Development, validation, and application of ligamentous cervical spinal segment C6-C7 of a six-year-old child and an adult

Li, Zhigang; Song, Guanghui; Su, Zhongqing; Wang, Guangliang

doi:10.1016/j.cmpb.2019.105080

Cited by 9 publications

(5 citation statements)

References 34 publications

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“…In the ACOP model, the screw stress was concentrated on the C5 vertebral screw during backward flexion. The stress change provided a possible reference for the loosening or breaking point of the screw [ 2 , 12 ]. ACBLP, ACSLP, ACVLP, and ACOP steel plates were subject to increasing stress in the left and right flexion conditions.…”

Section: Discussionmentioning

confidence: 99%

Finite Element Analysis and Comparative Study of 4 Kinds of Internal Fixation Systems for Anterior Cervical Discectomy and Fusion in Children

Zhou

et al. 2022

Computational and Mathematical Methods in Medicine

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Background. Spinal injury in children usually occurs in the cervical spine region. Anterior fixation of the lower cervical spine has been applied in treating pediatric cervical spine injury and disease due to its stable and firm mechanical properties. This study performed finite element analysis and comparison of four different anterior cervical internal fixation systems for children to explore more standard methods of anterior cervical internal fixation in children and seek more effective and safe treatment for children’s cervical spine diseases. Methods. A finite element model of 6-year-old children with lower cervical spine C4/5 discectomy was established, and the self-designed lower cervical spine anterior locking internal fixation system ACBLP and the children’s anterior cervical internal fixation system ACOP, ACVLP, and ACSLP plate screws were fixed and loaded on the model. 27.42 N·m torque load was applied to each internal fixation model under six working conditions of anteflexion, backward flexion, left flexion, right flexion, left rotation, and right rotation, to simulate the movement of the cervical spine. The activity and stress distribution cloud diagram of each finite element model was obtained to explore the optimal method of anterior cervical fixation in children. Results. In the four internal fixation models of ACOP, ACVLP, ACSLP, and ACBLP, the mobility of the C4/5 segment showed a decreasing relationship, and the mobility of adjacent segments increased significantly. In the Mises stress cloud diagram of the cervical spine of the four models, the vertebral body and accessories of the ACBLP model born the least stress, followed by ACSLP. The steel plate and screws in the ACVLP internal fixation model were the most stressed. The stress of the internal fixation system (plate/screw) in all models increased in the order of ACBLP, ACSLP, ACVLP, and ACOP. Conclusions. ACBLP internal fixation system had obvious advantages in anterior internal fixation of the lower cervical spine in children, C4/5 had the smallest degree of movement, relative displacement was minimal, and the stress on the centrum and pedicle was the least, while the stress on the plate screw was relatively the smallest.

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Section: Discussionmentioning

confidence: 99%

Finite Element Analysis and Comparative Study of 4 Kinds of Internal Fixation Systems for Anterior Cervical Discectomy and Fusion in Children

Zhou

et al. 2022

Computational and Mathematical Methods in Medicine

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“…In the Mises stress cloud diagram at the steel plate and screw,under ante exion and backward exion conditions, C4 left screw of ACVLP, ACSLP, ACBLP suffered greater stress. The stress was concentrated at the junction of the screw head and the nail shaft,In the ACOP model, the screw stress was concentrated on the C5 vertebral screw during backward exion.The stress change provided a possible reference for the loosening or breaking point of the screw [10,11] . In the left and right exion conditions, ACBLP, ACSLP, ACVLP, ACOP steel plates were subject to increasing stress.…”

