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Effect of the screw type (S2-alar-iliac and iliac), screw length, and screw head angle on the risk of screw and adjacent bone failures after a spinopelvic fixation technique: A finite element analysis

PURPOSE: Spinopelvic fixations involving the S2-alar-iliac (S2AI) and iliac screws are commonly used in various spinal fusion surgeries. This study aimed to compare the biomechanical characteristics, specifically the risk of screw and adjacent bone failures of S2AI screw fixation with those of iliac...

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Autores principales: Shin, Jong Ki, Lim, Beop-Yong, Goh, Tae Sik, Son, Seung Min, Kim, Hyung-Sik, Lee, Jung Sub, Lee, Chi-Seung
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6095501/
https://www.ncbi.nlm.nih.gov/pubmed/30114271
http://dx.doi.org/10.1371/journal.pone.0201801
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author Shin, Jong Ki
Lim, Beop-Yong
Goh, Tae Sik
Son, Seung Min
Kim, Hyung-Sik
Lee, Jung Sub
Lee, Chi-Seung
author_facet Shin, Jong Ki
Lim, Beop-Yong
Goh, Tae Sik
Son, Seung Min
Kim, Hyung-Sik
Lee, Jung Sub
Lee, Chi-Seung
author_sort Shin, Jong Ki
collection PubMed
description PURPOSE: Spinopelvic fixations involving the S2-alar-iliac (S2AI) and iliac screws are commonly used in various spinal fusion surgeries. This study aimed to compare the biomechanical characteristics, specifically the risk of screw and adjacent bone failures of S2AI screw fixation with those of iliac screw fixation using a finite element analysis (FEA). METHODS: A three-dimensional finite element (FE) model of a healthy spinopelvis was generated. The pedicle screws were placed on the L3-S1 with three different lengths of the S2AI and iliac screws (60 mm, 75 mm, and 90 mm). In particular, two types of the S2AI screw, 15°- and 30°-angled polyaxial screw, were adopted. Physiological loads, such as a combination of compression, torsion, and flexion/extension loads, were applied to the spinopelvic FE model, and the stress distribution as well as the maximum von Mises equivalent stress values were calculated. RESULTS: For the iliac screw, the highest stress on the screw was observed with the 75-mm screw, rather than the 60-mm screw. The bones around the iliac screw indicated that the maximum equivalent stress decreased as the screw length increased. For the S2AI screw, the lowest stress was observed in the 90-mm screw length with a 30° head angle. The bones around the S2AI screw indicated that the lowest stress was observed in the 90-mm screw length and a 15° head angle. CONCLUSIONS: It was found that the S2AI screw, rather than the iliac screw, reduced the risk of implant failure for the spinopelvic fixation technique, and the 90-mm screw length with a 15° head angle for the S2AI screw could be biomechanically advantageous.
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spelling pubmed-60955012018-08-30 Effect of the screw type (S2-alar-iliac and iliac), screw length, and screw head angle on the risk of screw and adjacent bone failures after a spinopelvic fixation technique: A finite element analysis Shin, Jong Ki Lim, Beop-Yong Goh, Tae Sik Son, Seung Min Kim, Hyung-Sik Lee, Jung Sub Lee, Chi-Seung PLoS One Research Article PURPOSE: Spinopelvic fixations involving the S2-alar-iliac (S2AI) and iliac screws are commonly used in various spinal fusion surgeries. This study aimed to compare the biomechanical characteristics, specifically the risk of screw and adjacent bone failures of S2AI screw fixation with those of iliac screw fixation using a finite element analysis (FEA). METHODS: A three-dimensional finite element (FE) model of a healthy spinopelvis was generated. The pedicle screws were placed on the L3-S1 with three different lengths of the S2AI and iliac screws (60 mm, 75 mm, and 90 mm). In particular, two types of the S2AI screw, 15°- and 30°-angled polyaxial screw, were adopted. Physiological loads, such as a combination of compression, torsion, and flexion/extension loads, were applied to the spinopelvic FE model, and the stress distribution as well as the maximum von Mises equivalent stress values were calculated. RESULTS: For the iliac screw, the highest stress on the screw was observed with the 75-mm screw, rather than the 60-mm screw. The bones around the iliac screw indicated that the maximum equivalent stress decreased as the screw length increased. For the S2AI screw, the lowest stress was observed in the 90-mm screw length with a 30° head angle. The bones around the S2AI screw indicated that the lowest stress was observed in the 90-mm screw length and a 15° head angle. CONCLUSIONS: It was found that the S2AI screw, rather than the iliac screw, reduced the risk of implant failure for the spinopelvic fixation technique, and the 90-mm screw length with a 15° head angle for the S2AI screw could be biomechanically advantageous. Public Library of Science 2018-08-16 /pmc/articles/PMC6095501/ /pubmed/30114271 http://dx.doi.org/10.1371/journal.pone.0201801 Text en © 2018 Shin et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Shin, Jong Ki
Lim, Beop-Yong
Goh, Tae Sik
Son, Seung Min
Kim, Hyung-Sik
Lee, Jung Sub
Lee, Chi-Seung
Effect of the screw type (S2-alar-iliac and iliac), screw length, and screw head angle on the risk of screw and adjacent bone failures after a spinopelvic fixation technique: A finite element analysis
title Effect of the screw type (S2-alar-iliac and iliac), screw length, and screw head angle on the risk of screw and adjacent bone failures after a spinopelvic fixation technique: A finite element analysis
title_full Effect of the screw type (S2-alar-iliac and iliac), screw length, and screw head angle on the risk of screw and adjacent bone failures after a spinopelvic fixation technique: A finite element analysis
title_fullStr Effect of the screw type (S2-alar-iliac and iliac), screw length, and screw head angle on the risk of screw and adjacent bone failures after a spinopelvic fixation technique: A finite element analysis
title_full_unstemmed Effect of the screw type (S2-alar-iliac and iliac), screw length, and screw head angle on the risk of screw and adjacent bone failures after a spinopelvic fixation technique: A finite element analysis
title_short Effect of the screw type (S2-alar-iliac and iliac), screw length, and screw head angle on the risk of screw and adjacent bone failures after a spinopelvic fixation technique: A finite element analysis
title_sort effect of the screw type (s2-alar-iliac and iliac), screw length, and screw head angle on the risk of screw and adjacent bone failures after a spinopelvic fixation technique: a finite element analysis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6095501/
https://www.ncbi.nlm.nih.gov/pubmed/30114271
http://dx.doi.org/10.1371/journal.pone.0201801
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