Do we need a transforaminal lumbar interbody fusion cage to increase the stability of functional spinal unit when comparing unilateral and bilateral fixation?

  • Yazar/lar ULUTAŞ, Murat
    ÖZKAYA, Mustafa
    YAMAN, Onur
    DEMİR, Tevfik
  • Yayın Türü Makale
  • Yayın Tarihi 2018
  • DOI Numarası 10.1177/0954411918783779
  • Yayıncı SAGE Publications Ltd
  • Tek Biçim Adres http://hdl.handle.net/20.500.12498/2866

Transforaminal lumbar interbody fusion was an alternative to posterior lumbar interbody fusion for decompression surgeries. This study investigates the biomechanical responses of the unilateral and bilateral pedicle screw fixations with/without transforaminal lumbar interbody fusion cages under axial compression, flexion, and torsional loads. Ovine vertebrae were used in this study. Cadavers, randomly divided into five, were intact control group, bilateral pedicle screw fixation group, bilateral pedicle screw fixation group with transforaminal lumbar interbody fusion cage, unilateral pedicle screw fixation group, and unilateral pedicle screw fixation group with transforaminal lumbar interbody fusion cage. Axial compression, flexion, and torsion tests were performed on specimens. All study groups provided higher stiffness and yield load values than control group under axial compression. Addition of transforaminal lumbar interbody fusion cage to bilateral fixation increased the stiffness under axial compression. Moreover, additional use of transforaminal lumbar interbody fusion in unilateral fixation increased the yield load values under axial compression. Control group was the stiffest in flexion test. Placing a transforaminal lumbar interbody fusion cage to both unilateral and bilateral fixations did not significantly change the stiffness values. Additional transforaminal lumbar interbody fusion cage increased the yield moment of the bilateral fixation. In torsion test, control group had the highest stiffness and yield torque. The facet joints are the most important parts of the vertebrae on the stability. When comparing the bilateral and unilateral fixations with transforaminal lumbar interbody fusion addition, the more facet preserving approach has significantly higher stability under axial compression, flexion, and torsion. Unilateral fixation with transforaminal lumbar interbody fusion cage can be said biomechanically stable and advantageous fixation system because of the advantage on the less facet and soft tissue resection compared to bilateral fixation with transforaminal lumbar interbody fusion. © 2018, IMechE 2018.

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Eser Adı
(dc.title)
Do we need a transforaminal lumbar interbody fusion cage to increase the stability of functional spinal unit when comparing unilateral and bilateral fixation?
Yayın Türü
(dc.type)
Makale
Yazar/lar
(dc.contributor.author)
ULUTAŞ, Murat
Yazar/lar
(dc.contributor.author)
ÖZKAYA, Mustafa
Yazar/lar
(dc.contributor.author)
YAMAN, Onur
Yazar/lar
(dc.contributor.author)
DEMİR, Tevfik
DOI Numarası
(dc.identifier.doi)
10.1177/0954411918783779
Atıf Dizini
(dc.source.database)
Scopus
Yayıncı
(dc.publisher)
SAGE Publications Ltd
Yayın Tarihi
(dc.date.issued)
2018
Kayıt Giriş Tarihi
(dc.date.accessioned)
2020-08-07T12:52:37Z
Açık Erişim tarihi
(dc.date.available)
2020-08-07T12:52:37Z
Kaynak
(dc.source)
Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine
ISSN
(dc.identifier.issn)
09544119 (ISSN)
Özet
(dc.description.abstract)
Transforaminal lumbar interbody fusion was an alternative to posterior lumbar interbody fusion for decompression surgeries. This study investigates the biomechanical responses of the unilateral and bilateral pedicle screw fixations with/without transforaminal lumbar interbody fusion cages under axial compression, flexion, and torsional loads. Ovine vertebrae were used in this study. Cadavers, randomly divided into five, were intact control group, bilateral pedicle screw fixation group, bilateral pedicle screw fixation group with transforaminal lumbar interbody fusion cage, unilateral pedicle screw fixation group, and unilateral pedicle screw fixation group with transforaminal lumbar interbody fusion cage. Axial compression, flexion, and torsion tests were performed on specimens. All study groups provided higher stiffness and yield load values than control group under axial compression. Addition of transforaminal lumbar interbody fusion cage to bilateral fixation increased the stiffness under axial compression. Moreover, additional use of transforaminal lumbar interbody fusion in unilateral fixation increased the yield load values under axial compression. Control group was the stiffest in flexion test. Placing a transforaminal lumbar interbody fusion cage to both unilateral and bilateral fixations did not significantly change the stiffness values. Additional transforaminal lumbar interbody fusion cage increased the yield moment of the bilateral fixation. In torsion test, control group had the highest stiffness and yield torque. The facet joints are the most important parts of the vertebrae on the stability. When comparing the bilateral and unilateral fixations with transforaminal lumbar interbody fusion addition, the more facet preserving approach has significantly higher stability under axial compression, flexion, and torsion. Unilateral fixation with transforaminal lumbar interbody fusion cage can be said biomechanically stable and advantageous fixation system because of the advantage on the less facet and soft tissue resection compared to bilateral fixation with transforaminal lumbar interbody fusion. © 2018, IMechE 2018.
Yayın Dili
(dc.language.iso)
en
Tek Biçim Adres
(dc.identifier.uri)
http://hdl.handle.net/20.500.12498/2866
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