Wang Beiyang, Tang Jian, Wang Zhiqiang, Deng Chen, Lv Junqiao, Gao Fang, Xiong Xiaoyan, Sun Lin
Shanxi Bethune Hospital, Tongji Shanxi Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Taiyuan, China.
College of Mechanical and Vehicle Engineering, Taiyuan University of Technology, Taiyuan, China.
Front Bioeng Biotechnol. 2025 Feb 27;13:1430047. doi: 10.3389/fbioe.2025.1430047. eCollection 2025.
The distribution of cervical bones in ankylosing spondylitis (AS) differs from that of the normal cervical spine. Traditional simulation methods often yield inaccurate results in finite element analysis. The current study aimed to construct ankylosing spondylitis cervical spine fracture (ASCF) models based on Hounsfield Unit (HU) values to analyze the effects of different fixation approaches.
Quantitative HU measurements of cervical vertebrae and lateral masses were obtained from CT scans of 20 patients with AS. A finite element model of ASCF was constructed based on HU values and was compared with a traditional ASCF model from multiple perspectives. Additionally, three ASCF models were used to compare the effects of various fixation approaches. A meta-analysis of screw loosening rates was conducted to further validate the efficacy of the models.
The HU value of the cervical lateral mass in AS is higher than the corresponding mass in the vertebral body. Finite element analysis results indicated that the anterior approach is less stable compared to other approaches, as evidenced by the maximum stress (MS) value of the screw and the maximum displacement (MD) of the entire model. These findings were corroborated by the meta-analysis of screw loosening rates in ASCF.
ASCF exhibits an uneven distribution of cervical bone, with more severe osteoporosis in the anterior cervical spine. Consequently, simple anterior approaches to fixation may lead to screw loosening in ASCF.
强直性脊柱炎（AS）患者颈椎骨骼的分布与正常颈椎不同。传统的模拟方法在有限元分析中常常产生不准确的结果。本研究旨在基于亨氏单位（HU）值构建强直性脊柱炎颈椎骨折（ASCF）模型，以分析不同固定方法的效果。
从20例AS患者的CT扫描中获取颈椎椎体和侧块的HU定量测量值。基于HU值构建ASCF有限元模型，并从多个角度与传统ASCF模型进行比较。此外，使用三个ASCF模型比较各种固定方法的效果。对螺钉松动率进行荟萃分析，以进一步验证模型的有效性。
AS患者颈椎侧块的HU值高于椎体相应部位。有限元分析结果表明，与其他方法相比，前路固定的稳定性较差，这由螺钉的最大应力（MS）值和整个模型的最大位移（MD）所证实。ASCF螺钉松动率的荟萃分析证实了这些发现。
ASCF患者颈椎骨分布不均，颈椎前路骨质疏松更严重。因此，单纯的前路固定方法可能导致ASCF患者螺钉松动。
