{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T09:47:31Z","timestamp":1774000051685,"version":"3.50.1"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T00:00:00Z","timestamp":1773964800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Oblique lateral interbody fusion (OLIF) is a minimally invasive technique widely used for lumbar degenerative diseases. However, high rates of cage subsidence, particularly in osteoporotic bone, necessitate supplemental fixation. Traditional bilateral pedicle screw (BPS) fixation compromises OLIF's minimally invasive advantages, while conventional lateral plates provide limited stability in the sagittal plane. To address these limitations, we developed and evaluated a novel L-shaped side-locking plate (NLSLP) using finite element analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A validated L3-S1 finite element model was adapted to simulate L4\/5 OLIF. Four surgical models were constructed: stand-alone (SA) OLIF, OLIF with a two-screw lateral plate (LP-2), OLIF with bilateral pedicle screws (BPS), and OLIF with the NLSLP. Three bone density conditions\u2014normal bone density (NBD), osteopenia, and osteoporosis\u2014were modeled to evaluate the biomechanical performance of each configuration. The range of motion (ROM), stress distribution in the endplates, adjacent intervertebral discs, and internal fixation were analyzed under vertical load (400 N) and torque (7.5 N\u00b7m).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All NLSLP configurations significantly reduced ROM at the L4-L5 segment, with lateral bending and axial rotation reductions exceeding 85%, and flexion-extension reductions of 85.84% and 75.01% for the NLSLP-d model. Compared to LP-2, the NLSLP system provided 17.85%\u201318.22% greater restriction in sagittal plane motion. In osteoporotic models, the NLSLP still maintained biomechanical stability, with ROM reduction exceeding 65%. Increased stress in adjacent intervertebral discs was observed in all surgical models, with the NLSLP showing a 39.86%\u201345.12% increase in lateral bending stress. Stress on the L5 superior endplate was reduced across all loading conditions in the NLSLP model compared to the SA model, thus reducing the risk of endplate damage and cage subsidence. Internal fixation stress remained well below the material fatigue and yield strength, indicating favorable stress distribution in NLSLP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The NLSLP represents a viable adjunctive fixation option for OLIF, offering superior sagittal plane stability compared to LP-2 while retaining the minimally invasive and single-position advantages of the OLIF procedure.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2026.1779510","type":"journal-article","created":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T06:36:52Z","timestamp":1773988612000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Biomechanical evaluation of a novel L-shaped side-locking plate combined with OLIF: a finite element analysis considering 3 different bone densities"],"prefix":"10.3389","volume":"13","author":[{"given":"Zemin","family":"Wang","sequence":"first","affiliation":[{"name":"First Clinical Medical College, Ningxia Medical University","place":["Yinchuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lijun","family":"Wang","sequence":"additional","affiliation":[{"name":"Shandong Weigao Orthopedic Materials Co., Ltd.","place":["Weihai, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Honglai","family":"Zhang","sequence":"additional","affiliation":[{"name":"First Clinical Medical College, Ningxia Medical University","place":["Yinchuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei","family":"Guo","sequence":"additional","affiliation":[{"name":"First Clinical Medical College, Ningxia Medical University","place":["Yinchuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei","family":"Yang","sequence":"additional","affiliation":[{"name":"First Clinical Medical College, Ningxia Medical University","place":["Yinchuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wanzhong","family":"Yang","sequence":"additional","affiliation":[{"name":"First Clinical Medical College, Ningxia Medical University","place":["Yinchuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shiyong","family":"Wang","sequence":"additional","affiliation":[{"name":"First Clinical