: The SR technique with a 15° screw inclination and 35 mm rod length offers good lumbar stability with a low risk of instrument-related complications.

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Section: Methodsmentioning

confidence: 99%

Biomechanical evaluation of a short-rod technique for lumbar fixation surgery

Huang

Nie

Zhang

et al. 2022

Front. Bioeng. Biotechnol.

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“…The influence of cage subsidence is multifactorial and affected not only by the stresses applied to the superior and inferior endplate surfaces but also by the stress concentrations due to high stresses on the cage, thus affecting bone healing and slowing down the segmental fusion [ 31 , 32 ]. An inappropriate cage during ACDF poses a greater risk.…”

Section: Discussionmentioning

confidence: 99%

Biomechanical analysis of customized cage conforming to the endplate morphology in anterior cervical discectomy fusion: A finite element analysis

Sun

Han

Sui

et al. 2023

Heliyon

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“…The number of lumbar fusions chosen for IVDD, IVD herniation, and spinal stenosis in the United States accounted for 42.3% of the total number of this procedure in 2015 ( Martin et al, 2019 ). Overall, spinal fusion has become the first choice for patients with IVDD, but complications such as slow postoperative recovery, infection, LBP recurrence, fusion failure, cage subsidence, and adjacent segmental disease also pose significant problems for patients and clinicians ( Eliasberg et al, 2016 ; Moser et al, 2022 ; Zhang N.-Z. et al, 2022 ).…”

Section: Mechanisms and Treatment Strategies Of Ivddmentioning

confidence: 99%

New Hope for Treating Intervertebral Disc Degeneration: Microsphere-Based Delivery System

Guo

Zhang

et al. 2022

Front. Bioeng. Biotechnol.

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Intervertebral disc (IVD) degeneration (IVDD) has been considered the dominant factor in low back pain (LBP), and its etiological mechanisms are complex and not yet fully elucidated. To date, the treatment of IVDD has mainly focused on relieving clinical symptoms and cannot fundamentally solve the problem. Recently, a novel microsphere-based therapeutic strategy has held promise for IVD regeneration and has yielded encouraging results with in vitro experiments and animal models. With excellent injectability, biocompatibility, and biodegradability, this microsphere carrier allows for targeted delivery and controlled release of drugs, gene regulatory sequences, and other bioactive substances and supports cell implantation and directed differentiation, aiming to improve the disease state of IVD at the source. This review discusses the possible mechanisms of IVDD and the limitations of current therapies, focusing on the application of microsphere delivery systems in IVDD, including targeted delivery of active substances and drugs, cellular therapy, and gene therapy, and attempts to provide a new understanding for the treatment of IVDD.

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Biomechanical changes at the adjacent segments induced by a lordotic porous interbody fusion cage

Cited by 13 publications

References 59 publications

Biomechanical evaluation of a short-rod technique for lumbar fixation surgery

Biomechanical evaluation of a short-rod technique for lumbar fixation surgery

Biomechanical analysis of customized cage conforming to the endplate morphology in anterior cervical discectomy fusion: A finite element analysis

New Hope for Treating Intervertebral Disc Degeneration: Microsphere-Based Delivery System

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