Abstract

BackgroundAn autologous bone-cage made from the spinous process and laminae might provide a stability in posterior lumbar interbody fusion (PLIF) close that of the traditional-cage made of polyetheretherketone (PEEK) or titanium. The biomechanical effect of autologous bone-cages on cage stability, stress, and strains, and on the facet contact force has not been fully described. This study aimed to verify whether autologous bone-cages can achieve similar performance as that of PEEK cages in PLIF by using a finite element analysis.MethodsThe finite element models of PLIF with an autologous bone-cage, a titanium cage, and a PEEK cage were constructed. The autologous bone-cage was compared with the titanium and PEEK cages. The mechanical properties of the autologous bone-cage were obtained through mechanical tests. The four motion modes were simulated. The range of motion (ROM), the stress in the cage-end plate interface, and the facet joint force (FJF) were compared.ResultsThe ROM was increased at adjacent levels but decreased over 97% at the treated levels, and the intradiscal pressure at adjacent levels was increased under all conditions in all models. The FJF disappeared at treated levels and increased under extension, lateral bending, and lateral rotation in all models. The maximum stress of the cage-endplate interface was much lower in the autologous bone-cage model than those in the PEEK and titanium cage models.ConclusionsIn a finite model of PLIF, the autologous bone-cage model could achieve stability close that of traditional titanium or PEEK cages, reducing the risk of subsidence.

Highlights

  • An autologous bone-cage made from the spinous process and laminae might provide a stability in posterior lumbar interbody fusion (PLIF) close that of the traditional-cage made of polyetheretherketone (PEEK) or titanium

  • This study aimed to evaluate the biomechanical performance of autologous bone-cages by comparing them with traditional PEEK and titanium cages using Finite element analysis (FEA)

  • Model validation To validate the model of intact lumbar spine L3-S, the range of motion (ROM) at the L3/4 level was compared to the literature

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Summary

Introduction

An autologous bone-cage made from the spinous process and laminae might provide a stability in posterior lumbar interbody fusion (PLIF) close that of the traditional-cage made of polyetheretherketone (PEEK) or titanium. This study aimed to verify whether autologous bone-cages can achieve similar performance as that of PEEK cages in PLIF by using a finite element analysis. The placement of interbody cages through a Traditional cages made of polyetheretherketone (PEEK) or titanium are widely used in lumbar fusion due to their good mechanical properties, which are close to that of cortical bone [2, 7]. Previous studies showed a high fusion rate after PLIF using cages made of autologous bone graft from spinous processes and laminae [8]. In one of our previous studies, the autologous bone-cage showed good performance in biomechanical in vitro experiments [9]

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