Three-Dimensional Fusion of Posterior Spinal Column to Prevent Postoperative Late Correction Loss in Thoracolumbar Fractures: Finite Element Analysis and Randomized Controlled Trial
Abstract：To assess the biomechanics and clinical effects of facet joint plus interspinous process graft 3D fusion on preventing postoperative late correct loss in thoracolumbar fractures with disc damage treated with posterior approach. By simulating the internal fixation removal postoperatively, two surgical finite element models of the L1-L2 segments for facet joint plus interspinous process fusion (treatment group model) and single-level facet joint fusion (control group model) were established. The compression, flexion and extension were modeled on the basis of a three-column spine theory. The radiologic follow-up of a prospective clinical randomized controlled trial for the treatment group (11 cases) and control group (13 cases) were conducted to detect clinical effects of these two surgical models. The disc vertical compressive displacement and strain of the treatment group model were significantly reduced when compared to those of the control group model. The stress level on bilateral articular process bone graft was decreased. Furthermore, the posterior tension band of the treatment model was stronger and more stable than that of the control model. Accordingly, radiologic follow-up results of the trial at postoperative late stage of the treatment group were significantly better than those of the control group, which had statistically significant difference (P<0.05). Bilateral facet joints plus interspinous process 3D fusion is able to model the three-dimensional spinal stability more effectively than single-level facet joints fusion and was superior in bony fusion to prevent postoperative late correction loss in the patients treated with posterior approach alone. Finite element analysis associated with small randomized controlled trial is useful to design, evaluate and optimize surgical interventions.
吴立军1* 余凤娇1 何登伟2*钟世镇3. 脊柱后方3D融合预防胸腰椎骨折晚期矫正丢失：有限元分析与随机对照试验[J]. 中国生物医学工程学报, 2016, 35(2): 184-193.
Wu Lijun1*Yu Fengjiao1 He Dengwei2*Zhong Shizhen3. Three-Dimensional Fusion of Posterior Spinal Column to Prevent Postoperative Late Correction Loss in Thoracolumbar Fractures: Finite Element Analysis and Randomized Controlled Trial. journal1, 2016, 35(2): 184-193.
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