Finite element analysis of polyetheretherketone and titanium rods in posterior lumbar interbody fusion

doi:10.12307/2023.398

Abstract

Abstract: BACKGROUND: Polyetheretherketone rod is a new material for semi-rigid fixation; however, its biomechanical properties in posterior lumbar interbody fusion remain unclear.
OBJECTIVE: To compare the biomechanical properties of polyetheretherketone rods and titanium rods in posterior lumbar interbody fusion, and try to answer whether polyetheretherketone rods have the potential to be a substitute for titanium rods, especially when the anterior column of the spine is not adequately supported.
METHODS: An intact L3-5 lumbar model was constructed using the finite element method. The four posterior lumbar interbody fusion constructs were developed: (1) polyetheretherketone rods with cage; (2) titanium rods with cage; (3) polyetheretherketone rods with bone grafts alone; and (4) titanium rods with bone grafts alone. The range of motion, stress and strain of the related structures were compared among the four posterior lumbar interbody fusion constructs.
RESULTS AND CONCLUSION: (1) There was no significant difference in the L4/5 range of motion among all surgical models. (2) Compared to titanium rods, polyetheretherketone rods increased the average strain of interbody bone grafts and the peak stresses of endplates and cages and reduced the peak stresses of the screws and bone-screw interfaces. The ratio of peak stress to yield stress for the polyetheretherketone rods (6%–26%) was higher than that for the titanium rods (3%–12%). (3) Polyetheretherketone rods only slightly reduced the range of motion and disc stress at the L3/4 segment. (4) Compared to titanium rods, polyetheretherketone rods maybe reduce the risks of pseudoarthroses, screw breaking, and loosening but lead to the higher risks of endplate collapse, cage failure, and rod fracture. Polyetheretherketone rods may have a weak advantage over titanium rods in retarding adjacent segment degeneration. Polyetheretherketone rods may be an alternative when interbody fusion is performed with bone grafts alone instead of cages.

Key words: polyetheretherketone rod, titanium rod, posterior lumbar interbody fusion, finite element analysis, stress shielding, bone graft alone, adjacent segment degeneration

CLC Number:

Li Jie, Cao Shuai, Guo Dong, Zhang Qiongchi, He Xijing, Li Haopeng, Lu Teng. Finite element analysis of polyetheretherketone and titanium rods in posterior lumbar interbody fusion[J]. Chinese Journal of Tissue Engineering Research, 2023, 27(22): 3445-3450.

Figures/Tables 4

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