Medical College, Ningxia Medical University","place":["Yinchuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rong","family":"Ma","sequence":"additional","affiliation":[{"name":"First Clinical Medical College, Ningxia Medical University","place":["Yinchuan, China"]},{"name":"Department of Orthopedics, General Hospital of Ningxia Medical University","place":["Yinchuan, Ningxia, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhaohui","family":"Ge","sequence":"additional","affiliation":[{"name":"First Clinical Medical College, Ningxia Medical University","place":["Yinchuan, China"]},{"name":"Department of Orthopedics, General Hospital of Ningxia Medical University","place":["Yinchuan, Ningxia, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,20]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"89","DOI":"10.4184\/asj.2012.6.2.89","article-title":"Complications and morbidities of Mini-open anterior retroperitoneal lumbar interbody fusion: oblique lumbar interbody fusion in 179 patients","volume":"6","author":"Silvestre","year":"2012","journal-title":"Asian Spine J"},{"key":"B2","doi-asserted-by":"publisher","first-page":"536","DOI":"10.14245\/ns.2244954.477","article-title":"Perioperative clinical features and long-term prognosis after oblique lateral interbody fusion (OLIF), OLIF with anterolateral screw fixation, or OLIF with percutaneous pedicle fixation: a comprehensive treatment strategy for patients with lumbar degenerative disease","volume":"20","author":"Zhang","year":"2023","journal-title":"Neurospine"},{"key":"B3","doi-asserted-by":"publisher","first-page":"461","DOI":"10.3171\/2020.4.SPINE20198","article-title":"Anterior lumbar compared to oblique lumbar interbody approaches for multilevel fusions to the sacrum in adults with spinal deformity and degeneration","volume":"33","author":"Xi","year":"2020","journal-title":"J Neurosurg Spine"},{"key":"B4","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1097\/BRS.0000000000001650","article-title":"Perioperative complications in 155 patients who underwent oblique lateral interbody fusion surgery: perspectives and indications from a retrospective, multicenter survey","volume":"42","author":"Abe","year":"2017","journal-title":"Spine (Phila Pa 1976)"},{"key":"B5","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1177\/2192568221992098","article-title":"The influence of endplate morphology on cage subsidence in patients with stand-alone oblique lateral lumbar interbody fusion (OLIF)","volume":"13","author":"Hu","year":"2023","journal-title":"Global Spine J"},{"key":"B6","doi-asserted-by":"publisher","first-page":"e285","DOI":"10.1016\/j.wneu.2021.08.049","article-title":"Biomechanical evaluation of stand-alone oblique lateral lumbar interbody fusion under 3 different bone mineral density conditions: a finite element analysis","volume":"155","author":"Wang","year":"2021","journal-title":"World Neurosurg"},{"key":"B7","doi-asserted-by":"publisher","first-page":"10276","DOI":"10.1038\/s41598-025-94696-6","article-title":"Preoperative CT attenuation value classification assesses cage subsidence risk in 112 OLIF surgery cases","volume":"15","author":"Chen","year":"2025","journal-title":"Sci Rep"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1306","DOI":"10.14245\/ns.2346692.346","article-title":"Simultaneous single-position oblique lateral interbody fusion combined with unilateral percutaneous pedicle screw fixation for single-level lumbar Tuberculosis: a 3-year retrospective comparative study","volume":"20","author":"He","year":"2023","journal-title":"Neurospine"},{"key":"B9","doi-asserted-by":"publisher","first-page":"269","DOI":"10.1186\/s13018-022-03143-z","article-title":"Biomechanical study of oblique lumbar interbody fusion (OLIF) augmented with different types of instrumentation: a finite element analysis","volume":"17","author":"Cai","year":"2022","journal-title":"J Orthop Surg Res"},{"key":"B10","doi-asserted-by":"publisher","first-page":"371","DOI":"10.1186\/s13018-023-03838-x","article-title":"Fixation-induced surgical segment's High stiffness and the damage of posterior structures together trigger a higher risk of adjacent segment disease in patients with lumbar interbody fusion operations","volume":"18","author":"Cai","year":"2023","journal-title":"J Orthop Surg Res"},{"key":"B11","doi-asserted-by":"publisher","first-page":"29432","DOI":"10.1038\/s41598-024-80631-8","article-title":"An