Will the adjustment of insertional pedicle screw positions affect the risk of adjacent segment diseases biomechanically? An in-silico study
BackgroundThe fixation-induced biomechanical deterioration will increase the risk of adjacent segment diseases (ASD) after lumbar interbody fusion with Bilateral pedicle screw (BPS) fixation. The accurate adjustment of insertional pedicle screw positions is possible, and published studies have repor...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-01-01
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| Series: | Frontiers in Surgery |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2022.1004642/full |
| _version_ | 1797955326817861632 |
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| author | Chenyi Huang Zongchao Liu Zhangchao Wei Zhongxin Fang Zhipeng Xi Ping Cai Jingchi Li |
| author_facet | Chenyi Huang Zongchao Liu Zhangchao Wei Zhongxin Fang Zhipeng Xi Ping Cai Jingchi Li |
| author_sort | Chenyi Huang |
| collection | DOAJ |
| description | BackgroundThe fixation-induced biomechanical deterioration will increase the risk of adjacent segment diseases (ASD) after lumbar interbody fusion with Bilateral pedicle screw (BPS) fixation. The accurate adjustment of insertional pedicle screw positions is possible, and published studies have reported its mechanical effects. However, no studies clarified that adjusting insertional screw positions would affect the postoperative biomechanical environment and the risk of ASD. The objective of this study was to identify this issue and provide theoretical references for the optimization of insertional pedicle screw position selections.MethodsThe oblique lumbar interbody fusion fixed by BPS with different insertional positions has been simulated in the L4-L5 segment of our previously constructed and validated lumbosacral model. Biomechanical indicators related to ASD have been computed and recorded under flexion, extension, bending, and axial rotation loading conditions.ResultsThe change of screw insertional positions has more apparent biomechanical effects on the cranial than the caudal segment. Positive collections can be observed between the reduction of the fixation length and the alleviation of motility compensation and stress concentration on facet cartilages. By contrast, no pronounced tendency of stress distribution on the intervertebral discs can be observed with the change of screw positions.ConclusionsReducing the fixation stiffness by adjusting the insertional screw positions could alleviate the biomechanical deterioration and be an effective method to reduce the risk of ASD caused by BPS. |
| first_indexed | 2024-04-10T23:31:20Z |
| format | Article |
| id | doaj.art-06c495f9285b47889269aeb429062a77 |
| institution | Directory Open Access Journal |
| issn | 2296-875X |
| language | English |
| last_indexed | 2024-04-10T23:31:20Z |
| publishDate | 2023-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Surgery |
| spelling | doaj.art-06c495f9285b47889269aeb429062a772023-01-12T04:58:55ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2023-01-01910.3389/fsurg.2022.10046421004642Will the adjustment of insertional pedicle screw positions affect the risk of adjacent segment diseases biomechanically? An in-silico studyChenyi Huang0Zongchao Liu1Zhangchao Wei2Zhongxin Fang3Zhipeng Xi4Ping Cai5Jingchi Li6Department of Orthopedics, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, ChinaDepartment of Orthopedics, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, ChinaDepartment of Orthopedics, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, ChinaFluid and Power Machinery Key Laboratory of Ministry of Education, Xihua University, Chengdu, ChinaDepartment of Spine Surgery, Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing, ChinaDepartment of Orthopedics, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, ChinaDepartment of Orthopedics, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, ChinaBackgroundThe fixation-induced biomechanical deterioration will increase the risk of adjacent segment diseases (ASD) after lumbar interbody fusion with Bilateral pedicle screw (BPS) fixation. The accurate adjustment of insertional pedicle screw positions is possible, and published studies have reported its mechanical effects. However, no studies clarified that adjusting insertional screw positions would affect the postoperative biomechanical environment and the risk of ASD. The objective of this study was to identify this issue and provide theoretical references for the optimization of insertional pedicle screw position selections.MethodsThe oblique lumbar interbody fusion fixed by BPS with different insertional positions has been simulated in the L4-L5 segment of our previously constructed and validated lumbosacral model. Biomechanical indicators related to ASD have been computed and recorded under flexion, extension, bending, and axial rotation loading conditions.ResultsThe change of screw insertional positions has more apparent biomechanical effects on the cranial than the caudal segment. Positive collections can be observed between the reduction of the fixation length and the alleviation of motility compensation and stress concentration on facet cartilages. By contrast, no pronounced tendency of stress distribution on the intervertebral discs can be observed with the change of screw positions.ConclusionsReducing the fixation stiffness by adjusting the insertional screw positions could alleviate the biomechanical deterioration and be an effective method to reduce the risk of ASD caused by BPS.https://www.frontiersin.org/articles/10.3389/fsurg.2022.1004642/fulladjacent segment diseasesbiomechanical deteriorationinsertional screw positionsarm of forcepedicle screw fixation |
| spellingShingle | Chenyi Huang Zongchao Liu Zhangchao Wei Zhongxin Fang Zhipeng Xi Ping Cai Jingchi Li Will the adjustment of insertional pedicle screw positions affect the risk of adjacent segment diseases biomechanically? An in-silico study Frontiers in Surgery adjacent segment diseases biomechanical deterioration insertional screw positions arm of force pedicle screw fixation |
| title | Will the adjustment of insertional pedicle screw positions affect the risk of adjacent segment diseases biomechanically? An in-silico study |
| title_full | Will the adjustment of insertional pedicle screw positions affect the risk of adjacent segment diseases biomechanically? An in-silico study |
| title_fullStr | Will the adjustment of insertional pedicle screw positions affect the risk of adjacent segment diseases biomechanically? An in-silico study |
| title_full_unstemmed | Will the adjustment of insertional pedicle screw positions affect the risk of adjacent segment diseases biomechanically? An in-silico study |
| title_short | Will the adjustment of insertional pedicle screw positions affect the risk of adjacent segment diseases biomechanically? An in-silico study |
| title_sort | will the adjustment of insertional pedicle screw positions affect the risk of adjacent segment diseases biomechanically an in silico study |
| topic | adjacent segment diseases biomechanical deterioration insertional screw positions arm of force pedicle screw fixation |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2022.1004642/full |
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