Suggestion of a safe zone for C1 pedicle screws depending on anatomical peculiarities

Lenz, Maximilian; Harland, Arne; Egenolf, Philipp; Perera, Akanksha; Pennig, Lenhard; Bredow, Jan; Eysel, Peer; Scheyerer, Max Joseph

doi:10.1007/s00586-021-06993-z

Cited by 4 publications

(1 citation statement)

References 26 publications

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“…[3,4] Thoracolumbar fractures often lead to patients with thoracolumbar instability. [5,6] If internal fixation treatment is not carried out in time, it will further lead to the aggravation of spinal cord injury and paralysis of the corresponding segments, causing huge losses and burdens to patients, their families, and society. The spinal pedicle screw internal fixation system meets the biomechanical requirements of spinal fixation and can effectively fix the anterior, middle, and posterior spine.…”

Section: Introductionmentioning

confidence: 99%

Biomechanical characteristics of 2 different posterior fixation methods of bilateral pedicle screws: A finite element analysis

Zhang

Song

et al. 2022

Medicine

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Background: To explore the biomechanical characteristics of 2 posterior bilateral pedicle screw fixation methods using finite element analysis.Methods: A normal L3-5 finite element model was established. Based on the verification of its effectiveness, 2 different posterior internal fixation methods were simulated: bilateral pedicle screws (model A) were placed in the L3 and L5 vertebral bodies, and bilateral pedicle screws (model B) were placed in the L3, L4, and L5 vertebral bodies. The stability and stress differences of intervertebral discs, endplates, screws, and rods between models were compared.Results: Compared with the normal model, the maximum stress of the range of motion, intervertebral disc, and endplate of the 2 models decreased significantly. Under the 6 working conditions, the 2 internal fixation methods have similar effects on the stress of the endplate and intervertebral disc, but the maximum stress of the screws and rods of model B is smaller than that of model A.Conclusions: Based on these results, it was found that bilateral pedicle screw fixation in 2 vertebrae L3 and L5 can achieve similar stability as bilateral pedicle screw fixation in 3 vertebrae L3, L4, and L5. However, the maximum stress of the screw and rod in model B is less than that in model A, so this internal fixation method can effectively reduce the risk of fracture. The 3-dimensional finite element model established in this study is in line with the biomechanical characteristics of the spine and can be used for further studies on spinal column biomechanics. This information can serve as a reference for clinicians for surgical selection.

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