Transforaminal lumbar interbody fusion (TLIF) surgery: A finite element analysis of open and minimally invasive approach on L4-L5 segment

Background: To compare the effect of minimally invasive and open transforaminal lumbar interbody fusion (TLIF) approaches in fusing the L4-L5 segment and predicting the potential risk of adjacent segment degeneration (ASD). Methods: A computed tomography scan image was processed and the three-dimens...

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Main Authors: Kishore Pradeep, Bidyut Pal, Kaushik Mukherjee, Gautam M. Shetty
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:Heliyon
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Online Access:http://www.sciencedirect.com/science/article/pii/S2405844025002221
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author Kishore Pradeep
Bidyut Pal
Kaushik Mukherjee
Gautam M. Shetty
author_facet Kishore Pradeep
Bidyut Pal
Kaushik Mukherjee
Gautam M. Shetty
author_sort Kishore Pradeep
collection DOAJ
description Background: To compare the effect of minimally invasive and open transforaminal lumbar interbody fusion (TLIF) approaches in fusing the L4-L5 segment and predicting the potential risk of adjacent segment degeneration (ASD). Methods: A computed tomography scan image was processed and the three-dimensional model of the L1-L5 spine was reconstructed. The minimally invasive and Open TLIF finite element models were constructed. The models were analyzed using an axial compressive load (500 N) and physiological movements like flexion, extension, and lateral bending with a combined load and moment (150 N and 10 Nm). The ranges of motion (ROM), stress-strain distributions on the L4-L5 implanted segment and cranial adjacent soft structures were compared with the intact model. Results: A substantially comparable drop in ROM was observed for both models due to implantation. The stress and strain distributions on the implanted segment of both models were nearly identical. The peak strain on the L4-L5 was higher than 0.007 for both models. The maximum stress and strain observed on adjacent segment soft structures, except for the annulus fibrosus of both the implanted models, were substantially higher than the intact structures. Conclusions: The open and MI-TLIF approaches are effective in reducing ROMs. However, the higher stress and strain on the L4-L5 segment indicate the chances of bone failure. The higher stress and strain on the adjacent segment soft structures indicate the potential risk of ASD in both models. However, considering the lower intrusive nature of the MI-TLIF technique, it might be favoured over Open TLIF.
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spelling doaj-art-7aad8c91a000457f9328a6acde237a162025-02-02T05:28:21ZengElsevierHeliyon2405-84402025-01-01112e41842Transforaminal lumbar interbody fusion (TLIF) surgery: A finite element analysis of open and minimally invasive approach on L4-L5 segmentKishore Pradeep0Bidyut Pal1Kaushik Mukherjee2Gautam M. Shetty3Department of Mechanical Engineering, Indian Institute of Engineering Science and Technology (IIEST), Shibpur, Howrah, 711103, West Bengal, IndiaDepartment of Mechanical Engineering, Indian Institute of Engineering Science and Technology (IIEST), Shibpur, Howrah, 711103, West Bengal, India; Corresponding author. Department of Mechanical Engineering, Indian Institute of Engineering Science and Technology, Shibpur, Howrah, 711103, West Bengal, India.Department of Mechanical Engineering, Indian Institute of Technology Delhi, Hauz Khas, New Delhi, 110 016, IndiaQI Spine Clinic, Mumbai, India; Knee & Orthopaedic Clinic, Mumbai, IndiaBackground: To compare the effect of minimally invasive and open transforaminal lumbar interbody fusion (TLIF) approaches in fusing the L4-L5 segment and predicting the potential risk of adjacent segment degeneration (ASD). Methods: A computed tomography scan image was processed and the three-dimensional model of the L1-L5 spine was reconstructed. The minimally invasive and Open TLIF finite element models were constructed. The models were analyzed using an axial compressive load (500 N) and physiological movements like flexion, extension, and lateral bending with a combined load and moment (150 N and 10 Nm). The ranges of motion (ROM), stress-strain distributions on the L4-L5 implanted segment and cranial adjacent soft structures were compared with the intact model. Results: A substantially comparable drop in ROM was observed for both models due to implantation. The stress and strain distributions on the implanted segment of both models were nearly identical. The peak strain on the L4-L5 was higher than 0.007 for both models. The maximum stress and strain observed on adjacent segment soft structures, except for the annulus fibrosus of both the implanted models, were substantially higher than the intact structures. Conclusions: The open and MI-TLIF approaches are effective in reducing ROMs. However, the higher stress and strain on the L4-L5 segment indicate the chances of bone failure. The higher stress and strain on the adjacent segment soft structures indicate the potential risk of ASD in both models. However, considering the lower intrusive nature of the MI-TLIF technique, it might be favoured over Open TLIF.http://www.sciencedirect.com/science/article/pii/S2405844025002221Adjacent segment degenerationFinite element analysisLumbar spineTransforaminal lumbar interbody fusionDegenerative Disc Diseases
spellingShingle Kishore Pradeep
Bidyut Pal
Kaushik Mukherjee
Gautam M. Shetty
Transforaminal lumbar interbody fusion (TLIF) surgery: A finite element analysis of open and minimally invasive approach on L4-L5 segment
Heliyon
Adjacent segment degeneration
Finite element analysis
Lumbar spine
Transforaminal lumbar interbody fusion
Degenerative Disc Diseases
title Transforaminal lumbar interbody fusion (TLIF) surgery: A finite element analysis of open and minimally invasive approach on L4-L5 segment
title_full Transforaminal lumbar interbody fusion (TLIF) surgery: A finite element analysis of open and minimally invasive approach on L4-L5 segment
title_fullStr Transforaminal lumbar interbody fusion (TLIF) surgery: A finite element analysis of open and minimally invasive approach on L4-L5 segment
title_full_unstemmed Transforaminal lumbar interbody fusion (TLIF) surgery: A finite element analysis of open and minimally invasive approach on L4-L5 segment
title_short Transforaminal lumbar interbody fusion (TLIF) surgery: A finite element analysis of open and minimally invasive approach on L4-L5 segment
title_sort transforaminal lumbar interbody fusion tlif surgery a finite element analysis of open and minimally invasive approach on l4 l5 segment
topic Adjacent segment degeneration
Finite element analysis
Lumbar spine
Transforaminal lumbar interbody fusion
Degenerative Disc Diseases
url http://www.sciencedirect.com/science/article/pii/S2405844025002221
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