Pilot study of oblique lumbar interbody fusion using mobile percutaneous pedicle screw and validation by a three-dimensional finite element assessment |
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| Institution: | 1. Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan;2. Yamanashi Industrial Technology Center, 2094, Ohtsumachi, Kofu, Yamanashi 400-0055, Japan;3. Department of Orthopaedic Surgery, Shimoshizu National Hospital, 934-5, Shikawatashi, Yotsukaido, Chiba 284-0003, Japan;4. Department of Orthopaedic Surgery, Eastern Chiba Medical Center, 3-6-2, Okayamadai, Togane, Chiba 283-8686, Japan;5. Department of Orthopedic Surgery, University of Tsukuba, 1-1-1 Tennodai, Tsukuba-City, Ibaraki 305-8575, Japan;6. Department of Orthopaedic Surgery, St. Marianna University School of Medicine, 2-16-1, Sugao, Miyamae-ku, Kawasaki, Kanagawa, Japan;7. Department of Orthopaedic Surgery, Toho University Sakura Medical Center, 564-1, Shimoshizu, Sakura, Chiba 285-8741, Japan;8. Biostatistics Section, Clinical Research Center, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba 260-8677, Japan;1. Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100041, China;2. Department of Neurology, Peking University Shougang Hospital, Beijing 100144, China;3. China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China;1. School of Basic Medical Sciences, Guangdong Provincial Key Laboratory of Medical Biomechanics, Southern Medical University, No. 1023, South Shatai Road, Baiyun District, Guangzhou, Guangdong, 510515, China;2. Dept of Spinal Surgery, The First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiang West Road, Guangzhou, Guangdong, 510120, China;3. MOE Key Laboratory of Disaster Forecast and Control in Engineering, Institute of Applied Mechanics, Jinan University, Guangzhou, Guangdong, 510632, China;4. School of Mechanical and Electrical Engineering, Putian University, Putian, Fujian, China;1. Department of Neurosurgery, Spine Center, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Gyeonggi, Korea;2. Department of Orthopaedic Surgery, Spine Service, Columbia University College of Physicians and Surgeons, New York, New York, USA;1. Department of Orthopedics, The First Affiliated Hospital of Xiamen University, Xiamen, PR China;2. Spine unit, Department of Orthopaedics, Queen Savang Vadhana Memorial Hospital, Sriracha, Chonburi, Thailand South Korea;3. Department of Spinal Surgery, Shenzhen Second People’s Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, PR China;4. Department of Orthopaedics, Naresuan University Hospital, Phitsanulok, Thailand;5. Department of Neurosurgery, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, South Korea;1. Ningxia Medical University, Yinchuan, Ningxia, China;2. Department of Orthopedics, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China;3. DECANS Medical Devices Co., Ltd., Jiaxing, Zhejiang, China |
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| Abstract: | The purpose of this study was to try oblique lateral interbody fusion (OLIF) using percutaneous pedicle screws (PPS) with mobility.Twelve patients who underwent single-level OLIF were observed for at least one year. These included 6 patients with conventional PPS (rigid group), and 6 with movable PPS (semi-rigid group). Mobile PPS used cosmicMIA, which is a load sharing system. The anterior and posterior disc height, screw loosening and bone healing period, and implant failure were evaluated at final observation by CT. Moreover, the stress on the vertebral body-cage, on the vertebral body-screw/rod and on the bone around the screw was estimated using a three-dimensional finite element assessment in both groups.There was no significant difference in surgical time, amount of bleeding, JOA score, or low back pain VAS between groups. There were no differences between groups in anterior and posterior disc height, screw loosening, and implant failure at final observation. The bone healing period was significantly shorter in the semi-rigid screw group (18.3 months vs 4.8 months, p = 0.01). The finite element analysis showed that the lower stress on the rod/screw would contribute to fewer implant fractures and that lower stress on the bone around the screw would reduce screw loosening, and that higher compressive force on the cage would promotes bone healing.OLIF combined with a movable screw accelerated bone healing by nearly 75%. We conclude that mobile PPS in combination with OLIF promotes bone healing and can be a better vertebral fusion technique. |
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| Keywords: | Oblique lumbar interbody fusion Load sharing Lumbar segmental mobility Pedicle screw Finite element analysis |
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