Treatment of Thoracolumbar Fractures Through Different Short Segment Pedicle Screw Fixation Techniques: A Finite Element Analysis

• Main Authors: Tie‐nan Wang, Bao‐lin Wu, Rui‐meng Duan, Ya‐shuai Yuan, Ming‐jia Qu, Shuo Zhang, Wei Huang, Tao Liu, Xiao‐bing Yu
• Format: Article
• Language: English
• Published: Wiley 2020-04-01
• Series: Orthopaedic Surgery
• Subjects: Finite element analysis; Pedicle screw system; Thoracolumbar fracture
• Online Access: https://doi.org/10.1111/os.12643
• ISSN: 1757-7853; 1757-7861

Objective To compare the von Mises stresses of the pedicle screw system and the displacement of injured vertebrae using 3‐D finite element analysis, and to evaluate the curative effect of the pedicle screw system. Methods Finite element methods were used for biomechanical comparison of four posterior short segment pedicle screw fixation techniques. The different pedicle screw models are traditional trajectory (TT), Universal Spine System (USS), cortical bone trajectory (CBT), and CBT at the cranial level and pedicle screw (PS) at the caudal level (UP‐CBT). The stress distribution of the screws and connecting rods under different working conditions and the displacement of the injured vertebrae were compared and analyzed. Results After the pedicle screw system was fixed, the stress under vertical compression was mainly concentrated at the proximal end of the screw, while the stress was mainly concentrated on the connecting rod during flexion, extension, lateral flexion, and rotation. The TT group had the greatest stress during the flexion, extension, and left and right rotation. The UP‐CBT group was most stressed when the left and right sides were flexed; the stress of the USS screw system was less than that of the other three models during flexion, lateral flexion, and rotation. The maximum von Mises stress values of pedicle screws in all exercise states were 556.2, 340.7, 458.1, and 533.4 MPa, respectively. In the USS group, the displacement of the injured vertebra was small in the flexion, and the left and right lateral flexion and the right rotation were higher than in the TT group and the CBT group. The maximum displacements of the injured vertebrae in all motion states were 1.679, 1.604, 1.752, and 1.777 mm, respectively. Conclusion Universal Spine System pedicle screws are relatively less stressed under different working conditions, the risk of breakage is small, and the model is relatively stable; CBT screws do not exhibit better mechanical properties than conventional pedicle screws and USS pedicle screws.