Finite Element Analysis of Two Kinds of Internal Fixation Methods after TotalSpondylectomy of Lower Cervical Spine
1 School of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, Shanghai 200093, China
2 School of Energy and Power Engineering, University of Shanghai for Science and Technology, Shanghai 200093, China
3 Department of Orthopedics, Shanghai First People′s Hospital, Shanghai 200080, China
4 Department of Orthopedics, Shanghai Yangpu District Central Hospital, Shanghai 200090, China
Abstract：To investigate effects from different combinations of anterior and posterior internal fixation on stability of the cervical spine after total spondylectomy of C5 vertebral. The intact finite element model of the lower cervical spine C3\|C7 was established based on CT images. Based on the verified finite element model of intact cervical spine, two reconstruction models after total spondylectomy of C5 vertebral were established: one was titanium mesh plus anterior plate plus posterior singlesegmental pedical screw model(TM+AP+SPS), the other one was titanium mesh plus anterior plate plus posterior doublesegmental pedical screw model(TM+AP+DPS). Moment of 0.5, 1.0, 1.5, 2.0 N·m was separately applied on top of the model, ROM of two reconstruction model under flexion, extension, lateral bending and torsion conditions and the stress distribution of internal fixation devices were analyzed. The ROM of reconstruction segments was increased with the increase of the torque, showing nonlinear trend, ROM of TM+AP+SPS model was increased larger. In the case of 1.0 N·m torque, the ROM of reconstruction segments was greatly reduced by over 83% as compare to that of the intact model.ROM of the adjacent segments of the TM+AP+SPS model was increased by over 11% under extension, bending and torsion conditions, the ROM of C6\|C7 segment was increased by over 41.79% under torsion condition, and ROM of adjacent segments of TM+AP+DPS model was significantly reduced. Stress of the titanium mesh of TM+AP+SPS model and TM+AP+DPS model were separately focused on the compression side and the rear. Adjacent segments of TM+AP+SPS model had a great compensatory activity, and ROM of each segment of the TM+AP+DPS model was significantly reduced, the stability of cervical spine was better in TM+AP+DPS model.
王晨曦1 赵改平1* 柏磊磊1 陈楠心1 陈二云2 赵庆华3 马童4 凃意辉4. 下颈椎全脊椎切除术后两种内固定重建方法的有限元分析[J]. 中国生物医学工程学报, 2016, 35(2): 194-201.
Wang Chenxi1 Zhao Gaiping1* Bai Leilei1 Chen Nanxin1 Chen Eryun2 Zhao Qinghua3 Ma Tong4 Tu Yihui4 . Finite Element Analysis of Two Kinds of Internal Fixation Methods after TotalSpondylectomy of Lower Cervical Spine. journal1, 2016, 35(2): 194-201.
［1］Stener B, Total spondylectomy in chondrosarcoma arising from the seventh thoracic vertebra［J］. J Bone Joint Surg Br,1971,53(2):288-295.
［2］Stener B, Johnsen OE. Complete removal of three vertebrae for giantcell tumour［J］. J Bone Joint Surg Br, 1971,53(2):278-287.
［3］Tomita K, Kawahara N, Baba H, et al. Total en bloc spondylectomy. A new surgical technique for primary malignant vertebral tumors［J］. Spine, 1997, 22:324-333.
［4］Roy\|Camille R, Saillant G, Bisserie M, et al. Total excision of thoracia vertebra［J］. Rev Chir Orhop Reparatrice Appar Mot, 1981, 67(3):421-430.
［5］Oda I, Cunningham BW, Abumi K, et al. The stability of reconstruction methods after thoracolumbar total spondylectomy［J］. Spine,1999,24(16):1634-1638.
［6］Sundaresan N, Steinberger AA, Moore F, et al. Indications and results of combined anteriorposterior approaches for spine tumor surgery［J］. J Neurosurg, 1996,85:438-446.
［7］Disch AC, Schaser KD, Melcher I, et al. En bloc spondylectomy reconstructions in a biomechanical invirto study［J］. Eur Spine J, 2008,17(5):715-725.
［8］Akamaru T, Kawahara N, Sakamoto J, et al. The transmission of stress to grafted bone inside a titanium mesh cage used in anterior column reconstruction after total spondylectomy: a finite element analysis［J］.Spine, 2005,30(24):2783-2787.
［9］李龙,陈阳,周建伟,等. 前后路全脊椎切除治疗下颈椎原发肿瘤［J］. 实用骨科杂志, 2014,20(5):401-404.
［10］滕红林,肖建如,倪向明,等.脊柱颈胸段全脊椎切除术内固定重建的生物力学［J］.中国骨伤,2006,19(5):287-290.
［11］Tomita K, Kawahara N, Murakami H, et al. Total en bloc spondylectomy for spinal tumors: improvement of the technique and its associated basic background［J］. J Orthop Sci, 2006, 11(1): 3-12.
［12］Teo EC, Ng HW. Evaluation of the role of ligaments, facets and disk nucleus in lower cervical spine under compression and sagittal moments using finite element method［J］.Med Eng Phys, 2001,23:155-164.
［13］Yoganandan N, Kumaresan S, Voo L, et al. Finite element model of the human lower cervical spine: parametric analysis of the C4\|C6 unit ［J］.J Biomed Eng, 1997, 119(1): 87-92.
［14］Sung KH. Finite element modeling of multilevel cervical spinal segments (C3-C6) and biomechanical analysis of an elastomertype prosthetic disc ［J］. Med Eng Phys, 2006,28:534-541.
［15］Matthew BP, Duane SC. C4-C5 segment finite element model development, validation, and loadsharing investigation［J］.J Biomech, 2009,42:480-490.
［16］Duan Y, Wang HH, Jin AM, et al. Finite element analysis of posterior cervical fixation［J］. Orthop TraumatolSur, 2015, 101:23-29.
［17］Panjabi MM, Crisco JJ, Vasavada A, et al. Mechanical properties of the human cervical spine as shown by threedimensional loaddisplacement curves［J］. Spine,2001,26(24):2692-2700.
［18］Zhang Qinghang, Teo EC, Ng HW. Finite element analysis of momentrotation relationships for human cervical spine［J］. J Biomech, 2006,39:189-193.
［19］冯勇,刘道志. 不同腰椎融合器对邻近节段影响的生物力学研究［J］. 中国生物医学工程学报, 2010, 29(5):717-723.
［20］苏再发,吴培增,王芳泰,等.终板切除对终板-钛网界面应力分布影响的三维有限元分析［J］.骨科,2011,2(1):9-12.
［21］Chen Chensheng, Chen Wenjer, Cheng Chengkung, et al. Failure analysis of broken pedicle screws on spinal instrumentation［J］. Med Eng Phys, 2005,27(6):487-496.
［22］Katonis P, Christoforakis J, Kontakis G, et al. Complications and problems related to pedicle screw fixation of the spine［J］. Clin Orthop Relat Res, 2003,(411):86-94.
