Numerical simulation of lateral and transforaminal lumbar interbody fusion, two minimally invasive surgical approaches

Comput Methods Biomech Biomed Engin. 2020 Jun;23(8):408-421. doi: 10.1080/10255842.2020.1734579. Epub 2020 Mar 19.

Abstract

The present study aims to compare spinal stability after two different minimally invasive techniques, the lateral lumbar interbody fusion (LLIF) and the transforaminal lumbar interbody fusion (TLIF) approaches. Two nonlinear three-dimensional finite element (FE) models of the L4-L5 functional spinal unit (FSU) were subjected to the loads that usually act on the lumbar spine. Findings show that the LLIF approach yields better results for torsion load case, due to the larger surface area of the implant. For extension, flexion and lateral bending loads, the TLIF approach presents smaller displacements probably due to the anterior placement of the cage and to the smaller damaged area of the annulus fibrosus.

Keywords: Minimally invasive lumbar fusion; finite element method; intervertebral implants; lateral and transforaminal approaches.

MeSH terms

  • Biomechanical Phenomena
  • Cancellous Bone / surgery
  • Computer Simulation*
  • Cortical Bone / surgery
  • Humans
  • Lumbar Vertebrae / surgery*
  • Minimally Invasive Surgical Procedures*
  • Models, Theoretical
  • Numerical Analysis, Computer-Assisted*
  • Prostheses and Implants
  • Reproducibility of Results
  • Rotation
  • Spinal Fusion*
  • Stress, Mechanical