Biomechanical evaluation of interbody fixation with secondary augmentation: lateral lumbar interbody fusion versus posterior lumbar interbody fusion

Authors

Jakub Godzik, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona.
Samuel Kalb, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona.
Marco T. Reis, Spinal Biomechanics Laboratory, Department of Neurosurgery Research, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona.
Phillip M. Reyes, Spinal Biomechanics Laboratory, Department of Neurosurgery Research, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona.
Vaneet Singh, Medtronic, Inc., Memphis, Tennessee.
Anna G. Newcomb, Spinal Biomechanics Laboratory, Department of Neurosurgery Research, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona.
Steve W. Chang, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona.Follow
Brian P. Kelly, Spinal Biomechanics Laboratory, Department of Neurosurgery Research, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona.Follow
Neil R. Crawford, Spinal Biomechanics Laboratory, Department of Neurosurgery Research, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona.

Document Type

Article

Abstract

Background: Many approaches to the lumbar spine have been developed for interbody fusion. The biomechanical profile of each interbody fusion device is determined by the anatomical approach and the type of supplemental internal fixation. Lateral lumbar interbody fusion (LLIF) was developed as a minimally invasive technique for introducing hardware with higher profiles and wider widths, compared with that for the posterior lumbar interbody fusion (PLIF) approach. However, the biomechanics of the interbody fusion construct used in the LLIF approach have not been rigorously evaluated, especially in the presence of secondary augmentation. Methods: Spinal stability of 21 cadaveric lumbar specimens was compared using standard nondestructive flexibility studies [mean range of motion (ROM), lax zone (LZ), stiff zone (SZ) in flexion-extension, lateral bending, and axial rotation]. Non-paired comparisons were made among four conditions: (I) intact; (II) with unilateral interbody + bilateral pedicle screws (BPS) using the LLIF approach (referred to as the LLIF construct); (III) with bilateral interbody + BPS using the PLIF approach (referred to as the PLIF construct); and (IV) with no lumbar interbody fusion (LIF) + BPS (referred to as the no-LIF construct). Results: With bilateral pedicle screw-rod fixation, stability was equivalent between PLIF and LLIF constructs in lateral bending and flexion-extension. PLIF and LLIF constructs had similar biomechanical profiles, with a trend toward less ROM in axial rotation for the LLIF construct. Conclusions: LLIF and PLIF constructs had similar stabilizing effects.

Keywords

Lateral lumbar interbody fusion (LLIF), lumbar biomechanics, lumbar interbody fusion (LIF), pedicle screw, posterior lumbar interbody fusion (PLIF), range of motion (ROM)

Publication Date

6-1-2018

Publication Title

Journal of spine surgery (Hong Kong)

ISSN

2414-469X

Volume

4

Issue

2

First Page

180

Last Page

186

PubMed ID

30069505

Digital Object Identifier (DOI)

10.21037/jss.2018.05.07

Recommended Citation

Godzik, Jakub; Kalb, Samuel; Reis, Marco T.; Reyes, Phillip M.; Singh, Vaneet; Newcomb, Anna G.; Chang, Steve W.; Kelly, Brian P.; and Crawford, Neil R., "Biomechanical evaluation of interbody fixation with secondary augmentation: lateral lumbar interbody fusion versus posterior lumbar interbody fusion" (2018). Translational Neuroscience. 1204.
https://scholar.barrowneuro.org/neurobiology/1204