Biomechanical differences of coflex-f and pedicle screw fixation in stabilization of TLIF or ALIF condition - A finite element study

C. C. Lo, K. J. Tsai, Z. C. Zhong, Ching-Hua Hung

Research output: Chapter in Book/Report/Conference proceedingConference contributionpeer-review

Abstract

Lumbar interbody fusion is a common procedure for treating lower back pain related to degenerative disc diseases. The Coflex-F is a recently developed interspinous spacer, the makers of which claim that it can provide stabilization similar to pedicle screw fixation. Therefore, this study compares the biomechanical behavior of the Coflex-F device and pedicle screw fixation with transforaminal lumbar interbody fusion (TLIF) or anterior lumbar interbody fusion (ALIF) surgeries. This study used a validated three-dimensional finite element model of the L1-L5 lumbar intact spine. To simulate TLIF surgery, left lateral total facetectomy and partial discectomy were performed at the L3/L4 segment of this intact model. An AVS-TL moon cage (Stryker Orthopaedics) was implanted in the L3/L4 segment and using a Coflex-F device or pedicle screw fixation. To simulate ALIF surgery, partial discectomy and total nuclectomy were performed at the L3/L4 segment of this intact model. A SynCage-Open cage (Synthes Spine, Inc.) was implanted into the L3/L4 segment and combined with a Coflex-F device or pedicle screw fixation. A 400 N follower load and a 10 Nm moment were applied to the intact model to mimic four physiological motions. All four implanted models were subjected to 400 N follower load and specific moments in accordance with the hybrid test method. The results show that the Coflex-F device combined with ALIF surgery can provide stability similar to that of pedicle screw fixation combined with TLIF or ALIF surgery. Also, both the posterior instrumentations (Coflex-F and pedicle screw fixation) combined with TLIF surgery had lower stability than combined with ALIF surgery.

Original languageEnglish
Title of host publication6th World Congress of Biomechanics, WCB 2010 - In Conjunction with 14th International Conference on Biomedical Engineering, ICBME and 5th Asia Pacific Conference on Biomechanics, APBiomech
Pages565-568
Number of pages4
DOIs
StatePublished - 22 Oct 2010
Event6th World Congress of Biomechanics, WCB 2010 - In Conjunction with 14th International Conference on Biomedical Engineering, ICBME and 5th Asia Pacific Conference on Biomechanics, APBiomech - Singapore, Singapore
Duration: 1 Aug 20106 Aug 2010

Publication series

NameIFMBE Proceedings
Volume31 IFMBE
ISSN (Print)1680-0737

Conference

Conference6th World Congress of Biomechanics, WCB 2010 - In Conjunction with 14th International Conference on Biomedical Engineering, ICBME and 5th Asia Pacific Conference on Biomechanics, APBiomech
CountrySingapore
CitySingapore
Period1/08/106/08/10

Keywords

  • Anterior lumbar interbody fusion (ALIF)
  • Finite element
  • Interspinous spacer
  • Pedicle screw fixation
  • Transforaminal lumbar interbody fusion (TLIF)

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