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This analysis investigates the biomechanical performance of lateral plating compared to bilateral pedicle screws in lumbar interbody fusion.

April 22, 2026Spine Open

Biomechanical In Vitro Analysis of Construct Fatigue Comparing Lateral Lumbar Interbody Fusion With Lateral Plate Augmentation to Bilateral Pedicle Screw Fixation

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Biomechanical analysis compares range-of-motion in lumbar interbody fusion with lateral versus posterior fixation, indicating potential alternatives.

This analysis investigates the biomechanical performance of lateral plating compared to bilateral pedicle screws in lumbar interbody fusion.
Fifteen cadaveric functional spine units were tested with either two-screw or four-screw lateral plates or bilateral pedicle screws after lateral lumbar interbody fusion.
Range-of-motion was measured using a motion simulator in multiple conditions: intact, post-operative, post-fatigue, and post-instability.
Fatigue was simulated with 1000 loading cycles to assess structural changes.
Post-operative range-of-motion significantly decreased compared to intact conditions.
All groups showed increased motion after fatigue simulations but the changes were not statistically significant.
Two-screw lateral plates showed the most instability after fatigue, while bilateral pedicle screws maintained more rigid performance.

Shah et al. (2026) studied this question.

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Biomechanical analysis compares range-of-motion in lumbar interbody fusion with lateral versus posterior fixation, indicating potential alternatives.