FINITE ELEMENT STUDY ON ANTERIOR TRANSPEDICULAR SCREW-ARTIFICIAL VERTEBRAL BODY FIXATION IN LOWER CERVICAL SPINE_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

WU Weidong ^1,2,3 , SUN Peidong ^1,2,3 , LIU Xiong ^1,2,3 , CHEN Chun ^1,2 , WU Changfu ⁴ , OUYANG Jun ^1,2,3

1Department of Anatomy, Southern Medical University, Guangzhou Guangdong, 510515, P.R.China;;
2Guangdong Provincial Medical Biomechanical Key Laboratory;;
3Clinically Anatomical and Biomechanical Institute of Guangdong Provincial Orthopaedic Academy;;
4Department of Orthopaedics, the Affiliated Hospital of Putian University. Corresponding author: OUYANG Jun, E-mail: jouyang@126.com;

Corresponding author：

Keywords：

Lower cervical spine; Anterior transpedicular screw; Artificial vertebral body; Finite element analysis

DOI：

10.7507/1002-1892.20130322

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Objective To compare the biomechanical properties of the anterior transpedicular screw-artificial vertebral body (AVB) and conventional anterior screw plate system (AP) in lower cervical spine by finite element study. Methods CT images (C1-T1) were obtained from a 38-year-old female volunteer. The models of intact C3-7 (intact group), AP fixation (AP group), and AVB fixation (AVB group) were established and analyzed by Mimics 14.0, Geomagic Studio 2013, and ANSYS 14.0 softwares. The axial force of 74 N and moment couple of 1 N·m were loaded on the upper surface and upper facet joint surfaces of C3. Under conditions of flexion, extension, lateral bending, and rotation, the Von Mises stress distribution regularity and maximum equivalent stree of AP and AVB groups were recorded, and the range of motion (ROM) was also analyzed of 3 groups. Results The intact model of lower cervical spine (C3-7) was established, consisting of 286 382 elements and 414 522 nodes, and it was successfully validated with the previously reported cadaveric experimental data of Panjabi and Kallemeyn. The stress concentrated on the connection between plate and screw in AP group, while it distributed evenly in AVB group. Between AP and AVB groups, there was significant difference in maximum equivalent stress values under conditions of 74 N axial force, flexion, extension, and rotation. AVB group had smaller ROM of fixed segments and larger ROM of adjacent segments than AP group. Compared with intact group, whole ROM of the lower cervical spine decreased about 3°, but ROM of C3, 4 and C6, 7 segments increased nearly 5° in both AP and AVB groups. Conclusion As a new reconstruction method of lower cervical spine, AVB fixation provides better stability and lower risk of failure than AP fixation.

Citation： WU Weidong,SUN Peidong,LIU Xiong,CHEN Chun,WU Changfu,OUYANG Jun. FINITE ELEMENT STUDY ON ANTERIOR TRANSPEDICULAR SCREW-ARTIFICIAL VERTEBRAL BODY FIXATION IN LOWER CERVICAL SPINE. Chinese Journal of Reparative and Reconstructive Surgery, 2013, 27(12): 1466-1470. doi: 10.7507/1002-1892.20130322 Copy

1.	Boockvar JA, Philips MF, Telfeian AE, et al. Results and risk factors for anterior cervicothoracic junction surgery. J Neurosurg, 2001, 94(1 Suppl): 12-17.
2.	Okawa A, Sakai K, Hirai T, et al. Risk factors for early reconstruction failure of multilevel cervical corpectomy with dynamic plate fixation. Spine (Phila Pa 1976), 2011, 36(9): E582-587.
3.	Koller H, Hempfing A, Acosta F, et al. Cervical anterior transpedicular screw fixation. Part I: Study on morphological feasibility, indications, and technical prerequisites. Eur Spine J, 2008, 17(4): 523-538.
4.	欧阳钧, 陈春, 吴长福. 一种颈椎的人工椎体: 中国, 201220178924. 7 [P]. 2012-11-21.
5.	Mercer S, Bogduk N. The ligaments and annulus fibrosus of human adult cervical intervertebral discs. Spine (Phila Pa 1976), 1999, 24(7): 619-628.
6.	Lee SH, Im YJ, Kim KT, et al. Comparison of cervical spine biomechanics after fixed- and mobile-core artificial disc replacement: a finite element analysis. Spine (Phila Pa 1976), 2011, 36(9): 700-708.
7.	Hussain M, Natarajan RN, Fayyazi AH, et al. Screw angulation affects bone-screw stresses and bone graft load sharing in anterior cervical corpectomy fusion with a rigid screw-plate construct: a finite element model study. Spine J, 2009, 9(12): 1016-1023.
8.	Tchako A, Sadegh AM. Stress changes in intervertebral discs of the cervical spine due to partial discectomies and fusion. J Biomech Eng, 2009, 131(5): 051013.
9.	王成焘. 人体生物摩擦学. 北京: 科学出版社, 2008: 428-432.
10.	Panjabi MM, Crisco JJ, Vasavada A, et al. Mechanical properties of the human cervical spine as shown by three-dimensional load-displacement curves. Spine (Phila Pa 1976), 2001, 26(24): 2692-2700.
11.	Kallemeyn N, Gandhi A, Kode S, et al. Validation of a C2-C7 cervical spine finite element model using specimen-specific flexibility data. Med Eng Phys, 2010, 32(5): 482-489.
12.	李家顺, 贾连顺. 颈椎外科学. 上海: 上海科学技术出版社, 2004: 294-298.
13.	陈春, 赵卫东, 孙培栋, 等. 钉道强化对颈椎前路椎间融合术式稳定性影响的生物力学研究. 中国修复重建外科杂志, 2010, 24(10): 1174-1179.
14.	Hussain M, Natarajan RN, An HS, et al. Progressive disc degeneration at C5-C6 segment affects the mechanics between disc heights and posterior facets above and below the degenerated segment: A flexion-extension investigation using a poroelastic C3-T1 finite element model. Med Eng Phys, 2012, 34(5): 552-558.
15.	Fice JB, Cronin DS, Panzer MB. Cervical spine model to predict capsular ligament response in rear impact. Ann Biomed Eng, 2011, 39(8): 2152-2162.
16.	Lau D, Song Y, Guan Z, et al. Radiological outcomes of static vs expandable titanium cages after corpectomy: a retrospective cohort analysis of subsidence. Neurosurgery, 2013, 72(4): 529-539.
17.	Kim HW, Ryu JI, Bak KH. The safety and efficacy of cadaveric allografts and titanium cage as a fusion substitutes in pyogenic osteomyelitis. J Korean Neurosurg Soc, 2011, 50(4): 348-356.

