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The effect of screw tunnels on the biomechanical stability of vertebral body after pedicle screws removal: a finite element analysis.

作者信息

Liu Jia-Ming, Zhang Yu, Zhou Yang, Chen Xuan-Yin, Huang Shan-Hu, Hua Zi-Kai, Liu Zhi-Li

机构信息

Department of Orthopedic Surgery, The First Affiliated Hospital of Nanchang University, No. 17 Yongwaizheng Street, Donghu District, Nanchang, 330006, Jiangxi Province, People's Republic of China.

Department of Orthopedic Surgery, Jiujiang No. 1 People's Hospital, Jiujiang, 332000, People's Republic of China.

出版信息

Int Orthop. 2017 Jun;41(6):1183-1187. doi: 10.1007/s00264-017-3453-y. Epub 2017 Mar 28.


DOI:10.1007/s00264-017-3453-y
PMID:28353052
Abstract

PURPOSE: Posterior reduction and pedicle screw fixation is a widely used procedure for thoracic and lumbar vertebrae fractures. Usually, the pedicle screws would be removed after the fracture healing and screw tunnels would be left. The aim of this study is to evaluate the effect of screw tunnels on the biomechanical stability of the lumbar vertebral body after pedicle screws removal by finite element analysis (FEA). METHODS: First, the CT values of the screw tunnels wall in the fractured vertebral bodies were measured in patients whose pedicle screws were removed, and they were then compared with the values of vertebral cortical bone. Second, an adult patient was included and the CT images of the lumbar spine were harvested. Three dimensional finite element models of the L1 vertebra with unilateral or bilateral screw tunnels were created based on the CT images. Different compressive loads were vertically acted on the models. The maximum loads which the models sustained and the distribution of the force in the different parts of the models were recorded and compared with each other. RESULTS: The CT values of the tunnels wall and vertebral cortical bone were 387.126±62.342 and 399.204±53.612, which were not statistically different (P=0.149). The models of three dimensional tetrahedral mesh finite element of normal lumbar 1 vertebra were established with good geometric similarity and realistic appearance. After given the compressive loads, the cortical bone was the first one to reach its ultimate stress. The maximum loads which the bilateral screw tunnels model, unilateral screw tunnel model, and normal vertebral model can sustain were 3.97 Mpa, 3.83 Mpa, and 3.78 Mpa, respectively. For the diameter of the screw tunnels, the model with a diameter of 6.5 mm could sustain the largest load. In addition, the stress distributing on the outside of the cortical bone gradually decreased as the thickness of the tunnel wall increased. CONCLUSIONS: Based on the FEA, pedicle screw tunnels would not decrease the biomechanical stability and strength of the vertebral body. A large diameter of screw tunnel and thick tunnel wall were helpful for the biomechanical stability of the vertebral body.

摘要

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引用本文的文献

[1]
Explantation of Pedicle Screws: When, Why, and How?

Cureus. 2024-10-17

[2]
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J Robot Surg. 2024-3-16

[3]
Poor bone mineral density aggravates adjacent segment's motility compensation in patients with oblique lumbar interbody fusion with and without pedicle screw fixation: An study.

Front Surg. 2022-8-31

[4]
Biomechanical characteristics of 2 different posterior fixation methods of bilateral pedicle screws: A finite element analysis.

Medicine (Baltimore). 2022-9-9

[5]
Biomechanical study of oblique lumbar interbody fusion (OLIF) augmented with different types of instrumentation: a finite element analysis.

J Orthop Surg Res. 2022-5-14

[6]
Biomechanical Effects of Pedicle Screw Positioning on the Surgical Segment in Models After Oblique Lumbar Interbody Fusion: An in-silico Study.

Int J Gen Med. 2022-2-2

[7]
[A finite element analysis of petal-shaped poly-axial locking plate fixation in treatment of Y-shaped patellar fracture].

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本文引用的文献

[1]
Biomechanical response of lumbar facet joints under follower preload: a finite element study.

BMC Musculoskelet Disord. 2016-3-15

[2]
Image driven subject-specific finite element models of spinal biomechanics.

J Biomech. 2016-4-11

[3]
Biomechanical evaluation of fixation strength among different sizes of pedicle screws using the cortical bone trajectory: what is the ideal screw size for optimal fixation?

Acta Neurochir (Wien). 2016-3

[4]
Is It Beneficial to Remove the Pedicle Screw Instrument After Successful Posterior Fusion of Thoracolumbar Burst Fractures?

Spine (Phila Pa 1976). 2015-6-1

[5]
Assessment of stress patterns on a spinal motion segment in healthy versus osteoporotic bony models with or without disc degeneration: a finite element analysis.

Spine J. 2015-3-2

[6]
Biomechanical comparison of anterior lumbar interbody fusion: stand-alone interbody cage versus interbody cage with pedicle screw fixation -- a finite element analysis.

BMC Musculoskelet Disord. 2013-7-26

[7]
Finite element application in implant research for treatment of lumbar degenerative disc disease.

Med Eng Phys. 2008-12

[8]
Three column stabilization through posterior approach alone: transpedicular placement of distractable cage with transpedicular screw fixation.

Neurol Med Chir (Tokyo). 2008-1

[9]
Relations between the bone density values from computerized tomography, and implant stability parameters: a clinical study of 230 regular platform implants.

J Clin Periodontol. 2007-8

[10]
The biomechanics of human femurs in axial and torsional loading: comparison of finite element analysis, human cadaveric femurs, and synthetic femurs.

J Biomech Eng. 2007-2

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