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Design of a new bone implant and its instrumentation for spinal fusion via transforaminal approach

(2020)

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Forster_39161500_2020.pdf
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Abstract
Intervertebral fusion is a common procedure in case of disc disease, and especially in case of disc degeneration. A lumbar intervertebral fusion can be achieved via the insertion of a cage between the vertebrae that need to be fused. This insertion can be done via a transforaminal approach, which is a recent promising insertion approach reducing the risk of the operation and decreasing the length of the patient's recovery period. The cages which are currently available do not integrate into the bony junction or degrades once the junction done. Therefore, the aim of this thesis is to develop an appropriate design of a cage made of cortical bone and to provide the tools in order to implement it. So, it is hypothesized that the cage would integrate into the bony junction. The cage was designed using a systematic design approach, from which multiple possible solutions were generated, and the best ones were combined. Then, using finite element modelling, the cage was optimized in term of porosity regarding its strength and stiffness under axial compression. Additionally, a design of its instrumentation is provided, in order to evaluate the appropriate cage dimensions and insert it. All together, this thesis provides a design for a cage made of cortical bone and its instrumentation for spinal fusion. The cage design and implementation tools, however, still needs to be clinically validated. Eventually, some insight for future perspectives are provided.