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Anterior cervical transpedicular screw fixation system in subaxial cervical spine: A finite element comparative study

Multilevel cervical corpectomy has raised the concern among surgeons that reconstruction with the anterior cervical screw plate system (ACSPS) alone may fail eventually. As an alternative, the anterior cervical transpedicular screw (ACTPS) has been adopted in clinical practice. We used the finite el...

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Autores principales: Li, Jie, Gan, Kaifeng, Chen, Binhui, Chen, Yilei, Hong, Jinjiong, Bei, Dikai, Fan, Tengdi, Zheng, Minzhe, Zhao, Liujun, Zhao, Fengdong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9302373/
https://www.ncbi.nlm.nih.gov/pubmed/35866798
http://dx.doi.org/10.1097/MD.0000000000029316
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author Li, Jie
Gan, Kaifeng
Chen, Binhui
Chen, Yilei
Hong, Jinjiong
Bei, Dikai
Fan, Tengdi
Zheng, Minzhe
Zhao, Liujun
Zhao, Fengdong
author_facet Li, Jie
Gan, Kaifeng
Chen, Binhui
Chen, Yilei
Hong, Jinjiong
Bei, Dikai
Fan, Tengdi
Zheng, Minzhe
Zhao, Liujun
Zhao, Fengdong
author_sort Li, Jie
collection PubMed
description Multilevel cervical corpectomy has raised the concern among surgeons that reconstruction with the anterior cervical screw plate system (ACSPS) alone may fail eventually. As an alternative, the anterior cervical transpedicular screw (ACTPS) has been adopted in clinical practice. We used the finite element analysis to investigate whether ACTPS is a more reasonable choice, in comparison with ACSPS, after a 2-level corpectomy in the subaxial cervical spine. These 2 types of implantation models with the applied 75 N axial pressure and 1 N • m pure moment of the couple were evaluated. Compared with the intact model, the range of motion (ROM) at the operative segments (C4–C7) decreased by 97.5% in flexion-extension, 91.3% in axial rotation, and 99.3% in lateral bending in the ACTPS model, whereas it decreased by 95.1%, 73.4%, 96.9% in the ACSPS model respectively. The ROM at the adjacent segment (C3/4) in the ACTPS model decreased in all motions, while that of the ACSPS model increased in axial rotation and flexion-extension compared with the intact model. Compared to the ACSPS model, whose stress concentrated on the interface between the screws and the titanium plate, the stress of the ACTPS model was well-distributed. There was also a significant difference between the maximum stress value of the 2 models. ACTPS and ACSPS are biomechanically favorable. The stability in reducing ROM of ACTPS may be better and the risk of failure for internal fixator is relatively low compared with ACSPS fixation except for under lateral bending in reconstruction the stability of the subaxial cervical spine after 2-level corpectomy.
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spelling pubmed-93023732022-08-03 Anterior cervical transpedicular screw fixation system in subaxial cervical spine: A finite element comparative study Li, Jie Gan, Kaifeng Chen, Binhui Chen, Yilei Hong, Jinjiong Bei, Dikai Fan, Tengdi Zheng, Minzhe Zhao, Liujun Zhao, Fengdong Medicine (Baltimore) Research Article Multilevel cervical corpectomy has raised the concern among surgeons that reconstruction with the anterior cervical screw plate system (ACSPS) alone may fail eventually. As an alternative, the anterior cervical transpedicular screw (ACTPS) has been adopted in clinical practice. We used the finite element analysis to investigate whether ACTPS is a more reasonable choice, in comparison with ACSPS, after a 2-level corpectomy in the subaxial cervical spine. These 2 types of implantation models with the applied 75 N axial pressure and 1 N • m pure moment of the couple were evaluated. Compared with the intact model, the range of motion (ROM) at the operative segments (C4–C7) decreased by 97.5% in flexion-extension, 91.3% in axial rotation, and 99.3% in lateral bending in the ACTPS model, whereas it decreased by 95.1%, 73.4%, 96.9% in the ACSPS model respectively. The ROM at the adjacent segment (C3/4) in the ACTPS model decreased in all motions, while that of the ACSPS model increased in axial rotation and flexion-extension compared with the intact model. Compared to the ACSPS model, whose stress concentrated on the interface between the screws and the titanium plate, the stress of the ACTPS model was well-distributed. There was also a significant difference between the maximum stress value of the 2 models. ACTPS and ACSPS are biomechanically favorable. The stability in reducing ROM of ACTPS may be better and the risk of failure for internal fixator is relatively low compared with ACSPS fixation except for under lateral bending in reconstruction the stability of the subaxial cervical spine after 2-level corpectomy. Lippincott Williams & Wilkins 2022-07-22 /pmc/articles/PMC9302373/ /pubmed/35866798 http://dx.doi.org/10.1097/MD.0000000000029316 Text en Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY) (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Li, Jie
Gan, Kaifeng
Chen, Binhui
Chen, Yilei
Hong, Jinjiong
Bei, Dikai
Fan, Tengdi
Zheng, Minzhe
Zhao, Liujun
Zhao, Fengdong
Anterior cervical transpedicular screw fixation system in subaxial cervical spine: A finite element comparative study
title Anterior cervical transpedicular screw fixation system in subaxial cervical spine: A finite element comparative study
title_full Anterior cervical transpedicular screw fixation system in subaxial cervical spine: A finite element comparative study
title_fullStr Anterior cervical transpedicular screw fixation system in subaxial cervical spine: A finite element comparative study
title_full_unstemmed Anterior cervical transpedicular screw fixation system in subaxial cervical spine: A finite element comparative study
title_short Anterior cervical transpedicular screw fixation system in subaxial cervical spine: A finite element comparative study
title_sort anterior cervical transpedicular screw fixation system in subaxial cervical spine: a finite element comparative study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9302373/
https://www.ncbi.nlm.nih.gov/pubmed/35866798
http://dx.doi.org/10.1097/MD.0000000000029316
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