生物骨科材料与临床研究2026，Vol.23Issue(3)：1-9,9.DOI:10.3969/j.issn.1672-5972.2026.03.001
MIS-TLIF中Cage置入角度对内固定应力及邻近椎间盘力学影响的有限元分析
Finite element analysis of the effects of Cage insertion angles in MIS-TLIF on internal fixation stress and adjacent intervertebral disc biomechanics
摘要
Abstract
Objective To investigate the biomechanical effects of different cage insertion angles during minimally invasive transforaminal lumbar interbody fusion(MIS-TLIF)on internal fixation stability and adjacent intervertebral discs using three-dimensional finite element analysis,and to provide recommendations for optimal clinical practice.Methods A three-dimensional finite element model of the L3-S1 lumbar spine was reconstructed from CT imaging data.MIS-TLIF was simulated at the L4/5 segment,with the interbody cage inserted at the sagittal midline and tilted horizontally at 0°,15°,30°,and 45°,defined as groups A,B,C,and D,respectively.A compressive load of 500 N and a torque of 10 N·m were applied to each model to simulate lumbar motions(flexion,extension,lateral bending,and axial rotation).Range of motion(ROM),stress distribution on pedicle screws and cages,and stress changes in adjacent discs(L3/4,L5/S1)were analyzed.Results Compared with the intact model,all fusion models(A-D)showed a significant reduction in ROM across all motion states,with little difference among insertion angles.As the cage insertion angle increased,cage stress gradually rose,whereas the stress on the fixation system decreased.Meanwhile,disc stress at adjacent segments(L3/4,L5/S1)also increased with larger insertion angles.Conclusion Insertion of cages at different inclination angles during MIS-TLIF effectively reduces the range of motion(ROM)of the operated segment and enhances stability.As the insertion angle increases,cage stress rises,screw-rod system stress shows a slight decrease,and adjacent intervertebral disc stress increases accordingly.Considering segmental stability,load distribution,and adjacent segment loading,transverse(0°)insertion is recommended to achieve an optimal biomechanical balance and long-term risk control.关键词
MIS-TLIF/Cage置入角度/内固定系统/邻近节段/有限元分析Key words
MIS-TLIF/Cage insertion angle/Internal fixation system/Adjacent segment/Finite element analysis分类
医药卫生引用本文复制引用
尚德鹏,康源辞,付大鹏,廉皓屹,赵振华,丛洋,杨帆..MIS-TLIF中Cage置入角度对内固定应力及邻近椎间盘力学影响的有限元分析[J].生物骨科材料与临床研究,2026,23(3):1-9,9.基金项目
辽宁省科技计划联合计划(2024011521-JH3/4700) （2024011521-JH3/4700）
大连市科技局生命健康领域指导计划项目[大科社农(2023)243号] （2023）