1. Boockvar JA, Philips MF, Telfeian AE, et al. Results and risk factors for anterior cervicothoracic junction surgery. J Neurosurg, 2001, 94(1 Suppl): 12-17.
2. Okawa A, Sakai K, Hirai T, et al. Risk factors for early reconstruction failure of multilevel cervical corpectomy with dynamic plate fixation. Spine (Phila Pa 1976), 2011, 36(9): E582-587.
3. Koller H, Hempfing A, Acosta F, et al. Cervical anterior transpedicular screw fixation. Part I: Study on morphological feasibility, indications, and technical prerequisites. Eur Spine J, 2008, 17(4): 523-538.
4. 欧阳钧, 陈春, 吴长福. 一种颈椎的人工椎体: 中国, 201220178924. 7 [P]. 2012-11-21.
5. Mercer S, Bogduk N. The ligaments and annulus fibrosus of human adult cervical intervertebral discs. Spine (Phila Pa 1976), 1999, 24(7): 619-628.
6. Lee SH, Im YJ, Kim KT, et al. Comparison of cervical spine biomechanics after fixed- and mobile-core artificial disc replacement: a finite element analysis. Spine (Phila Pa 1976), 2011, 36(9): 700-708.
7. Hussain M, Natarajan RN, Fayyazi AH, et al. Screw angulation affects bone-screw stresses and bone graft load sharing in anterior cervical corpectomy fusion with a rigid screw-plate construct: a finite element model study. Spine J, 2009, 9(12): 1016-1023.
8. Tchako A, Sadegh AM. Stress changes in intervertebral discs of the cervical spine due to partial discectomies and fusion. J Biomech Eng, 2009, 131(5): 051013.
9. 王成焘. 人体生物摩擦学. 北京: 科学出版社, 2008: 428-432.
10. Panjabi MM, Crisco JJ, Vasavada A, et al. Mechanical properties of the human cervical spine as shown by three-dimensional load-displacement curves. Spine (Phila Pa 1976), 2001, 26(24): 2692-2700.
11. Kallemeyn N, Gandhi A, Kode S, et al. Validation of a C2-C7 cervical spine finite element model using specimen-specific flexibility data. Med Eng Phys, 2010, 32(5): 482-489.
12. 李家顺, 贾连顺. 颈椎外科学. 上海: 上海科学技术出版社, 2004: 294-298.
13. 陈春, 赵卫东, 孙培栋, 等. 钉道强化对颈椎前路椎间融合术式稳定性影响的生物力学研究. 中国修复重建外科杂志, 2010, 24(10): 1174-1179.
14. Hussain M, Natarajan RN, An HS, et al. Progressive disc degeneration at C5-C6 segment affects the mechanics between disc heights and posterior facets above and below the degenerated segment: A flexion-extension investigation using a poroelastic C3-T1 finite element model. Med Eng Phys, 2012, 34(5): 552-558.
15. Fice JB, Cronin DS, Panzer MB. Cervical spine model to predict capsular ligament response in rear impact. Ann Biomed Eng, 2011, 39(8): 2152-2162.
16. Lau D, Song Y, Guan Z, et al. Radiological outcomes of static vs expandable titanium cages after corpectomy: a retrospective cohort analysis of subsidence. Neurosurgery, 2013, 72(4): 529-539.
17. Kim HW, Ryu JI, Bak KH. The safety and efficacy of cadaveric allografts and titanium cage as a fusion substitutes in pyogenic osteomyelitis. J Korean Neurosurg Soc, 2011, 50(4): 348-356.

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Chinese Journal of Reparative and Reconstructive Surgery

FINITE ELEMENT STUDY ON ANTERIOR TRANSPEDICULAR SCREW-ARTIFICIAL VERTEBRAL BODY FIXATION IN LOWER CERVICAL SPINE

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