The Mismatch Between Bony Endplates and Grafted Bone Increases Screw Loosening Risk for OLIF Patients With ALSR Fixation Biomechanically
The mismatch between bony endplates (BEPs) and grafted bone (GB) triggers several complications biomechanically. However, no published study has identified whether this factor increases the risk of screw loosening by deteriorating the local stress levels. This study aimed to illustrate the biomechan...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-04-01
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| Series: | Frontiers in Bioengineering and Biotechnology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fbioe.2022.862951/full |
| _version_ | 1819045456142925824 |
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| author | Jing-Chi Li Tian-Hang Xie Zhuang Zhang Zhe-Tao Song Yue-Ming Song Jian-Cheng Zeng |
| author_facet | Jing-Chi Li Tian-Hang Xie Zhuang Zhang Zhe-Tao Song Yue-Ming Song Jian-Cheng Zeng |
| author_sort | Jing-Chi Li |
| collection | DOAJ |
| description | The mismatch between bony endplates (BEPs) and grafted bone (GB) triggers several complications biomechanically. However, no published study has identified whether this factor increases the risk of screw loosening by deteriorating the local stress levels. This study aimed to illustrate the biomechanical effects of the mismatch between BEP and GB and the related risk of screw loosening. In this study, radiographic and demographic data of 56 patients treated by single segment oblique lumbar interbody fusion (OLIF) with anterior lateral single rod (ALSR) fixation were collected retrospectively, and the match sufficiency between BEP and GB was measured and presented as the grafted bony occupancy rate (GBOR). Data in patients with and without screw loosening were compared; regression analyses identified independent risk factors. OLIF with different GBORs was simulated in a previously constructed and validated lumbosacral model, and biomechanical indicators related to screw loosening were computed in surgical models. The radiographic review and numerical simulations showed that the coronal plane’s GBOR was significantly lower in screw loosening patients both in the cranial and caudal vertebral bodies; the decrease in the coronal plane’s GBOR has been proven to be an independent risk factor for screw loosening. In addition, numerical mechanical simulations showed that the poor match between BEP and GB will lead to stress concentration on both screws and bone-screw interfaces. Therefore, we can conclude that the mismatch between the BEP and GB will increase the risk of screw loosening by deteriorating local stress levels, and the increase in the GBOR by modifying the OLIF cage’s design may be an effective method to optimize the patient’s prognosis. |
| first_indexed | 2024-12-21T10:28:51Z |
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| id | doaj.art-0494396d853e46e6a84a6712208a2a60 |
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| language | English |
| last_indexed | 2024-12-21T10:28:51Z |
| publishDate | 2022-04-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Bioengineering and Biotechnology |
| spelling | doaj.art-0494396d853e46e6a84a6712208a2a602022-12-21T19:07:15ZengFrontiers Media S.A.Frontiers in Bioengineering and Biotechnology2296-41852022-04-011010.3389/fbioe.2022.862951862951The Mismatch Between Bony Endplates and Grafted Bone Increases Screw Loosening Risk for OLIF Patients With ALSR Fixation BiomechanicallyJing-Chi Li0Tian-Hang Xie1Zhuang Zhang2Zhe-Tao Song3Yue-Ming Song4Jian-Cheng Zeng5Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital/West China School of Medicine for Sichuan University, Chengdu, ChinaDepartment of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital/West China School of Medicine for Sichuan University, Chengdu, ChinaDepartment of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital/West China School of Medicine for Sichuan University, Chengdu, ChinaDepartment of Imaging, West China Hospital, Chengdu, ChinaDepartment of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital/West China School of Medicine for Sichuan University, Chengdu, ChinaDepartment of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital/West China School of Medicine for Sichuan University, Chengdu, ChinaThe mismatch between bony endplates (BEPs) and grafted bone (GB) triggers several complications biomechanically. However, no published study has identified whether this factor increases the risk of screw loosening by deteriorating the local stress levels. This study aimed to illustrate the biomechanical effects of the mismatch between BEP and GB and the related risk of screw loosening. In this study, radiographic and demographic data of 56 patients treated by single segment oblique lumbar interbody fusion (OLIF) with anterior lateral single rod (ALSR) fixation were collected retrospectively, and the match sufficiency between BEP and GB was measured and presented as the grafted bony occupancy rate (GBOR). Data in patients with and without screw loosening were compared; regression analyses identified independent risk factors. OLIF with different GBORs was simulated in a previously constructed and validated lumbosacral model, and biomechanical indicators related to screw loosening were computed in surgical models. The radiographic review and numerical simulations showed that the coronal plane’s GBOR was significantly lower in screw loosening patients both in the cranial and caudal vertebral bodies; the decrease in the coronal plane’s GBOR has been proven to be an independent risk factor for screw loosening. In addition, numerical mechanical simulations showed that the poor match between BEP and GB will lead to stress concentration on both screws and bone-screw interfaces. Therefore, we can conclude that the mismatch between the BEP and GB will increase the risk of screw loosening by deteriorating local stress levels, and the increase in the GBOR by modifying the OLIF cage’s design may be an effective method to optimize the patient’s prognosis.https://www.frontiersin.org/articles/10.3389/fbioe.2022.862951/fulloblique lumbar interbody fusiongrafted bony occupancy ratescrew looseningbiomechanical deteriorationanterior lateral single rod fixation |
| spellingShingle | Jing-Chi Li Tian-Hang Xie Zhuang Zhang Zhe-Tao Song Yue-Ming Song Jian-Cheng Zeng The Mismatch Between Bony Endplates and Grafted Bone Increases Screw Loosening Risk for OLIF Patients With ALSR Fixation Biomechanically Frontiers in Bioengineering and Biotechnology oblique lumbar interbody fusion grafted bony occupancy rate screw loosening biomechanical deterioration anterior lateral single rod fixation |
| title | The Mismatch Between Bony Endplates and Grafted Bone Increases Screw Loosening Risk for OLIF Patients With ALSR Fixation Biomechanically |
| title_full | The Mismatch Between Bony Endplates and Grafted Bone Increases Screw Loosening Risk for OLIF Patients With ALSR Fixation Biomechanically |
| title_fullStr | The Mismatch Between Bony Endplates and Grafted Bone Increases Screw Loosening Risk for OLIF Patients With ALSR Fixation Biomechanically |
| title_full_unstemmed | The Mismatch Between Bony Endplates and Grafted Bone Increases Screw Loosening Risk for OLIF Patients With ALSR Fixation Biomechanically |
| title_short | The Mismatch Between Bony Endplates and Grafted Bone Increases Screw Loosening Risk for OLIF Patients With ALSR Fixation Biomechanically |
| title_sort | mismatch between bony endplates and grafted bone increases screw loosening risk for olif patients with alsr fixation biomechanically |
| topic | oblique lumbar interbody fusion grafted bony occupancy rate screw loosening biomechanical deterioration anterior lateral single rod fixation |
| url | https://www.frontiersin.org/articles/10.3389/fbioe.2022.862951/full |
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