Digitalized Design of Extraforaminal Lumbar Interbody Fusion: A Computer-Based Simulation and Cadaveric Study

Mingjie Yang, Cheng Zeng, Song Guo, Jie Pan, Yingchao Han, Zeqing Li, Lijun Li and Jun Tan

PLOS ONE, 2014, vol. 9, issue 8, 1-6

Abstract: Purpose: This study aims to investigate the feasibility of a novel lumbar approach named extraforaminal lumbar interbody fusion (ELIF), a newly emerging minimally invasive technique for treating degenerative lumbar disorders, using a digitalized simulation and a cadaveric study. Methods: The ELIF surgical procedure was simulated using the Mimics surgical simulator and included dissection of the superior articular process, dilation of the vertebral foramen, and placement of pedicle screws and a cage. ELIF anatomical measures were documented using a digitalized technique and subsequently validated on fresh cadavers. Results: The use of the Mimics allowed for the vivid simulation of ELIF surgical procedures, while the cadaveric study proved the feasibility of this novel approach. ELIF had a relatively lateral access approach that was located 8–9 cm lateral to the median line with an access depth of approximately 9 cm through the intermuscular space. Dissection of the superior articular processes could fully expose the target intervertebral discs and facilitate a more inclined placement of the pedicle screws and cage with robust enhancement. Conclusions: According to the computer-based simulation and cadaveric study, it is feasible to perform ELIF. Further research including biomechanical study is needed to prove ELIF has a superior ability to preserve the posterior tension bands of the spinal column, with similar effects on spinal decompression, fixation, and fusion, and if it can enhance post-fusion spinal stability and expedites postoperative recovery.

Date: 2014
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0105646

DOI: 10.1371/journal.pone.0105646

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