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Research ArticleArticles

Biomechanics of an Expandable Lumbar Interbody Fusion Cage Deployed Through Transforaminal Approach

Michael Conti Mica, Leonard I. Voronov, Gerard Carandang, Robert M. Havey, Bartosz Wojewnik and Avinash G. Patwardhan
International Journal of Spine Surgery January 2017, 11 (4) 24; DOI: https://doi.org/10.14444/4024
Michael Conti Mica
1Department of Orthopaedic Surgery and Rehabilitation, Loyola University Medical Center, Maywood, Illinois
MD
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Leonard I. Voronov
1Department of Orthopaedic Surgery and Rehabilitation, Loyola University Medical Center, Maywood, Illinois
2Musculoskeletal Biomechanics Laboratory, Department of Veterans Affairs, Edward Hines Jr. VA Hospital, Hines, Illinois
MD, PhD
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Gerard Carandang
2Musculoskeletal Biomechanics Laboratory, Department of Veterans Affairs, Edward Hines Jr. VA Hospital, Hines, Illinois
MS
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Robert M. Havey
1Department of Orthopaedic Surgery and Rehabilitation, Loyola University Medical Center, Maywood, Illinois
2Musculoskeletal Biomechanics Laboratory, Department of Veterans Affairs, Edward Hines Jr. VA Hospital, Hines, Illinois
MS
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Bartosz Wojewnik
1Department of Orthopaedic Surgery and Rehabilitation, Loyola University Medical Center, Maywood, Illinois
MD
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Avinash G. Patwardhan
1Department of Orthopaedic Surgery and Rehabilitation, Loyola University Medical Center, Maywood, Illinois
2Musculoskeletal Biomechanics Laboratory, Department of Veterans Affairs, Edward Hines Jr. VA Hospital, Hines, Illinois
Ph.D.
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  • Article
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Article Figures & Data

Figures

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  • Fig. 1
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    Fig. 1

    Lumbar spine (L1-L5) experimental set-up showing compressive follower preload cables and guides.

  • Fig. 2
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    Fig. 2

    Fluoroscopic images of protocol steps: 1) Intact spine; 2) Stand-alone ALIF 3) ALIF + Bilateral pedicle screws; 4) Stand-alone expandable TLIF; 5)Expandable TLIF + Bilateral pedicle screws.

  • Fig. 3
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    Fig. 3

    View of inferior endplates and implant placements after sectioning of intervertebral disc. A) Expandable TLIF cage showing the posterior approach. B) ALIF cage showing the anterior approach.

  • Fig. 4
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    Fig. 4

    Expandable TLIF cage surgical stages. A) interbody cage during deployment, B) cage fully deployed, C) cage expanded.

  • Fig. 5
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    Fig. 5

    Range of motion of ALIF and the expandable TLIF devices in both implanted segments (L2-L3 and L3-L4) in flexion-extension without preload.

  • Fig. 6
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    Fig. 6

    Range of motion of ALIF and the expandable TLIF devices in both implanted segments (L2-L3 and L3-L4) in flexion-extension under 400N follower preload.

  • Fig. 7
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    Fig. 7

    Range of motion of ALIF and expandable TLIF devices in both implanted segments (L2-L3 and L3-L4) in lateral bending.

  • Fig. 8
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    Fig. 8

    Range of motion of ALIF and expandable TILF devices in both implanted segments (L2-L3 and L3-L4) in axial rotation.

Tables

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    Table 1

    Segmental Range of motion* (Mean ± SD) with (experimental) TLIF cage (degrees).

    IntactTLIFTLIF+PS% Change TLIF from Intact% Change TLIF+PS from Intact
    Flexion-Extension ON7.1±1.13.3±1.30.6±0.3-53±18%-91±3.9%
    Flexion-Extension 400N7.1±1.13.1±1.10.6±0.2-57±14%-91±3.5%
    Lateral Bending8.0±1.54.1±1.51.1±0.4-50±16%-86±4.5%
    Axial Rotation2.4±1.41.5±0.50.7±0.2-21±40%-62±24%
    • ↵* Reported ranges of motion are from combined L2-L3 and L3-L4 motion data.

    • View popup
    Table 2

    Segmental Range of motion* (Mean ± SD) with (control) ALIF cage (degrees).

    IntactALIFALIF+PS% Change ALIF from Intact% Change ALIF+PS from Intact
    Flexion-Extension 0N7.4±1.85.2±1.40.8±0.3-28±15%-89±4.7%
    Flexion-Extension 400N7.4±1.62.9±0.80.6±0.1-61±12%-92±1.9%
    Lateral Bending8.9±1.93.9±1.71.1±0.4-56±14%-88±3.4%
    Axial Rotation2.6±2.11.6±0.90.6±0.3-22±36%-66±22%
    • ↵* Reported ranges of motion are from combined L2-L3 and L3-L4 motion data.

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International Journal of Spine Surgery
Vol. 11, Issue 4
1 Jan 2017
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Biomechanics of an Expandable Lumbar Interbody Fusion Cage Deployed Through Transforaminal Approach
Michael Conti Mica, Leonard I. Voronov, Gerard Carandang, Robert M. Havey, Bartosz Wojewnik, Avinash G. Patwardhan
International Journal of Spine Surgery Jan 2017, 11 (4) 24; DOI: 10.14444/4024

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Biomechanics of an Expandable Lumbar Interbody Fusion Cage Deployed Through Transforaminal Approach
Michael Conti Mica, Leonard I. Voronov, Gerard Carandang, Robert M. Havey, Bartosz Wojewnik, Avinash G. Patwardhan
International Journal of Spine Surgery Jan 2017, 11 (4) 24; DOI: 10.14444/4024
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Keywords

  • lumbar spine
  • expandable cage
  • tlif
  • fusion
  • biomechanics

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