Comparison of Different Bipolar Construct Configurations for the Correction of Adult Spine Deformity: A Finite Element Analysis.

IF 5.4 2区 医学 Q3 ENGINEERING, BIOMEDICAL
Claudio Vergari, Sylvain Persohn, Stéphane Wolff, Pierre-Emmanuel Moreau, Lotfi Miladi, Guillaume Riouallon
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引用次数: 0

Abstract

Purpose: A minimally invasive bipolar spinal fixation was recently developed to correct the deformity in pediatric neuromuscular scoliosis and has recently been adapted for adult scoliosis. Although the clinical results are promising, mechanical complications are still not negligible. In this work, alternative configurations of bipolar constructs were compared through numerical simulation, in order to evaluate stress distribution along the implant according to each configuration.

Methods: The configurations included doubling the rods, adding lumbar screws to strengthen the distal anchorage, and combining two different materials (titanium and chromium-cobalt alloy). This resulted in seven different configurations, which were implemented in a subject-specific and experimentally validated finite element model, based on the geometry of an asymptomatic subject. Von Mises stresses were compared between configurations.

Results: The results confirm that doubling the rods reduced mid-rod stresses, as expected, but also shifted some of the load from the distal anchorage to the rods, which is a common site of implant failure. The addition of pedicle screws also reduced the stress in the distal anchorage. The configuration showing the best compromise between stress reduction and the mini-invasive character of surgery included a doubling of both rods in titanium.

Conclusions: These results should be confirmed by clinical results, but they already provide clear guidelines for the surgeon.

不同双极结构对成人脊柱畸形矫正的比较:有限元分析。
目的:一种微创双极脊柱固定最近被开发用于矫正小儿神经肌肉性脊柱侧凸的畸形,最近也被用于成人脊柱侧凸。虽然临床结果很有希望,但机械并发症仍然不可忽视。在这项工作中,通过数值模拟比较了双极结构的不同配置,以便根据每种配置评估沿种植体的应力分布。方法:采用双根棒、增加腰椎螺钉加强远端支具、钛和铬钴合金两种不同材料的组合配置。这导致了七种不同的配置,这些配置是在基于无症状受试者几何形状的特定受试者和实验验证的有限元模型中实现的。比较了不同构型的Von Mises应力。结果:结果证实,如预期的那样,加倍的棒减少了棒中间的应力,但也将一些负荷从远端支具转移到棒上,这是种植体失败的常见部位。椎弓根螺钉的加入也减少了远端锚固的应力。在减压和微创手术之间表现出最佳折衷的配置包括两根钛棒的加倍。结论:这些结果需要临床结果的证实,但已经为外科医生提供了明确的指导。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Annals of Biomedical Engineering
Annals of Biomedical Engineering 工程技术-工程:生物医学
CiteScore
7.50
自引率
15.80%
发文量
212
审稿时长
3 months
期刊介绍: Annals of Biomedical Engineering is an official journal of the Biomedical Engineering Society, publishing original articles in the major fields of bioengineering and biomedical engineering. The Annals is an interdisciplinary and international journal with the aim to highlight integrated approaches to the solutions of biological and biomedical problems.
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