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논문 기본 정보

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학술저널
저자정보
Kulkarni Arvind Gopalrao (Mumbai Spine Scoliosis & Disc Replacement Centre) Kumar Priyambada (Bombay Hospital and Medical Research Centre, Mumbai, India) Shetty Gautam Manjayya (Orthopaedic Surgery, Knee & Orthopedic Clinic, Mumbai, India) Roy Sandipan (SRM Institute of Science and Technology, Kattankulathur, India) Manickam Pechimuthu Susai (SRM Institute of Science and Technology, Kattankulathur, India) Dhason Raja (SRM Institute of Science and Technology, Kattankulathur, India) Chadalavada Aditya Raghavendra Sai Siva (Bombay Hospital and Medical Research Centre, Mumbai, India) Adbalwad Yogesh Madhavrao (Bombay Hospital and Medical Research Centre, Mumbai, India)
저널정보
대한척추외과학회 Asian Spine Journal Asian Spine Journal Vol.18 No.2
발행연도
2024.4
수록면
163 - 173 (11page)
DOI
10.31616/asj.2023.0231

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초록· 키워드

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Study Design: Basic research.Purpose: This finite element (FE) analysis (FEA) aimed to compare the biomechanical parameters in multilevel posterior cervical fixation with the C7 vertebra instrumented by two techniques: lateral mass screw (LMS) vs. transpedicular screw (TPS).Overview of Literature: Very few studies have compared the biomechanics of different multilevel posterior cervical fixation constructs.Methods: Four FE models of multilevel posterior cervical fixation were created and tested by FEA in various permutations and combinations. Generic differences in fixation were determined, and the following parameters were assessed: (1) maximum moment at failure, (2) maximum angulation at failure, (3) maximum stress at failure, (4) point of failure, (5) intervertebral disc stress, and (6) influence of adding a C2 pars screw to the multilevel construct.Results: The maximum moment at failure was higher in the LMS fixation group than in the TPS group. The maximum angulation in flexion allowed by LMS was higher than that by TPS. The maximum strain at failure was higher in the LMS group than in the TPS group. The maximum stress endured before failure was higher in the TPS group than in the LMS group. Intervertebral stress levels at C6–C7 and C7–T1 intervertebral discs were higher in the LMS group than in the TPS group. For both models where C2 fixation was performed, lower von Mises stress was recorded at the C2–C3 intervertebral disc level.Conclusions: Ending a multilevel posterior cervical fixation construct with TPS fixation rather than LMS fixation at the C7 vertebra provides a stiff and more constrained construct system, with higher stress endurance to compressive force. The constraint and durability of the construct can be further enhanced by adding a C2 pars screw in the fixation system.

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