A Hybrid Uniplanar Pedicle Screw System with a New Intermediate Screw for Minimally Invasive Spinal Fixation: A Finite Element Analysis.
A Hybrid Uniplanar Pedicle Screw System with a New Intermediate Screw for Minimally Invasive Spinal Fixation: A Finite Element Analysis.
复制标题
DOI：
10.1155/2020/5497030
复制
发表时间：
2020
影响因子：
--
通讯作者：
Zhang W
中科院分区：
文献类型：
--
作者：
Li J;Zhang LC;Li J;Zhang H;Zhao JX;Zhang W
基于单平面椎弓根螺钉结构和一种新型中间螺钉，研制了一种用于微创脊柱固定的混合椎弓根螺钉系统。采用有限元分析评价其生物力学性能。建立T12-L2 FE模型，模拟L1椎体压缩性骨折，Magerl分级为A1.2。建立了6种固定模型来模拟后路椎弓根螺钉骨折的固定，并将其分为两组，分别为(1)六轴/单平面/多轴椎弓根螺钉固定模型和(2)采用新型中间螺钉的四轴/单平面/多轴椎弓根螺钉固定模型。在模型验证后，对有限元模型施加7.5 Nm力矩的屈曲、伸展、侧向弯曲和轴向旋转以及500 N垂直压缩预载荷，比较6种固定模型在最大von Mises应力、运动范围和最大椎体位移下的生物力学性能。在4种加载情况下，最大von Mises应力出现在上、下椎弓根螺钉根部。在屈曲、侧弯和轴向旋转的情况下，各亚组中单平面螺钉结构的最大von Mises应力位于单轴和多轴螺钉结构之间。考虑到侧弯，在每个亚组中，单平面螺钉结构比单轴和多轴椎弓根螺钉结构更能降低最大von Mises应力。两个亚组在终板上的最大von Mises应力、T12- l1的活动范围和T12在相应结构间的最大位移方面的结果相似。本研究的观察结果证实，与其他后路短节段结构相比，混合单平面椎弓根螺钉系统具有相当的生物力学性能。这种新型固定系统的潜在优势可能为研究人员和临床医生提供一种微创脊柱固定与椎体增强的替代方法。
A hybrid pedicle screw system for minimally invasive spinal fixation was developed based on the uniplanar pedicle screw construct and a new intermediate screw. Its biomechanical performance was evaluated using finite element (FE) analysis. A T12-L2 FE model was established to simulate the L1 vertebral compression fracture with Magerl classification A1.2. Six fixation models were developed to simulate the posterior pedicle screw fracture fixation, which were divided into two subgroups with different construct configurations: (1) six-monoaxial/uniplanar/polyaxial pedicle screw constructs and (2) four-monoaxial/uniplanar/polyaxial pedicle screw constructs with the new intermediate screw. After model validation, flexion, extension, lateral bending, and axial rotation with 7.5 Nm moments and preloading of 500 N vertical compression were applied to the FE models to compare the biomechanical performances of the six fixation models with maximum von Mises stress, range of motion, and maximum displacement of the vertebra. Under four loading scenarios, the maximum von Mises stresses were found to be at the roots of the upper or lower pedicle screws. In the cases of flexion, lateral bending, and axial rotation, the maximum von Mises stress of the uniplanar screw construct lay in between the monoaxial and polyaxial screw constructs in each subgroup. Considering lateral bending, the uniplanar screw construct enabled to lower the maximum von Mises stress than monoaxial and polyaxial pedicle screw constructs in each subgroup. Two subgroups showed comparable results of the maximum von Mises stress on the endplates, range of motion of T12-L1, and maximum displacement of T12 between the corresponding constructs with the new intermediate screw or not. The observations shown in this study verified that the hybrid uniplanar pedicle screw system exhibited comparable biomechanical performance as compared with other posterior short-segment constructs. The potential advantage of this new fixation system may provide researchers and clinical practitioners an alternative for minimally invasive spinal fixation with vertebral augmentation.
登录
查看更多内容
影响因子：
1.8
作者：
Schmidt, Hendrik;Heuer, Frank;Wilke, Hans-Joachim
通讯作者：
Wilke, Hans-Joachim
DOI：
10.1016/j.msec.2017.02.014
发表时间：
2017-06-01
影响因子：
7.9
作者：
Okazaki, Yoshimitsu;Ishii, Daisuke;Ogawa, Atsushi
通讯作者：
Ogawa, Atsushi
影响因子：
2.3
作者：
Xu, G.;Fu, X.;Ma, X.
通讯作者：
Ma, X.
DOI：
10.6061/clinics/2017(10)04
发表时间：
2017-10
期刊：
Clinics (Sao Paulo, Brazil)
影响因子：
--
作者：
Wang H;Zhao Y;Mo Z;Han J;Chen Y;Yu H;Wang Q;Liu J;Li C;Zhou Y;Xiang L
通讯作者：
Xiang L
影响因子：
2
作者：
Basaran, Recep;Efendioglu, Mustafa;Ucar, Mehmet
通讯作者：
Ucar, Mehmet