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지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2021.10
- 수록면
- 566 - 574 (9page)
- DOI
- 10.31616/asj.2020.0353
이용수
초록· 키워드
오류제보하기
Study Design: Biomechanical study.
Purpose: To quantitatively investigate the effect of screw size on screw fixation in osteoporotic vertebrae with finite element analysis (FEA) Overview of Literature: Osteoporosis poses a challenge in spinal instrumentation; however, the selection of screw size is directly related to fixation and is closely dependent on each surgeon’s experience and preference.
Methods: Total 1,200 nonlinear FEA with various screw diameters (4.5?7.5 mm) and lengths (30?50 mm) were performed on 25 patients (seven men and 18 women; mean age, 75.2±10.8 years) with osteoporosis. The axial pullout strength, and the vertebral fixation strength of a paired-screw construct against flexion, extension, lateral bending, and axial rotation were examined. Thereafter, we calculated the equivalent stress of the bone-screw interface during nondestructive loading. Then, using diameter parameters (screw diameter or screw fitness in the pedicle [%fill]), and length parameters (screw length or screw depth in the vertebral body [%length]), multiple regression analyses were performed in order to evaluate the factors affecting various fixations.
Results: Larger diameter and longer screws significantly increased the pullout strength and vertebral fixation strength; further, they decreased the equivalent stress around the screws. Multiple regression analyses showed that the actual screw diameter and %length were factors that had a stronger effect on the fixation strength than %fill and the actual screw length. Screw diameter had a greater effect on the resistance to screw pullout and flexion and extension loading (β=0.38?0.43, p<0.01); while the %length had a greater effect on resistance to lateral bending and axial rotation loading (β=0.25?0.36, p<0.01) as well as mechanical stress of the bone-screw interface (β=?0.42, p<0.01).
Conclusions: The screw size should be determined based on the biomechanical behavior of the screws, type of mechanical force applied on the corresponding vertebra, and anatomical limitations.
목차
등록된 정보가 없습니다.
참고문헌 (25)
참고문헌 신청
Halvorson TL / 1994 / Effects of bone mineral density on pedicle screw fixation / Spine(Phila Pa 1976) 19:2415~2420
Zindrick MR / 1986 / A biomechanical study of intrapeduncular screw fixation in the lumbosacral spine / Clin Orthop Relat Res (203):99~112
Hsu CC / 2005 / Increase of pullout strength of spinal pedicle screws with conical core : biomechanical tests and finite element analyses / J Orthop Res 23:788~794
Chao CK / 2008 / Increasing bending strength and pullout strength in conical pedicle screws : biomechanical tests and finite element analyses / J Spinal Disord Tech 21:130~138
Chatzistergos PE / 2010 / The influence of the insertion technique on the pullout force of pedicle screws : an experimental study / Spine(Phila Pa 1976) 35:E332~7
Zindrick MR / 1986 / A biomechanical study of intrapeduncular screw fixation in the lumbosacral spine / Clin Orthop Relat Res (203):99~112
Hsu CC / 2005 / Increase of pullout strength of spinal pedicle screws with conical core : biomechanical tests and finite element analyses / J Orthop Res 23:788~794
Chao CK / 2008 / Increasing bending strength and pullout strength in conical pedicle screws : biomechanical tests and finite element analyses / J Spinal Disord Tech 21:130~138
Chatzistergos PE / 2010 / The influence of the insertion technique on the pullout force of pedicle screws : an experimental study / Spine(Phila Pa 1976) 35:E332~7
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