in vitro biomechanical evaluation of integrated lateral plate combined with oblique lateral interbody fusion in different bone conditions","volume":"14","author":"Wang","year":"2024","journal-title":"Sci Rep"},{"key":"B12","doi-asserted-by":"publisher","first-page":"1315","DOI":"10.2106\/00004623-199609000-00004","article-title":"Biomechanical study of screws in the lateral masses: variables affecting pull-out resistance","volume":"78","author":"Heller","year":"1996","journal-title":"J Bone Joint Surg Am"},{"key":"B13","doi-asserted-by":"publisher","first-page":"1359","DOI":"10.1007\/s00590-018-2207-x","article-title":"Stability of L-shaped and inverted triangle fixation assemblies in treating pauwels type II femoral neck fracture: a comparative mechanical study","volume":"28","author":"Giordano","year":"2018","journal-title":"Eur J Orthop Surg Traumatol"},{"key":"B14","doi-asserted-by":"publisher","first-page":"1562268","DOI":"10.3389\/fbioe.2025.1562268","article-title":"Biomechanical evaluation of oblique lateral interbody fusion with various fixation methods for degenerative lumbar scoliosis: a finite element analysis considering different bone densities","volume":"13","author":"Guo","year":"2025","journal-title":"Front Bioeng Biotechnol"},{"key":"B15","doi-asserted-by":"publisher","first-page":"962","DOI":"10.1186\/s13018-023-04461-6","article-title":"Biomechanical differences between two different shapes of oblique lumbar interbody fusion cages on whether to add posterior internal fixation system: a finite element analysis","volume":"18","author":"Liu","year":"2023","journal-title":"J Orthop Surg Res"},{"key":"B16","doi-asserted-by":"publisher","first-page":"804","DOI":"10.1186\/s12891-024-07887-z","article-title":"Finite element analysis of biomechanical investigation on diverse internal fixation techniques in oblique lumbar interbody fusion","volume":"25","author":"Yu","year":"2024","journal-title":"BMC Musculoskelet Disord"},{"key":"B17","doi-asserted-by":"publisher","first-page":"794","DOI":"10.1186\/s12891-022-05645-7","article-title":"Effects of osteoporosis on the biomechanics of various supplemental fixations co-applied with oblique lumbar interbody fusion (OLIF): a finite element analysis","volume":"23","author":"Liu","year":"2022","journal-title":"BMC Musculoskelet Disord"},{"key":"B18","doi-asserted-by":"publisher","first-page":"1508385","DOI":"10.3389\/fbioe.2024.1508385","article-title":"The effects of cage on endplate collapse after stand-alone OLIF: based on finite element analysis and in vitro mechanics experiments","volume":"12","author":"Li","year":"2024","journal-title":"Front Bioeng Biotechnol"},{"key":"B19","doi-asserted-by":"publisher","first-page":"2622","DOI":"10.1007\/s00586-021-06909-x","article-title":"Iatrogenic muscle damage in transforaminal lumbar interbody fusion and adjacent segment degeneration: a comparative finite element analysis of open and minimally invasive surgeries","volume":"30","author":"Kumaran","year":"2021","journal-title":"Eur Spine J"},{"key":"B20","doi-asserted-by":"publisher","first-page":"991","DOI":"10.1097\/01.BRS.0000061987.71624.17","article-title":"The effect of cement augmentation on the load transfer in an osteoporotic functional spinal unit: finite-element analysis","volume":"28","author":"Polikeit","year":"2003","journal-title":"Spine (Phila Pa 1976)"},{"key":"B21","doi-asserted-by":"publisher","first-page":"920","DOI":"10.1186\/s12891-022-05873-x","article-title":"Impact of cage position on biomechanical performance of stand-alone lateral lumbar interbody fusion: a finite element analysis","volume":"23","author":"Nan","year":"2022","journal-title":"BMC Musculoskelet Disord"},{"key":"B22","doi-asserted-by":"publisher","first-page":"556","DOI":"10.1007\/s00586-003-0556-5","article-title":"The importance of the endplate for interbody cages in the lumbar spine","volume":"12","author":"Polikeit","year":"2003","journal-title":"Eur Spine J"},{"key":"B23","doi-asserted-by":"publisher","first-page":"e126","DOI":"10.1016\/j.wneu.2021.12.105","article-title":"Biomechanical evaluation of an oblique lateral locking plate system for oblique lumbar interbody fusion: a finite element analysis","volume":"160","author":"Wang","year":"2022","journal-title":"World Neurosurg"},{"key":"B24","doi-asserted-by":"publisher","first-page":"695","DOI":"10.1080\/10255842.2010.493517","article-title":"Parametric