Novel uniplanar pedicle screw systems applied to thoracolumbar fractures: a biomechanical study

Frontiers in Bioengineering and Biotechnology

Bioengineering and Biotechnology

Yanli Shi¹  Wei Ji²  Jingxin Zhao³  Peifu Tang³  Junsong Wang³  Wei Zhang³  Jia Li³  Xiang Cui³  Yuheng Jiang⁴ 

[1] Anesthesia and Operation Center, The First Medical Center of Chinese PLA General Hospital, Beijing, China;Department of Orthopedics, Chinese PLA General Hospital, Beijing, China;Department of Orthopedics, Chinese PLA General Hospital, Beijing, China;National Clinical Research Center for Orthopaedics, Sports Medicine and Rehabilitation, Beijing, China;Department of Orthopedics, Chinese PLA General Hospital, Beijing, China;National Clinical Research Center for Orthopaedics, Sports Medicine and Rehabilitation, Beijing, China;Department of Orthopedics, General Hospital of Southern Theater Command of PLA, Guangzhou, China;

关键词: biomechanical study;    uniplanar pedicle screw;    intermediate screw;    thoracolumbar fractures;    screw tulip design;   

DOI  :  10.3389/fbioe.2023.1172934

 received in 2023-02-24, accepted in 2023-04-25,  发布年份 2023

来源: Frontiers

【 摘 要 】

Objective: In this study, the advantages of the internal fixation configuration composed of uniplanar pedicle screws in the treatment of thoracolumbar fractures were verified by biomechanical experimental methods, which provided the basis for subsequent clinical experiments and clinical applications.Methods: A total of 24 fresh cadaveric spine specimens (T12-L2) were utilized to conduct biomechanical experiments. Two different internal fixation configurations, namely, the 6-screw configuration and the 4-screw/2-NIS (new intermediate screws) configuration, were tested using fixed-axis pedicle screws (FAPS), uniplanar pedicle screws (UPPS), and polyaxial pedicle screws (PAPS) respectively. The spine specimens were uniformly loaded with 8NM pure force couples in the directions of anteflexion, extension, left bending, right bending, left rotation, and right rotation, and the range of motion (ROM) of the T12-L1 and L1-L2 segments of the spine was measured and recorded to access biomechanical stability.Results: No structural damage such as ligament rupture or fracture occurred during all experimental tests. In the 6-screw configuration, the ROM of the specimens in the UPPS group was significantly better than that of the PAPS group but weaker than those of the FAPS group (p < 0.01). In the 4-screw/2-NIS configuration, the results were identical to the biomechanical test results for the 6-screw configuration (p < 0.01).Conclusion: Biomechanical test results show that the internal fixation configuration with UPPS can maintain the stability of the spine well, and the results are better than that of PAPS. UPPS has both the biomechanical advantages of FAPS and the superiority of easy operation of PAPS. We believe it is an optional internal fixation device for minimally invasive treatment of thoracolumbar fractures.

【 授权许可】

Unknown   
Copyright © 2023 Jiang, Cui, Ji, Li, Shi, Zhao, Wang, Tang and Zhang.