{"title":"不同双极结构对成人脊柱畸形矫正的比较:有限元分析。","authors":"Claudio Vergari, Sylvain Persohn, Stéphane Wolff, Pierre-Emmanuel Moreau, Lotfi Miladi, Guillaume Riouallon","doi":"10.1007/s10439-025-03867-z","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>These results should be confirmed by clinical results, but they already provide clear guidelines for the surgeon.</p>","PeriodicalId":7986,"journal":{"name":"Annals of Biomedical Engineering","volume":" ","pages":""},"PeriodicalIF":5.4000,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Comparison of Different Bipolar Construct Configurations for the Correction of Adult Spine Deformity: A Finite Element Analysis.\",\"authors\":\"Claudio Vergari, Sylvain Persohn, Stéphane Wolff, Pierre-Emmanuel Moreau, Lotfi Miladi, Guillaume Riouallon\",\"doi\":\"10.1007/s10439-025-03867-z\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>These results should be confirmed by clinical results, but they already provide clear guidelines for the surgeon.</p>\",\"PeriodicalId\":7986,\"journal\":{\"name\":\"Annals of Biomedical Engineering\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":5.4000,\"publicationDate\":\"2025-10-02\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of Biomedical Engineering\",\"FirstCategoryId\":\"5\",\"ListUrlMain\":\"https://doi.org/10.1007/s10439-025-03867-z\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ENGINEERING, BIOMEDICAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Biomedical Engineering","FirstCategoryId":"5","ListUrlMain":"https://doi.org/10.1007/s10439-025-03867-z","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ENGINEERING, BIOMEDICAL","Score":null,"Total":0}
Comparison of Different Bipolar Construct Configurations for the Correction of Adult Spine Deformity: A Finite Element Analysis.
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.
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.