Biomechanical evaluation of a short-rod technique for lumbar fixation surgery
Objective: The purpose of this study was to analyze the stability and instrument-related complications associated with fixation of the lumbar spine using the Short-Rod (SR) technique.Methods: Using finite element analysis, this study assessed the stability of a bilateral lumbar fixation system when...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2022-08-01
|
| Series: | Frontiers in Bioengineering and Biotechnology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fbioe.2022.959210/full |
| _version_ | 1811322045239132160 |
|---|---|
| author | Ze-Bin Huang Mao-Dan Nie Ning-Ze Zhang Shu Liu Jia-Bin Yuan Xu-Miao Lin Cheng-Kung Cheng Zhi-Cai Shi Ning-Fang Mao |
| author_facet | Ze-Bin Huang Mao-Dan Nie Ning-Ze Zhang Shu Liu Jia-Bin Yuan Xu-Miao Lin Cheng-Kung Cheng Zhi-Cai Shi Ning-Fang Mao |
| author_sort | Ze-Bin Huang |
| collection | DOAJ |
| description | Objective: The purpose of this study was to analyze the stability and instrument-related complications associated with fixation of the lumbar spine using the Short-Rod (SR) technique.Methods: Using finite element analysis, this study assessed the stability of a bilateral lumbar fixation system when inserting the pedicle screws at angles of 10°, 15°, and 20° to the endplate in the sagittal plane. Using the most stable construct with a screw angle, the model was then assessed with different rod lengths of 25, 30, 35, and 45 mm. The optimal screw inclination angle and rod length were incorporated into the SR model and compared against traditional parallel screw insertion (pedicle screws in parallel to the endplate, PPS) in terms of the stability and risk of instrument-related complications. The following parameters were evaluated using the validated L4–L5 lumbar finite element model: axial stiffness, range of motion (ROM), stress on the endplate and facet joint, von-Mises stress on the contact surface between the screw and rod (CSSR), and screw displacement.Results: The results showed that the SR model with a 15° screw inclination angle and 35 mm rod length was superior in terms of construct stability and risk of complications. Compared to the PPS model, the SR model had lower stiffness, lower ROM, less screw displacement, and lower stress on the facet cartilage, the CSSR, and screws. However, the SR model also suffered more stress on the endplate in flexion and lateral bending.Conclusion: The SR technique with a 15° screw inclination and 35 mm rod length offers good lumbar stability with a low risk of instrument-related complications. |
| first_indexed | 2024-04-13T13:28:18Z |
| format | Article |
| id | doaj.art-79cdb8d7ed194736b8cfd5750841b5f1 |
| institution | Directory Open Access Journal |
| issn | 2296-4185 |
| language | English |
| last_indexed | 2024-04-13T13:28:18Z |
| publishDate | 2022-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Bioengineering and Biotechnology |
| spelling | doaj.art-79cdb8d7ed194736b8cfd5750841b5f12022-12-22T02:45:03ZengFrontiers Media S.A.Frontiers in Bioengineering and Biotechnology2296-41852022-08-011010.3389/fbioe.2022.959210959210Biomechanical evaluation of a short-rod technique for lumbar fixation surgeryZe-Bin Huang0Mao-Dan Nie1Ning-Ze Zhang2Shu Liu3Jia-Bin Yuan4Xu-Miao Lin5Cheng-Kung Cheng6Zhi-Cai Shi7Ning-Fang Mao8Department of Spine Surgery, First Affiliated Hospital of Naval Medical University, Shanghai, ChinaSchool of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, ChinaKey Laboratory of Biomechanics and Mechanobiology, Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, ChinaDepartment of Spine Surgery, First Affiliated Hospital of Naval Medical University, Shanghai, ChinaDepartment of Spine Surgery, First Affiliated Hospital of Naval Medical University, Shanghai, ChinaDepartment of Spine Surgery, First Affiliated Hospital of Naval Medical University, Shanghai, ChinaSchool