000079775 001__ 79775 000079775 005__ 20200716101500.0 000079775 0247_ $$2doi$$a10.1186/s12938-019-0684-8 000079775 0248_ $$2sideral$$a112685 000079775 037__ $$aART-2019-112685 000079775 041__ $$aeng 000079775 100__ $$0(orcid)0000-0002-7985-6412$$aCalvo-Echenique, A. 000079775 245__ $$aIs there any advantage of using stand-alone cages? A numerical approach 000079775 260__ $$c2019 000079775 5060_ $$aAccess copy available to the general public$$fUnrestricted 000079775 5203_ $$aBackground: Segment fusion using interbody cages supplemented with pedicle screw fixation is the most common surgery for the treatment of low back pain. However, there is still much controversy regarding the use of cages in a stand-alone fashion. The goal of this work is to numerically compare the influence that each surgery has on lumbar biomechanics. Methods: A non-linear FE model of the whole lumbar spine was developed to compare between two types of cages (OLYS and NEOLIF) with and without supplementary fixation. The motion of the whole spine was analysed and the biomechanical environment of the adjacent segments to the operated one was studied. Moreover, the risk of subsidence of the cages was qualitatively evaluated. Results: A great ROM reduction occurred when supplementary fixation was used. This stiffening increased the stresses at the adjacent levels. It might be hypothesised that the overloading of these segments could be related with the clinically observed adjacent disc degeneration. Meanwhile, the stand-alone cages allowed for a wider movement, and therefore, the influence of the surgery on adjacent discs was much lower. Regarding the risk of subsidence, the contact pressure magnitude was similar for both intervertebral cage designs and near the value of the maximum tolerable pressure of the endplates. Conclusions: A minimally invasive posterior insertion of an intervertebral cage (OLYS or NEOLIF) was compared using a stand-alone design or adding supplementary fixation. The outcomes of these two techniques were compared, and although stand-alone cage may diminish the risk of disease progression to the adjacent discs, the spinal movement in this case could compromise the vertebral fusion and might present a higher risk of cage subsidence. 000079775 536__ $$9info:eu-repo/grantAgreement/ES/MINECO/DPI2016-79302-R 000079775 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttp://creativecommons.org/licenses/by/3.0/es/ 000079775 590__ $$a2.059$$b2019 000079775 591__ $$aENGINEERING, BIOMEDICAL$$b56 / 87 = 0.644$$c2019$$dQ3$$eT2 000079775 592__ $$a0.578$$b2019 000079775 593__ $$aMedicine (miscellaneous)$$c2019$$dQ2 000079775 593__ $$aRadiology, Nuclear Medicine and Imaging$$c2019$$dQ2 000079775 593__ $$aBiomedical Engineering$$c2019$$dQ2 000079775 593__ $$aRadiological and Ultrasound Technology$$c2019$$dQ3 000079775 593__ $$aBiomaterials$$c2019$$dQ3 000079775 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion 000079775 700__ $$aCegonino, J. 000079775 700__ $$0(orcid)0000-0003-0669-777X$$aPérez del Palomar, A.$$uUniversidad de Zaragoza 000079775 7102_ $$15004$$2605$$aUniversidad de Zaragoza$$bDpto. Ingeniería Mecánica$$cÁrea Mec.Med.Cont. y Teor.Est. 000079775 773__ $$g18 (2019), 63 [17 pp]$$pBiomedical Engineering Online$$tBiomedical Engineering Online$$x1475-925X 000079775 8564_ $$s2194056$$uhttps://zaguan.unizar.es/record/79775/files/texto_completo.pdf$$yVersión publicada 000079775 8564_ $$s87253$$uhttps://zaguan.unizar.es/record/79775/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada 000079775 909CO $$ooai:zaguan.unizar.es:79775$$particulos$$pdriver 000079775 951__ $$a2020-07-16-09:12:42 000079775 980__ $$aARTICLE