convergence sensitivity and validation of a finite element model of the human lumbar spine","volume":"14","author":"Ayturk","year":"2011","journal-title":"Comput Methods Biomech Biomed Engin"},{"key":"B25","doi-asserted-by":"publisher","first-page":"1287","DOI":"10.1016\/j.medengphy.2008.09.006","article-title":"Finite element analysis of the spine: towards a framework of verification, validation and sensitivity analysis","volume":"30","author":"Jones","year":"2008","journal-title":"Med Eng Phys"},{"key":"B26","doi-asserted-by":"publisher","first-page":"E820","DOI":"10.1097\/BRS.0b013e3181894fb1","article-title":"Biomechanical evaluation of an interspinous stabilizing device, locker","volume":"33","author":"Shim","year":"2008","journal-title":"Spine (Phila Pa 1976)"},{"key":"B27","doi-asserted-by":"publisher","first-page":"1013","DOI":"10.1007\/s00586-009-0936-6","article-title":"Segmental in vivo vertebral motion during functional human lumbar spine activities","volume":"18","author":"Li","year":"2009","journal-title":"Eur Spine J"},{"key":"B28","doi-asserted-by":"publisher","first-page":"1256","DOI":"10.1097\/00007632-198911000-00020","article-title":"Three-dimensional movements of the whole lumbar spine and lumbosacral joint","volume":"14","author":"Yamamoto","year":"1989","journal-title":"Spine (Phila Pa 1976)"},{"key":"B29","doi-asserted-by":"publisher","first-page":"105741","DOI":"10.1016\/j.cmpb.2020.105741","article-title":"Biomechanical characterization of vertebral body replacement in situ: effects of different fixation strategies","volume":"197","author":"Dong","year":"2020","journal-title":"Comput Methods Programs Biomed"},{"key":"B30","doi-asserted-by":"publisher","first-page":"e17","DOI":"10.1016\/j.wneu.2018.11.139","article-title":"Efficacy of oblique lateral interbody fusion in treatment of degenerative lumbar disease","volume":"124","author":"Zhang","year":"2019","journal-title":"World Neurosurg"},{"key":"B31","doi-asserted-by":"publisher","first-page":"2985","DOI":"10.3390\/jcm12082985","article-title":"Stand-Alone oblique lumbar interbody fusion (OLIF) for the treatment of adjacent segment disease (ASD) after previous posterior lumbar fusion: clinical and radiological outcomes and comparison with posterior revision surgery","volume":"12","author":"Miscusi","year":"2023","journal-title":"J Clin Med"},{"key":"B32","doi-asserted-by":"publisher","first-page":"1331","DOI":"10.1016\/j.spinee.2013.03.048","article-title":"Biomechanics of lateral plate and pedicle screw constructs in lumbar spines instrumented at two levels with laterally placed interbody cages","volume":"13","author":"Nayak","year":"2013","journal-title":"Spine J"},{"key":"B33","doi-asserted-by":"publisher","first-page":"1060059","DOI":"10.3389\/fbioe.2023.1060059","article-title":"Biomechanical comparative analysis of conventional pedicle screws and cortical bone trajectory fixation in the lumbar spine: an in vitro and finite element study","volume":"11","author":"Pei","year":"2023","journal-title":"Front Bioeng Biotechnol"},{"key":"B34","doi-asserted-by":"publisher","first-page":"e969","DOI":"10.1016\/j.wneu.2018.10.182","article-title":"Cage subsidence and fusion rate in extreme lateral interbody fusion with and without fixation","volume":"122","author":"Chen","year":"2019","journal-title":"World Neurosurg"},{"key":"B35","first-page":"123","article-title":"Caudal vertebral body fractures following lateral interbody fusion in nonosteoporotic patients","volume":"14","author":"Tender","year":"2014","journal-title":"Ochsner J"},{"key":"B36","doi-asserted-by":"publisher","first-page":"584","DOI":"10.1186\/s13018-021-02725-7","article-title":"Additional lateral plate fixation has no effect to prevent cage subsidence in oblique lumbar interbody fusion","volume":"16","author":"Ge","year":"2021","journal-title":"J Orthop Surg Res"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2026.1779510\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T06:36:54Z","timestamp":1773988614000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2026.1779510\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,20]]},"references-count":36,"alternative-id":["10.3389\/fsurg.2026.1779510"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2026.1779510","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,20]]},"article-number":"1779510"}}