The feasibility of short-segment Schanz screw implanted in an oblique downward direction for the treatment of lumbar 1 burst fracture: a finite element analysis

Liu, Jifeng; Yang, Shu-hua; Fei, Zhou; Lu, Jianrong; Xia, Chunyang; Wang, Huanhuan; Chen, Chao

doi:10.1186/s13018-020-02024-7

Cited by 7 publications

(5 citation statements)

References 24 publications

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“…[30] Furthermore, in tests using synthetic spines, a maximum non-destructive axial compression of 350 N is recommended. [31,32] Accordingly, we chose 325 N which corresponded to a 3 mm displacement. The first set of experiments were carried out using a synthetic biomimetic lumbar spine model (Sawbones, WA, USA) at the L3-L4 vertebrae level.…”

Section: Resultsmentioning

confidence: 99%

Patient‐Specific Self‐Powered Metamaterial Implants for Detecting Bone Healing Progress

Barri

Zhang

Swink

et al. 2022

Adv Funct Materials

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There is an unmet need for developing a new class of smart medical implants with novel properties and advanced functionalities. Here, the concept of “self‐aware implants” is proposed to enable the creation of a new generation of multifunctional metamaterial implantable devices capable of responding to their environment, empowering themselves, and self‐monitoring their condition. These functionalities are achieved via integrating nano energy harvesting and mechanical metamaterial design paradigms. Various aspects of the proposed concept are highlighted by developing proof‐of‐concept interbody spinal fusion cage implants with self‐sensing, self‐powering, and mechanical tunability features. Bench‐top testing is performed using synthetic biomimetic and human cadaver spine models to evaluate the electrical and mechanical performance of the developed patient‐specific metamaterial implants. The results show that the self‐aware cage implants can diagnose bone healing process using the voltage signals generated internally through their built‐in contact‐electrification mechanisms. The voltage and current generated by the implants under the axial compression forces of the spine models reach 9.2 V and 4.9 nA, respectively. The metamaterial implants can serve as triboelectric nanogenerators to empower low‐power electronics. The capacity of the proposed technology to revolutionize the landscape of implantable devices and to achieve better surgical outcomes is further discussed.

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Section: Resultsmentioning

confidence: 99%

Patient‐Specific Self‐Powered Metamaterial Implants for Detecting Bone Healing Progress

Barri

Zhang

Swink

et al. 2022

Adv Funct Materials

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“…Upward and backward traction not only makes the bone fragments continue to be restored upward, but also makes the bone fragments displaced forward and downward return upward and backward [8]. The author's research based on his finite element model of burst fracture shows that it is safe to implant pedicle screw oblique downward within 15 degrees [19,21].…”

Section: Mechanism and Advantage Of Traction Reduction Of Oblique Dow...mentioning

confidence: 99%

“…The author's series of studies on the treatment of thoracolumbar fractures with short-segment pedicle screw fixation since 2018 showed that [8,12,18,19,21]: the maximum stress of pedicle screws increased with the aggravation of fracture degree, and the increase of screw stress in forward flexion was the most obvious. In moderate thoracolumbar fracture (LSC score 4-6), the risk of screw breakage is low with both types of screws, so brace assistance is not required.…”

Section: Thoracolumbosacral Orthosis (Tlso)mentioning

confidence: 99%

Short-Segment Schanz Pedicle Screw Oblique Downward Fixation for Thoracolumbar Burst Fractures: A New Method for the Reduction of Intraspinal Bone Fragments

Yang¹,

Xia²

2022

Frontiers in Spinal Neurosurgery

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Short-segment pedicle screw internal fixation for thoracolumbar burst fracture has been widely used in clinic. When the fracture fragment enters the spinal canal seriously, it is often necessary to decompress. The authors pioneered the reduction of fracture fragments in the spinal canal by direct traction with pedicle screws implanted obliquely downward without lamina decompression. Compared with the previous pedicle screw parallel endplate fixation and lamina decompression, this new method has less trauma, better reduction and can remove the internal fixation after fracture healing. Compared with conventional pedicle screws, short-segment Schanz pedicle screws are more similar to normal posterior columns in structure and stress conduction and have better safety and stability, so the latter is more suitable for the treatment of severe burst fractures.

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“…Four previous study models were referenced to generate the fractured spine model [32,[34][35][36]. Each study conducted a comparative analysis according to the screw type, fracture level, and CS screw insertion angle.…”

Section: Spinal Fracturementioning

confidence: 99%

Numerical Evaluation of Spinal Stability after Posterior Spinal Fusion with Various Fixation Segments and Screw Types in Patients with Osteoporotic Thoracolumbar Burst Fracture Using Finite Element Analysis

et al. 2021

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The aim of this study was to analyze the spinal stability and safety after posterior spinal fusion with various fixation segments and screw types in patients with an osteoporotic thoracolumbar burst fracture based on finite element analysis (FEA). To realize various osteoporotic vertebral fracture conditions on T12, seven cases of Young’s modulus, namely 0%, 1%, 5%, 10%, 25%, 50%, and 100% of the Young’s modulus, for vertebral bones under intact conditions were considered. Four types of fixation for thoracolumbar fracture on T12 (fixed with T11-L1, T10-T11-L1, T11-L1-L2, and T10-T11-L1-L2) were applied to the thoracolumbar fusion model. The following screw types were considered: pedicle screw (PS) and cortical screw (CS). Using FEA, four motions were performed on the fixed spine, and the stress applied to the screw, peri-implant bone (PIB), and intervertebral disc (IVD) and the range of motion (ROM) were calculated. The lowest ROM calculated corresponded to the T10-T11-L1-L2 model, while the closest to the intact situation was achieved in the T11-L1-L2 fixation model using PS. The lowest stress in the screw and PB was detected in the T10-T11-L1-L2 fixation model.

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The feasibility of short-segment Schanz screw implanted in an oblique downward direction for the treatment of lumbar 1 burst fracture: a finite element analysis

Cited by 7 publications

References 24 publications

Patient‐Specific Self‐Powered Metamaterial Implants for Detecting Bone Healing Progress

Patient‐Specific Self‐Powered Metamaterial Implants for Detecting Bone Healing Progress

Short-Segment Schanz Pedicle Screw Oblique Downward Fixation for Thoracolumbar Burst Fractures: A New Method for the Reduction of Intraspinal Bone Fragments

Numerical Evaluation of Spinal Stability after Posterior Spinal Fusion with Various Fixation Segments and Screw Types in Patients with Osteoporotic Thoracolumbar Burst Fracture Using Finite Element Analysis

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