Computational model predicts risk of spinal screw loosening in patients.
Finite element simulations
Lumbar spine
Musculoskeletal modeling
Pedicle screw fixation strength
Spondylodesis surgery
Journal
European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
ISSN: 1432-0932
Titre abrégé: Eur Spine J
Pays: Germany
ID NLM: 9301980
Informations de publication
Date de publication:
10 2022
10 2022
Historique:
received:
15
10
2021
accepted:
12
03
2022
revised:
15
10
2021
pubmed:
25
4
2022
medline:
12
10
2022
entrez:
24
4
2022
Statut:
ppublish
Résumé
Pedicle screw loosening is a frequent complication in lumbar spine fixation, most commonly among patients with poor bone quality. Determining patients at high risk for insufficient implant stability would allow clinicians to adapt the treatment accordingly. The aim of this study was to develop a computational model for quantitative and reliable assessment of the risk of screw loosening. A cohort of patient vertebrae with diagnosed screw loosening was juxtaposed to a control group with stable fusion. Imaging data from the two cohorts were used to generate patient-specific biomechanical models of lumbar instrumented vertebral bodies. Single-level finite element models loading the screw in axial or caudo-cranial direction were generated. Further, multi-level models incorporating individualized joint loading were created. The simulation results indicate that there is no association between screw pull-out strength and the manifestation of implant loosening (p = 0.8). For patient models incorporating multiple instrumented vertebrae, CT-values and stress in the bone were significantly different between loose screws and non-loose screws (p = 0.017 and p = 0.029, for CT-values and stress, respectively). However, very high distinction (p = 0.001) and predictability (R The use of a biomechanics-based score for risk assessment of implant fixation failure might represent a paradigm shift in addressing screw loosening after spondylodesis surgery.
Identifiants
pubmed: 35461383
doi: 10.1007/s00586-022-07187-x
pii: 10.1007/s00586-022-07187-x
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
2639-2649Informations de copyright
© 2022. The Author(s).
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