Chinese Journal of Tissue Engineering Research ›› 2025, Vol. 29 ›› Issue (21): 4421-4429.doi: 10.12307/2025.820

Previous Articles     Next Articles

Effect of minimally invasive interbody fusion device height on lumbar biomechanics in patients with adolescent lumbar disc herniation

Zhang Ruofan1, Guan Huanhuan1, He Zhuoqun1, Zhang Yunfeng2, Jin Feng3, Wang Zhiqiang4, Wang Jianzhong4, Li Xiaohe4, Zhu Yong5, Wang Haiyan4, Zhang Kai6   

  1. 1Graduate School of Inner Mongolia Medical University, Hohhot 010010, Inner Mongolia Autonomous Region, China; 2Department of Imaging, Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010010, Inner Mongolia Autonomous Region, China; 3Department of Imaging, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010010, Inner Mongolia Autonomous Region, China; 4Department of Human Anatomy, School of Basic Medicine, Inner Mongolia Medical University, Hohhot 010010, Inner Mongolia Autonomous Region, China; 5Inner Mongolia Hospital, Peking University Cancer Hospital (Cancer Hospital Affiliated to Inner Mongolia Medical University), Hohhot 010010, Inner Mongolia Autonomous Region, China; 6Department of Orthopedics, Ulanqab Second Hospital, Ulanqab 012000, Inner Mongolia Autonomous Region, China
  • Received:2024-05-06 Accepted:2024-08-23 Online:2025-07-28 Published:2024-12-04
  • Contact: Corresponding author: Li Xiaohe, Professor, Doctoral supervisor, Department of Human Anatomy, School of Basic Medicine, Inner Mongolia Medical University, Hohhot 010010, Inner Mongolia Autonomous Region, China Co-corresponding author: Zhu Yong, Master’s supervisor, Inner Mongolia Hospital, Peking University Cancer Hospital (Cancer Hospital Affiliated to Inner Mongolia Medical University), Hohhot 010010, Inner Mongolia Autonomous Region, China
  • About author:Zhang Ruofan, Master candidate, Graduate School of Inner Mongolia Medical University, Hohhot 010010, Inner Mongolia Autonomous Region, China
  • Supported by:
     Inner Mongolia Natural Science Foundation, No. 2020MS08124 (to LXH); Inner Mongolia Autonomous Region "Grassland Talent" Project Youth Innovation and Entrepreneurship Talent Project, No. 2020 (to LXH); Inner Mongolia Medical University Follow-up Scientific Research Project, No. 2020 (to LXH); Inner Mongolia Science and Technology Plan Project, No. 2019GG115 (to LXH); 2021 Inner Mongolia Autonomous Region Mongolian Medicine Collaborative Innovation Center Scientific Research Project (to LXH); 2021 Inner Mongolia Medical University Zhiyuan Talent Project, No. 2021 (to LXH); Inner Mongolia Project leader of the Autonomous Region Higher Education Innovation Team Development Plan, No. NMGIRT2419 (to WHY); Inner Mongolia Medical University 2021 School-level Scientific Research Key Project, No. YKD2021ZD001 (to LXH); Inner Mongolia Education Department Higher Education Innovation Team Development Plan, No. NMGIRT2227 (to LXH); 2022 "Grassland Talents" Project (to ZK); Inner Mongolia Autonomous Region 2023 Autonomous Region Key R&D and Achievement Transformation Plan (Science and Technology Support for Ecological Protection and High-Quality Development of the Yellow River Basin) Project, No. 2023YFHH0003 (to LXH) 

PDF

39

Abstract: BACKGROUND: Adolescent lumbar disc herniation is the main cause of low back pain in adolescents. At present, most of them are treated by conservative treatment. When long-term non-surgical treatment attempts, surgery may be necessary to prevent further injury when the patient’s symptoms are not sufficiently relieved or when the patient has symptoms of single nerve paralysis or compression of the cauda equina, it is very important to choose a suitable interbody fusion device for the surgical treatment of the patients.
OBJECTIVE: To explore the effects of minimally invasive interbody fusion with different heights on lumbar biomechanics in patients with adolescent lumbar disc herniation. 
METHODS: CT scans of a 17-year-old male patient with adolescent lumbar disc herniation (L4-5 segment herniation) were collected. After the three-dimensional reconstruction of MIMICS, the interbody fusion device equal to and 3 mm higher than the intervertebral space was selected for analysis, so two expandable mixed material interbody fusion devices were designed and reconstructed. Fusion device L: 11 mm high front, 9 mm high posterior, 9 mm wide, 28 mm long, and fusion device H: 14 mm high front, 11 mm high posterior, 11 mm wide, 28 mm long and the lumbar fusion device was modeled. The fusion device and lumbar spine model were optimized, inversely modeled, and then imported into ABAQUS, and finally the 3D model of lumbar fusion was obtained. The physiological activities of the human body were simulated, such as lumbar extension, forward bending, right bending, and left bending, to obtain the corresponding stress contours. The biomechanical characteristics of the L4-5 vertebra under seven different working conditions were observed. 
RESULTS AND CONCLUSION: (1) The maximum stress of the two kinds of fuses was in the condition of forward bending and backward extension, the stress value of H fuses was (18.27±3.80) MPa and (15.02±3.24) MPa; the stress value of L fuses was (9.16±0.05) MPa and (9.17±1.83) MPa. The stress values of the end plate of the H-fusion in the extension station were (19.11±4.03) MPa and (16.32±3.72) MPa respectively. The stress values of the L-fusion end plate were (9.13±0.01) MPa and (4.92±1.01) MPa respectively. (2) The stress of H-type fusing end plate was higher than that of L-type fusing end plate except for L-5 end plate at neutral position (P < 0.05). (3) Choosing an interbody fusion device with a height of more than 3 mm in the same intervertebral space has a more stable biomechanics.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: ">adolescent lumbar disc herniation, interbody fusion device, internal fixation, fusion device height, finite element analysis, biomechanics

CLC Number: