Mechanical Properties of Modified Cortical Bone Trajectory Placement in Lumbar Revision:A Finite Element Analysis
10.16156/j.1004-7220.2024.03.006
- VernacularTitle:有限元分析改良皮质骨轨迹置钉在腰椎翻修术中的力学性能
- Author:
Lianpeng ZHANG
1
;
Julaiti·MAITIROUZI
;
Zhihao ZHANG
;
Rui ZHANG
;
Abulikemu·MAIMAITI
;
Paerhati·REXITI
Author Information
1. 新疆大学智能制造现代化产业学院,乌鲁木齐 830017
- Keywords:
lumbar spine;
modified cortical bone trajectory;
cortical bone trajectory;
revision surgery
- From:
Journal of Medical Biomechanics
2024;39(3):413-420
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the mechanical properties of modified cortical bone trajectory(MCBT)and cortical bone trajectory(CBT)in lumbar revision surgery using finite element analysis and to analyze the advantages of MCBT over CBT in lumbar revision.Methods A three-dimensional(3D)model of the L1-5 vertebral body,endplate,annulus fibrosus,and nucleus pulposus was established based on CT tomography data.The traditional trajectory(TT)was used for pedicle screw placement in the vertebral body model;then,the TT screws were removed,retaining the TT screw path,and revision screws were placed on the vertebral body with MCBT and CBT screws.The mechanical properties of the MCBT and CBT during revision surgery were analyzed using finite element analysis.Results Under flexion,extension,lateral bending,and axial rotation,the range of motion(ROM)in the CBT revision group decreased by 12.07％,19.60％,8.72％,and 7.66％,respectively;the annulus stress of L3-4 segment increased by 11.27％,30.43％,35.52％,and 25.36％,respectively;and the annulus stress of L4-5 segment decreased by 39.84％,52.64％,23.91％,and 15.77％,respectively,compared with the control group.The ROM in the MCBT revision group decreased by 13.18％,20.27％,25.63％,and 8.59％,respectively;the annulus stress of the L3-4 segment increased by 10.41％,21.60％,15.83％,and 18.41％,respectively;and the annulus stress of the L4-5 segment decreased by 37.14％,61.94％,39.46％,and 35.23％,respectively,compared with the control group.The ROM of the MCBT revision group decreased by 1.26％,0.83％,18.53％,and 1.00％,respectively.The annulus stress of the L3-4 segment decreased by 0.77％,6.77％,14.53％,and 5.54％,respectively,whereas that of the L4-5 segment decreased by 2.82％,15.91％,19.79％,and 8.75％,respectively,compared to the CBT revision group.Compared with the CBT revision group,the annulus stress of the L4-5 segment in the MCBT revision group increased by 4.49％under flexion and decreased by 19.65％,20.44％,and 23.11％under extension,lateral bending,and axial rotation,respectively.Conclusions Both MCBT and CBT can provide mechanical properties that meet the requirements of vertebral fixation,and the fixation performance and safety of MCBT are comparable to those of CBT.This study provides a reference for using the MCBT and CBT techniques in revision surgery in clinical practice.