Section: Discussionmentioning

confidence: 99%

Finite Element Analysis and Comparative Study of 4 Kinds of Internal Fixation Systems for Anterior Cervical Discectomy and Fusion in Children

z¹,

Zhou²,

Z³

et al. 2021

Preprint

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Background: Spinal injury in children usually occurs in the cervical spine region. Anterior fixation of lower cervical spine has been applied in the treatment of pediatric cervical spine injury and disease due to its stable and firm mechanical properties. This study performed finite element analysis and comparison of 4 different anterior cervical internal fixation systems for children, and explored more stable methods of anterior cervical internal fixation in children. Methods: A finite element model of 6-year-old children with lower cervical spine C4/5 discectomy was established, and the self-designed lower cervical spine anterior locking internal fixation system ACBLP and the children’s anterior cervical internal fixation system ACOP, ACVLP, ACSLP plate screws were fixed and loaded on the model. 27.42N•m torque load was applied to each internal fixation model under 6 working conditions of anteflexion, backward flexion, left flexion, right flexion, left rotation and right rotation, to simulate the movement of the cervical spine. The activity and stress distribution cloud diagram of each finite element model was obtained. Results: In the four internal fixation models of ACOP, ACVLP, ACSLP, and ACBLP, the mobility of C4/5 segment basically showed a decreasing relationship, and the mobility of adjacent segments increased significantly. In the Mises stress cloud diagram of the cervical spine of the four models, the vertebral body and accessories of the ACBLP model born the least stress, followed by ACSLP; The steel plate and screws in the ACVLP internal fixation model were the most stressed; The stress of the internal fixation system (plate/screw) in all models increased in the order of ACBLP, ACSLP, ACVLP, and ACOP.Conclusions: ACBLP internal fixation system had obvious advantages in anterior internal fixation of lower cervical spine in children, C4/5 had the smallest degree of movement, relative displacement was minimal, the stress on the pedicle was the least while the stress on the plate screw was relatively the smallest.

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“…Additionally, indirect validation compared the finite element results with other literature data. Some researchers have conducted biomechanical experiments on pediatric bones [ 25 , 26 , 27 ] providing us with a reference basis.…”

Section: Methodsmentioning

confidence: 99%

Effects of Growing Rod Technique with Different Surgical Modes and Growth Phases on the Treatment Outcome of Early Onset Scoliosis: A 3-D Finite Element Analysis

Pei

et al. 2022

IJERPH

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Early onset scoliosis (EOS) is emerging as a serious threat to children’s health and is the third largest threat to their health after myopia and obesity. At present, the growing rod technique (GRT), which allows patients to regain a well-balanced sagittal profile, is commonly considered as an invasive surgical procedure for the treatment of EOS. However, the risk of postoperative complications and instrumentation breakage remains high, which is mainly related to the choice of fixed mode. Several authors have studied primary stability and instrumentation loads, neglecting the mechanical transmission of the spinal long-segment model in different growth phases, which is fundamental to building a complete biomechanical environment. The present study aimed to investigate the kinematic and biomechanical properties that occur after GRT, across the long spinal structure and the posterior instrumentation, which are affected by unilateral or bilateral fixation. Accordingly, spinal segments (C6-S1) were loaded under flexion (Flex), extension (Ext), left lateral bending (LB), right lateral bending (RB), left torsion (LT), and right torsion (RT) using 11 established spinal models, which were from three growth phases. The stress distribution, spinal and intervertebral range of motion (ROM), counter torque of the vertebra, and bracing force on the rods were measured. The results showed that bilateral posterior fixation (BPF) is more stable than unilateral posterior fixation (UPF), at the expense of more compensations for the superior adjacent segment (SAS), especially when the superior fixed segment is closer to the head. Additionally, the bracing force of the instrumentation on the spine increases as the Cobb angle decreases. Accordingly, this biomechanical analysis provides theoretical suggestions for the selection of BPF or UPF and fixed segments in different growing phases.

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Development, validation, and application of ligamentous cervical spinal segment C6-C7 of a six-year-old child and an adult

Cited by 9 publications

References 34 publications

Finite Element Analysis and Comparative Study of 4 Kinds of Internal Fixation Systems for Anterior Cervical Discectomy and Fusion in Children

Finite Element Analysis and Comparative Study of 4 Kinds of Internal Fixation Systems for Anterior Cervical Discectomy and Fusion in Children

Finite Element Analysis and Comparative Study of 4 Kinds of Internal Fixation Systems for Anterior Cervical Discectomy and Fusion in Children

Effects of Growing Rod Technique with Different Surgical Modes and Growth Phases on the Treatment Outcome of Early Onset Scoliosis: A 3-D Finite Element Analysis

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