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Research ArticleBiomechanics

Comparative Biomechanical Analysis of Anterior Lumbar Interbody Fusion and Bilateral Expandable Transforaminal Lumbar Interbody Fusion Cages: A Finite Element Analysis Study

Mohamad Bakhaidar, Balaji Harinathan, Karthik Banurekha Devaraj, Andrew DeGroot, Narayan Yoganandan and Saman Shabani
International Journal of Spine Surgery August 2024, 18 (4) 441-447; DOI: https://doi.org/10.14444/8630
Mohamad Bakhaidar
1 Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA
2 Division of Neurosurgery, Department of Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
MD, MSc, FRCSc
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  • ORCID record for Mohamad Bakhaidar
  • For correspondence: mbakhaidar@mcw.edu
Balaji Harinathan
1 Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA
3 School of Mechanical Engineering, Vellore Institute of Technology, Chennai, Tamil Nadu, India
MS
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  • ORCID record for Balaji Harinathan
Karthik Banurekha Devaraj
1 Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA
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  • ORCID record for Karthik Banurekha Devaraj
Andrew DeGroot
1 Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA
MD
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Narayan Yoganandan
1 Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA
PʜD
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  • ORCID record for Narayan Yoganandan
Saman Shabani
1 Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA
MD
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  • ORCID record for Saman Shabani
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    Figure 1

    Three-dimensional representation of the finite element model. (A) Baseline intact model. (B) Axial (left) and posterior (right) views of the bilateral transforaminal lumbar interbody fusion model. (C) Anterior lumbar interbody fusion model with both lateral (left) and posterior (right) perspectives.

  • Figure 2
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    Figure 2

    Comparative analysis of motion at each vertebral segment in the anterior lumbar interbody fusion (ALIF) model and the 2 largest transforaminal lumbar interbody fusion (TLIF) cage models during flexion (A) and extension (B).

Tables

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    Table 1

    Dimensions of cages utilized in the study.

    CageHeight
    (mm)
    Width
    (mm)
    Length
    (mm)
    Lordotic Angle
    (°)
    Surface Area (mm2)
    TLIF cage 1982215340
    TLIF cage 29102515484
    TLIF cage 39102815536
    TLIF cage 49122815652
    TLIF cage 59123215740
    ALIF cage113426152194
    • Abbreviations: ALIF, anterior lumbar interbody fusion; TLIF, transforaminal lumbar interbody fusion.

    • View popup
    Table 2

    Degrees of range of motion in the intact spine model and spine models with each cage inserted during flexion and extension.

    FlexionIntactCage 1 TLIFCage 2 TLIFCage 3 TLIFCage 4 TLIFCage 5 TLIFALIF Cage
    T12–L14.364.414.414.404.414.414.39
    L1–L24.484.584.584.564.584.594.53
    L2–L33.333.393.393.363.393.403.35
    L3–L45.215.505.475.405.475.505.33
    L4–L54.013.653.893.953.984.224.04
    L5–S18.891.851.641.521.280.930.18
    Total30.2723.3723.3823.2023.1023.0621.83
    ExtensionIntactCage 1 TLIFCage 2 TLIFCage 3 TLIFCage 4 TLIFCage 5 TLIFALIF Cage
    T12–L15.435.475.465.465.465.475.52
    L1–L23.573.623.653.653.583.583.81
    L2–L33.083.193.193.193.193.193.17
    L3–L43.643.713.703.703.693.693.68
    L4–L51.431.631.691.861.942.172.51
    L5–S17.540.710.680.530.250.190.33
    Total24.7118.3218.3718.4018.1118.2819.02
    • Abbreviations: ALIF, anterior lumbar interbody fusion; TLIF, transforaminal lumbar interbody fusion.

    • View popup
    Table 3

    Endplate stress at L5 to S1 level measured in MPa.

    FlexionCage 1 TLIFCage 2 TLIFCage 3 TLIFCage 4 TLIFCage 5 TLIFALIF Cage
    L57.527.086.215.906.5914.22
    S17.446.466.456.196.6611.83
    ExtensionCage 1 TLIFCage 2 TLIFCage 3 TLIFCage 4 TLIFCage 5 TLIFALIF cage
    L52.353.514.574.624.8913.56
    S14.658.058.509.3211.9011.66
    • Abbreviations: ALIF, anterior lumbar interbody fusion; TLIF, transforaminal lumbar interbody fusion.

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International Journal of Spine Surgery
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1 Aug 2024
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Comparative Biomechanical Analysis of Anterior Lumbar Interbody Fusion and Bilateral Expandable Transforaminal Lumbar Interbody Fusion Cages: A Finite Element Analysis Study
Mohamad Bakhaidar, Balaji Harinathan, Karthik Banurekha Devaraj, Andrew DeGroot, Narayan Yoganandan, Saman Shabani
International Journal of Spine Surgery Aug 2024, 18 (4) 441-447; DOI: 10.14444/8630

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Comparative Biomechanical Analysis of Anterior Lumbar Interbody Fusion and Bilateral Expandable Transforaminal Lumbar Interbody Fusion Cages: A Finite Element Analysis Study
Mohamad Bakhaidar, Balaji Harinathan, Karthik Banurekha Devaraj, Andrew DeGroot, Narayan Yoganandan, Saman Shabani
International Journal of Spine Surgery Aug 2024, 18 (4) 441-447; DOI: 10.14444/8630
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Keywords

  • transforaminal interbody fusion (TLIF)
  • anterior lumbar interbody fusion (ALIF)
  • finite element
  • bilateral TLIF
  • expandable cages
  • Biomechanics

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