Stress Distribution of Different Pedicle Screw Insertion Techniques Following Single-Segment TLIF: A Finite Element Analysis Study

Overview

Journal Orthop Surg

Specialty Orthopedics

Date 2023 Mar 1

PMID 36855914

Authors

Simengge Yang

Tianze Sun

Liwen Zhang

Menglin Cong

Anyun Guo

Dakai Liu

Mingzhi Song

Affiliations

Soon will be listed here.

Abstract

Objectives: At present, a variety of posterior lumbar internal fixation implantation methods have been developed, which makes it difficult for spine surgeons to choose. The stress distribution of the internal fixation system is one of the important indexes to evaluate these technologies. Common insertion technologies include Roy Camille, Magerl, Krag, AO, and Weinstein insertion techniques. This study aimed to compare the distribution of von Mises stresses in different screw fixation systems established by these insertion technologies.

Methods: Here, the three-dimensional finite element (FE) method was selected to evaluate the postoperative stress distribution of internal fixation. Following different pedicle screw insertion techniques, five single-segment transforaminal lumbar interbody fusion (TLIF) models were established after modeling and validation of the L1-S1 vertebrae FE model.

Results: By analyzing the data, we found that stress concentration phenomenon was in all the models. Additionally, Roy-Camille, Krag, AO, and Weinstein insertion techniques led to the great stress on lumbar vertebra, intervertebral disc, and screw-rod fixation systems. Therefore, we hope that the results can provide ideas for clinical work and development of pedicle screws in the future. It is worth noting that flexion, unaffected side lateral bending, and affected side axial rotation should be limited for the patients with cages implanted.

Conclusions: Overall, our method obtained the results that Magerl insertion technique was the relatively safe approach for pedicle screw implantation due to its relatively dispersive stress in TLIF models.

Citing Articles

Biomechanical Characteristics of First Coronal Reverse Vertebrae in Lenke Type V Adolescent Idiopathic Scoliosis: A Study Using Finite Element Analysis.

Shang Z, Hou Z, Chen W, Chang H, Xu J, Zhang D Orthop Surg. 2024; 17(2):563-574.

PMID: 39653682 PMC: 11787968. DOI: 10.1111/os.14294.

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