Biomechanical Properties of Porous Titanium Cages for Different Lumbar Interbody Fusion Surgeries / 医用生物力学

Objective To study the biomechanical properties of porous titanium cages used for different lumbar interbody fusion surgeries. Methods The three-dimensional (3D) finite element model of the lumbar spine was constructed, and mechanical parameters of porous materials were obtained by mechanical test. The biomechanical properties of porous titanium cages in anterior lumbar interbody fusion (ALIF), posterior lumbar interbody fusion (PLIF), transforaminal lumbar interbody fusion (TLIF), direct lateral interbody fusion (DLIF) were compared. Results After lumbar interbody surgery, the predicted range of motion (ROM) and the maximum stress in cage of DLIF model and ALIF model were substantially lower than those of PLIF model and TLIF model. The maximum stress in endplate of DLIF model, ALIF model and TLIF model were obviously lower than that of PLIF model. Conclusions DLIF with the porous cage showed advantages in biomechanical properties, which was simple to operate and suitable for minimally invasive surgery in clinical practice. DLIF performed the superior comprehensive properties.

Video-Assisted Thoracoscopic Minimally Invasive Anterior Interbody Fusion of the T11-T12 Level Using Direct Lateral Interbody Fusion Devices: A Case Report

STUDY DESIGN: Case report OBJECTIVES: To report a case of video-assisted thoracoscopic (VAT) minimally invasive anterior interbody fusion of the T11-T12 level using direct lateral interbody fusion (DLIF) devices. SUMMARY OF LITERATURE REVIEW: Interbody fusion of the thoracolumbar junction (especially T11-T12) is technically challenging from anterior, lateral, or posterior approaches. A VAT anterior interbody fusion approach using DLIF devices is a safe, minimally invasive alternative approach to the thoracolumbar spine. MATERIALS AND METHODS: A 37-year-old male pedestrian was struck by a car sustaining fracture-dislocation at the T11-T12 level. The accident resulted in complete paraplegia of both lower extremities and multiple lower extremity fractures. A classical instrumented posterolateral fusion from T8 to L3 and staged VAT anterior interbody fusion at the T11-T12 level were performed. RESULTS: At one year postoperatively, he was capable of independent ambulation using a wheelchair without back pain, and plain radiographs and CT scans showed a solid fusion at the T11-T12 level. CONCLUSIONS: VAT anterior interbody fusion using DLIF devices provides excellent access to the anterior spinal column with the added benefits of an improved field of view and can be a safe and effective alternative to open thoracotomy in the management of various thoracolumbar junction problems.