Verification of ideal screw size, trajectory, and shape for single and double endplate penetrating screw trajectories using osteoporotic vertebral body models based on the finite element method
- Author:
Takumi TAKEUCHI
1
;
Kaito JINNAI
;
Yosuke KAWANO
;
Kazumasa KONISHI
;
Masahito TAKAHASHI
;
Hitoshi KONO
;
Naobumi HOSOGANE
Author Information
- Publication Type:Basic Study
- From:Asian Spine Journal 2026;20(1):1-9
- CountryRepublic of Korea
- Language:English
-
Abstract:
Methods:Finite element models of T12 and L1 were constructed from computed tomography images of osteoporotic patients. Three analyses were conducted: (1) the impact of various screw diameters with DEPST, (2) a comparison of fixation strength between short DEPST (S-DEPST), which penetrates the posterolateral endplate, and conventional DEPST (C-DEPST), and (3) a comparison between conventional cancellous thread screws (CTS) and endplate screws (ETS). Pullout strength (POS) was measured in all analyses. Vertebral motion angle (VMA) of the lower instrumented vertebra (LIV) was measured in analyses (2) and (3), and the four-directional load test (4DLT) was performed in analysis (2).
Results:Larger screw diameters with DEPST correlated with elevated POS. S-DEPST demonstrated significantly better fixation strength with a POS 1.46 times higher than C-DEPST and 2.5 times higher than traditional trajectories. S-DEPST also demonstrated higher fixation in all directions in 4DLT. However, no significant difference was observed in the VMA of LIV. ETS demonstrated slightly higher fixation than CTS, but the difference was not statistically significant.
Conclusions:Fixation strength improved with larger screw diameters in DEPST. S-DEPST provided additional fixation due to rim penetration. ETS may offer a higher fixation strength and warrants further validation.
