PhD Scientific Days 2023

Clinical Medicine III.

The Effect of Screw PMMA Augmentation on the Primary Stability of Different Implants Used in Oblique Lumbar Interbody Fusion with Normal and Osteoporotic Bone Quality – a Finite Element Assisted Study

Előadó neve

Dr. Ferenc, Bereczki

Neptun code

N3S91O

Előadó munkahelye

In Silico Biomechanics Laboratory, National Center for Spinal Disorders, Buda Health Center, Budapest, Hungary; School of PhD Studies, Semmelweis University, Budapest, Hungary

Előadó telefonszáma

+36-30/289-54-22

Előadó e-mail címe

bereczki.f0074@gmail.com

Az előadás címe

The Effect of Screw PMMA Augmentation on the Primary Stability of Different Implants Used in Oblique Lumbar Interbody Fusion with Normal and Osteoporotic Bone Quality – a Finite Element Assisted Study

Szerző(k) neve és munkahelye

Ferenc Bereczki (2,4), Máté Turbucz(2,4), Ágoston Pokorni(2,4), Áron Lazáry (2,3), Péter Endre Éltes(2,3),
1. National Center for Spinal Disorders, Buda Health Center, Budapest, Hungary
2. In Silico Biomechanics Laboratory, National Center for Spinal Disorders, Buda Health Center, Budapest, Hungary
3. Department of Spine Surgery, Department of Orthopaedics, Semmelweis University, Budapest, Hungary
4. School of PhD Studies, Semmelweis University, Budapest, Hungary

Bemutatás módja

Szóbeli

Szekció

Clinical Medicine III.

Language of the presentation

English

Preferred session

Clinical Medicine

Összefoglaló szövege

Introduction: Oblique lumbar interbody fusion (OLIF) is a minimally invasive surgical procedure and can be ideal for older population, with numerous comorbidities and decreased bone quality. Stabilisation can be achieved with bilateral pedicle screws (BPS - additional incisions and longer operative time), or self-anchoring stand-alone lateral plate systems (SSA - no additional incision is required). The primary construct stability is a vital factor in the long-term patient recovery. In osteoporosis, PMMA augmentation is often used, but a fairly new concept in OLIF surgery.
Aims: The aim of this study is to investigate stabilising effect of screw augmentation on different implants used in OLIF surgery with normal and osteoporotic bone quality using finite element analysis.
Method: An L2-L4 spinal finite element model was created and validated with different bone material properties. The OLIF implant models were inserted inside the L3-L4 motion-segment with increasing volumes of PMMA augmentation. 400 N follower load was applied on the instrumented models, with 10 Nm torque in the 6 general motion directions.
Results: Except for left bending BPS had smaller segmental ROM (range of motion), and the difference is increased by osteoporosis. At approximately 3 cm3 injected PMMA/screw SSA, and standard BPS values were comparable. In osteoporosis the general caudal displacement of the cage in SSA construct is increased by 101%. 2 cm3/screw PMMA injection decreased this value by 33%, making it comparable to the BPS construct. Both ROM, and cage caudal displacement had negative linear correlation with the amount of injection. PMMA injection had greater stabilising effect on screw tip displacement in SSA constructs. At 3 cm3 injected PMMA/screw BPS had 28%, SSA had 46 % decrease in screw tip displacement.
Conclusion: Based on the results, the BPS system provides more primal segmental stability compared to the SSA system in osteoporosis. However, OLIF screw augmentation has the possibility to reduce the observed differences, and this effect seems to correlate with the amount of injected PMMA. In order to fully understand the implications, further biomechanical testing is required.
Funding: Supported by the ÚNKP-22-3-II New National Excellence Program of the Ministry for Culture and Innovation from the source of the National Research, Development and Innovation Fund.

University and Doctoral School

Semmelweis University, Károly Rácz Doctoral School of Clinical Medicine

Supervisor

Dr. Éltes Péter Endre, PhD; Dr. Lazáry Áron, PhD

Publication of my abstract

I do not give consent to the publication of my abstract on the website of the congress.

Kind

Szabad

Status

elfogadva

Accepted presentation method

szóbeli

Előadás fájl jóváhagyás

nem rendelkezett róla

Előadó

6091

Start

09:00

End

09:15

Authors (legacy)

Ferenc Bereczki (2,4), Máté Turbucz(2,4), Ágoston Pokorni(2,4), Áron Lazáry (2,3), Péter Endre Éltes(2,3),
1. National Center for Spinal Disorders, Buda Health Center, Budapest, Hungary
2. In Silico Biomechanics Laboratory, National Center for Spinal Disorders, Buda Health Center, Budapest, Hungary
3. Department of Spine Surgery, Department of Orthopaedics, Semmelweis University, Budapest, Hungary
4. School of PhD Studies, Semmelweis University, Budapest, Hungary