BACKGROUND Which lumbar fusion approaches having fewer impacts on the lumbar spine, reducing the risk of complications and the most conducive to bone fusion under whole-body vibration is urgent to know. OBJECTIVES This study researched the best approach under vibration by comparing the effects of four different approaches on the spine, especially regarding some significant indexes related to complications and outcomes. METHODS The L1-L5 finite element model was modified to simulate anterior, posterior, trans-foraminal and direct lateral lumbar interbody fusion approaches with bilateral pedicle screw fixation at L4-L5 level. FINDINGS Anterior lumbar interbody fusion decreased the corresponding vibration amplitude of the dynamic response at adjacent segments compared with the other three approaches. Direct lateral lumbar interbody fusion decreased the maximum stress in the cage, the endplates at the fused level, and the maximum compressive stress at the interface between the cage and endplates. The maximum disc height and segmental lordosis of Direct lateral lumbar interbody fusion model were the highest among these fusion approaches. INTERPRETATION Anterior lumbar interbody fusion may provide a more stable environment for the adjacent segments under vibration. Direct lateral lumbar interbody fusion may reduce the risk of subsidence, cage failure, and adjacent segment disease. Direct lateral lumbar interbody fusion may provide a more stable and suitable environment for vertebral cell growth and lead to better fusion outcomes. The findings may help us understand the effect of various fusion approaches on lumbar and provide some references for choosing a fusion approach.

中文翻译：

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比较四种椎间融合方法在振动下对融合段和相邻段的影响。

背景技术迫切需要知道哪种腰椎融合​​方法对腰椎的影响较小，降低并发症的风险并且最有利于在全身振动下进行骨融合。目的本研究通过比较四种不同方法对脊柱的影响，特别是与并发症和结果相关的一些重要指标，研究了振动下的最佳方法。方法修改L1-L5有限元模型，以模拟前路，后路，椎间孔和直接外侧腰椎椎间融合术，并以L4-L5水平双侧椎弓根螺钉固定。结果与其他三种方法相比，前路腰椎椎间融合治疗降低了相邻节段动态响应的相应振动幅度。直接外侧腰椎椎间融合减少了融合器中的最大应力，端板处于融合水平，并降低了融合器和终板之间界面的最大压缩应力。在这些融合方法中，直接外侧腰椎椎间融合模型的最大椎间盘高度和节段性脊柱前凸最高。解释前腰椎椎间融合可以为振动下的相邻节段提供更稳定的环境。直接的外侧腰椎椎间融合可以减少下陷，笼破裂和相邻节段疾病的风险。直接外侧腰椎椎间融合可以为椎细胞的生长提供更稳定和合适的环境，并导致更好的融合结果。