Novel Modular Spine Blocks Affect the Lumbar Spine on Finite Element Analysis

INTRODUCTION: There are various surgical interventions to manage osteoporotic vertebral compression fracture. Modular spine block (MSB) is a novel intravertebral fixator that can be assembled. This study aimed to quantitatively investigate the force distribution in vertebrae with the various structural designs and implantation methods by finite element analysis (FEA). METHODS: A three-dimensional nonlinear FEA of the L3 implanted with MSB was constructed. Different structural designs (solid vs. hollow) and implantation methods (three-layered vs. six-layered and unilateral vs. bilateral) were studied. The model was preloaded to 150 N-m before the effects of flexion, extension, torsion, and lateral bending were analyzed at the controlled ranges of motion of 20°, 15°, 8°, and 20°, respectively. The resultant intervertebral range of motion (ROM) and disk stress as well as intravertebral force distribution were analyzed at the adjacent segments. RESULTS: The different layers of MSB provided similar stability at the adjacent segments regarding the intervertebral ROM and disk stress. Under stress tests, the force of the solid MSB was shown to be evenly distributed within the vertebrae. The maximum stress value of the unilaterally three-layered hollow MSB was generally lower than that of the bilaterally six-layered solid MSB. CONCLUSIONS: The MSB has little stress shielding effect on the intervertebral ROM and creates no additional loading to the adjacent disks. The surgeon can choose the appropriate numbers of MSB to fix vertebrae without worrying about poly(methyl methacrylate) extravasation, implant failure, or adjacent segment disease.