Biomechanical comparison of cervical discectomy/fusion model using allograft spacers between anterior and posterior fixation methods (lateral mass and pedicle screw)

Ji won Kwon, Sun Hee Bang, Tae Hyun Park, Sung Jae Lee, Hwan Mo Lee, Soo Bin Lee, Byung Ho Lee, Seong Hwan Moon

Research output: Contribution to journalArticlepeer-review

9 Citations (Scopus)

Abstract

Background: The purpose of this study is to investigate effects of different fixation methods on the physical stress on allospacers, endplate-vertebral body, and implants using finite element model analyses. Methods: Stress distribution and subsidence risk according to the fixation methods under the condition of hybrid motion control were analyzed. The detailed finite element model of a previously validated, three-dimensional, intact cervical spinal segment model, with C5–C6 segmental fusion using allospacer, was used to evaluate the biomechanical characteristics of different fixation combinations, such as anterior plate/screws, lateral mass screw, and posterior pedicle screw. Findings: The load sharing on allospacers increased in extension in order of posterior pedicle screws (21.4%), lateral mass screws (31.5%), and anterior plate/screws (56.6%). lateral mass screw demonstrated the highest load sharing (68.1%) on the allospacer in flexion. The Peak von Mises stress of the allospacer was the lowest in flexion and axial rotation but the highest in extension with anterior plate/screws. Allospacer subsidence risk was the lowest in extension, lateral bending, and axial rotation with posterior pedicle screws but the lowest in flexion with anterior plate/screws. The bone-screw loosening risk was the lowest in all modes with posterior pedicle screws but the highest with anterior plate/screws. Interpretation: Posterior pedicle screws demonstrated the best mechanical stability of allospacer failure-subsidence and the lowest risk of screw loosening. Different motion restrictions depending on the fixation method should be considered for implant and allospacer safety.

Original languageEnglish
Pages (from-to)226-233
Number of pages8
JournalClinical Biomechanics
Volume73
DOIs
Publication statusPublished - 2020 Mar

Bibliographical note

Publisher Copyright:
© 2020 Elsevier Ltd

All Science Journal Classification (ASJC) codes

  • Biophysics
  • Orthopedics and Sports Medicine

Fingerprint

Dive into the research topics of 'Biomechanical comparison of cervical discectomy/fusion model using allograft spacers between anterior and posterior fixation methods (lateral mass and pedicle screw)'. Together they form a unique fingerprint.

Cite this