of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Spine Surgery, First Affiliated Hospital of Naval Medical University, Shanghai, ChinaDepartment of Spine Surgery, First Affiliated Hospital of Naval Medical University, Shanghai, ChinaObjective: The purpose of this study was to analyze the stability and instrument-related complications associated with fixation of the lumbar spine using the Short-Rod (SR) technique.Methods: Using finite element analysis, this study assessed the stability of a bilateral lumbar fixation system when inserting the pedicle screws at angles of 10°, 15°, and 20° to the endplate in the sagittal plane. Using the most stable construct with a screw angle, the model was then assessed with different rod lengths of 25, 30, 35, and 45 mm. The optimal screw inclination angle and rod length were incorporated into the SR model and compared against traditional parallel screw insertion (pedicle screws in parallel to the endplate, PPS) in terms of the stability and risk of instrument-related complications. The following parameters were evaluated using the validated L4–L5 lumbar finite element model: axial stiffness, range of motion (ROM), stress on the endplate and facet joint, von-Mises stress on the contact surface between the screw and rod (CSSR), and screw displacement.Results: The results showed that the SR model with a 15° screw inclination angle and 35 mm rod length was superior in terms of construct stability and risk of complications. Compared to the PPS model, the SR model had lower stiffness, lower ROM, less screw displacement, and lower stress on the facet cartilage, the CSSR, and screws. However, the SR model also suffered more stress on the endplate in flexion and lateral bending.Conclusion: The SR technique with a 15° screw inclination and 35 mm rod length offers good lumbar stability with a low risk of instrument-related complications.https://www.frontiersin.org/articles/10.3389/fbioe.2022.959210/fullimplantation techniqueshort-rod techniquepedicle screwscrew inclination anglerod lengthbiomechanical evaluation |
| spellingShingle | Ze-Bin Huang Mao-Dan Nie Ning-Ze Zhang Shu Liu Jia-Bin Yuan Xu-Miao Lin Cheng-Kung Cheng Zhi-Cai Shi Ning-Fang Mao Biomechanical evaluation of a short-rod technique for lumbar fixation surgery Frontiers in Bioengineering and Biotechnology implantation technique short-rod technique pedicle screw screw inclination angle rod length biomechanical evaluation |
| title | Biomechanical evaluation of a short-rod technique for lumbar fixation surgery |
| title_full | Biomechanical evaluation of a short-rod technique for lumbar fixation surgery |
| title_fullStr | Biomechanical evaluation of a short-rod technique for lumbar fixation surgery |
| title_full_unstemmed | Biomechanical evaluation of a short-rod technique for lumbar fixation surgery |
| title_short | Biomechanical evaluation of a short-rod technique for lumbar fixation surgery |
| title_sort | biomechanical evaluation of a short rod technique for lumbar fixation surgery |
| topic | implantation technique short-rod technique pedicle screw screw inclination angle rod length biomechanical evaluation |
| url | https://www.frontiersin.org/articles/10.3389/fbioe.2022.959210/full |
| work_keys_str_mv | AT zebinhuang biomechanicalevaluationofashortrodtechniqueforlumbarfixationsurgery AT maodannie biomechanicalevaluationofashortrodtechniqueforlumbarfixationsurgery AT ningzezhang biomechanicalevaluationofashortrodtechniqueforlumbarfixationsurgery AT shuliu biomechanicalevaluationofashortrodtechniqueforlumbarfixationsurgery AT jiabinyuan biomechanicalevaluationofashortrodtechniqueforlumbarfixationsurgery AT xumiaolin biomechanicalevaluationofashortrodtechniqueforlumbarfixationsurgery AT chengkungcheng biomechanicalevaluationofashortrodtechniqueforlumbarfixationsurgery AT zhicaishi biomechanicalevaluationofashortrodtechniqueforlumbarfixationsurgery AT ningfangmao biomechanicalevaluationofashortrodtechniqueforlumbarfixationsurgery |