Page 453 - IJB-9-5

International Journal of Bioprinting

RESEARCH ARTICLE
Designing an anatomical contour titanium

3D-printed oblique lumbar interbody fusion
cage with porous structure and embedded

fixation screws for patients with osteoporosis

Po-Liang Lai , Shao-Fu Huang , Hsuan-Wen Wang , Pei-Hsin Liu , Chun-Li Lin *
2
1
3
2
2
1 Department of Orthopedic Surgery, Bone and Joint Research Center, Chang Gung Memorial
Hospital at Linkou, College of Medicine, Chang Gung University, Taoyuan City, Taiwan
2 Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Hsinchu,
Taiwan
3
Department of Biomedical Engineering, Medical Device Innovation & Translation Center, National
Yang Ming Chaio Tung University, Hsinchu, Taiwan
Abstract

This study aimed to design an anatomical contour metal three-dimensional (3D)-
printed oblique lateral lumbar interbody fusion (OLIF) cage with porous (lattices)
structure and embedded screw fixation to enhance bone ingrowth to reduce the risk
*Corresponding author: of cage subsidence and avoid the stress-shielding effect. Finite element (FE) analysis
Chun-Li Lin and weight topology optimization (WTO) were used to optimize the structural design
(cllin2@nycu.edu.tw)
of the OLIF cage based on the anatomical contour morphology of patients with
Citation: Lai P-L, Huang S-F, osteoporosis. Two oblique embedded fixation screws and lattice design with 65%
Wang H-W, et al., 2023, Designing
an anatomical contour titanium porosity and average pore size of 750 μm were equipped with the cage structure.
3D-printed oblique lumbar interbody The cage was fabricated via metal 3D printing, and static/dynamic compression and
fusion cage with porous structure compressive-shear tests were performed in accordance with the ASTM F2077-14
and embedded fixation screws for
patients with osteoporosis. standard to evaluate its mechanical resistance. On FE analysis, the OLIF cage with
Int J Bioprint, 9(5): 772. embedded screw model had the most stability, lowest stress values on the endplate,
https://doi.org/10.18063/ijb.772 and uniform stress distribution versus standalone cage and fixed with lateral plate
Received: January 27, 2023 under extension, lateral flexion, and rotation. The fatigue test showed that the
Accepted: April 6, 2023 stiffnesses/endurance limits (pass 5 million dynamic test) were 16,658 N/mm/6000 N
Published Online: June 13, 2023
for axial load and 19,643 N/mm/2700 N for compression shear. In conclusion, an OLIF
Copyright: © 2023 Author(s). cage with embedded fixation screws can be designed by integrating FE and WTO
This is an Open Access article analysis based on the statistical results of endplate morphology. This improves the
distributed under the terms of the
Creative Commons Attribution stability of the OLIF cage to decrease endplate destruction. The complex contour and
License, permitting distribution, lattice design of the OLIF cage need to be manufactured via metal 3D printing; the
and reproduction in any medium, dynamic axial compression and compressive-shear strengths are greater than that of
provided the original work is
properly cited. the U.S. Food and Drug Administration (FDA) standard.
Publisher’s Note: Whioce
Publishing remains neutral with Keywords: Oblique lumbar interbody fusion; Cage; 3D printing; Finite element;
regard to jurisdictional claims in
published maps and institutional Topological optimization
affiliations.

Volume 9 Issue 5 (2023) 445 https://doi.org/10.18063/ijb.772