Pedicle Screw Fixation with Kyphoplasty Decreases the Fracture Risk of the Treated and Adjacent Non-treated Vertebral Bodies：a Finite Element Analysis

• Published in: Journal of Huazhong University of Science and Technology. Medical sciences Vol. 36; no. 6; pp. 887 - 894
• Main Author: 杨攀 章莹 丁焕文 刘坚 叶林强 肖进 涂强 杨涛 王非 孙国刚
• Format: Journal Article
• Language: English
• Published: Wuhan Huazhong University of Science and Technology 01.12.2016; Department of Orthopedics, Chongqing Traditional Chinese Medicine Hospital(the First People's Hospital of Chongqing), Chongqing 400011, China%Orthopedic Hospital, Guangzhou General Hospital of People's Liberation Army, Guangzhou 510010, China%Department of Spinal Surgery, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510006, China; Orthopedic Hospital, Guangzhou General Hospital of People's Liberation Army, Guangzhou 510010, China
• Subjects: Computer Simulation; Finite Element Analysis; Fracture Fixation, Internal - adverse effects; Fracture Fixation, Internal - instrumentation; Fracture Fixation, Internal - methods; Humans; Kyphoplasty - adverse effects; Kyphoplasty - instrumentation; Kyphoplasty - methods; Medicine; Medicine & Public Health; Osteoporotic Fractures - etiology; Osteoporotic Fractures - prevention & control; Pedicle Screws - adverse effects; Postoperative Complications - prevention & control; Spinal Fractures - etiology; Spinal Fractures - prevention & control; Spine - diagnostic imaging; Spine - surgery; osteoporotic vertebral compression fractures; biomechanics; finite element analysis; pedicle screw fixation; kyphoplasty
• ISSN: 1672-0733; 1993-1352
• DOI: 10.1007/s11596-016-1680-x

Adjacent vertebral fractures are common in patients with osteoporotic vertebral compression fractures（OVCFs） after kyphoplasty.This finite element study was to examine whether short segment pedicle screw fixation（PSF） with kyphoplasty may decrease the fracture risk of the treated and adjacent non-treated vertebrae after kyphoplasty for OVCFs.By simulating cement augmentation with or without short segment pedicle screw fixation（PSF）,two tridimensional,anatomically detailed finite element models of the T10–L2 functional spinal junction were developed.The insertion of pedicle screws into the intact vertebra apparently decreased the stress distribution of the treated vertebra in vertical compression and other load situations.The stress distribution in the bone structures of the intact vertebra adjacent to the intact-screwed vertebra was much less than that in the one adjacent to the treated vertebra.The insertion of pedicle screws into the intact vertebra greatly decreased the maximum displacement of the cortical bones and cancellous bones of the vertebrae.Our results indicated that short segment PSF with kyphoplasty may decrease the fracture risk of the treated and adjacent non-treated vertebrae in the management of OVCFs.