Finite element study on whether posterior upper wall fracture is a risk factor for the failure of short-segment pedicle screw fixation in the treatment of L1 burst fracture

Xia, Chunyang; Yang, Shu-hua; Liu, Jifeng; Lu, Jianrong; Shang, Depeng; Fu, Dapeng; Zhao, Zhenhua; Wang, Xiahua

doi:10.1016/j.injury.2021.08.020

Cited by 2 publications

(7 citation statements)

References 38 publications

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“…Positioning with the aid of a C-arm X-ray machine can clarify the length and location of the surgical incision and does not require, which can reduce intraoperative bleeding and can avoid damage to the muscles and medically induced injuries, with a short postoperative recovery time. Minimally invasive internal fixation of the pedicle nail has a greater improvement in patient prognosis compared to traditional treatment, but this treatment also has limitations due to the limited length of the incision [ 18 ]. Therefore, the operator needs to be technically competent and needs to adjust the angle of the approaching needle under X-ray guidance to avoid displacement and deviation of the guide pin, and if abnormalities occur the positioning pin should be reinserted in the bone tract to use it as a guide for vertebral body posterior margin expansion [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Effect of Minimally Invasive Internal Arch Nailing Surgery on Tissue Traumatic Stress Response in Patients with Vertebral Fractures

Zhou

Chen

Gao

et al. 2022

Contrast Media & Molecular Imaging

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Objective. To analyze the influence of minimally invasive arch root nailing internal fixation surgery on tissue traumatic stress response in patients with vertebral fractures and explore the advantages of this treatment. Methods. One hundred and thirty-six patients with vertebral fractures admitted to our hospital from January 2020 to January 2022 were selected and divided into two groups based on the treatment method: the control group was treated with open arch root nail internal fixation surgery and the study group was treated with minimally invasive arch root nail internal fixation. The lumbar spine function, ODI, VAS, JOA score, complications, inflammation, and stress response were compared between the two groups. Results. After the operation, the ratio of intervertebral space and anterior edge height increased, and the Cobb angle decreased in both groups; the surgical incision, hospital stay, and operation time in the study group were shorter than those in the control group, and the intraoperative drainage volume and intraoperative blood loss were smaller than those in the control group ( P < 0.05 ); before surgery, there was no significant difference in ODI and VAS scores between the two groups ( P > 0.05 ). After surgery, the ODI and VAS scores in the two groups were significantly decreased, and the JOA score was significantly increased; complications occurred in the control group and the study. The incidence of complications in the study group was lower than that in the control group ( P < 0.05 ); after surgery, compared with the control group, the serum TNF-α, CRP levels, and stress response indexes of the study group decreased more significantly ( P < 0.05 ). Conclusion. Minimally invasive pedicle screw fixation has high safety and obvious advantages. The patient’s stress response index and pain level are low, and it will not cause obvious damage to the patient. The postoperative lumbar spine function is significantly improved, which is beneficial to the patient’s postoperative recovery. It is easy to operate, will not damage the thoracic and lumbar vertebrae significantly, and the fluoroscopy time is relatively short, and it has a good recovery effect. Therefore, minimally invasive internal arch nailing surgery can be used as the preferred treatment for patients with vertebral fractures.

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Section: Discussionmentioning

confidence: 99%

Effect of Minimally Invasive Internal Arch Nailing Surgery on Tissue Traumatic Stress Response in Patients with Vertebral Fractures

Zhou

Chen

Gao

et al. 2022

Contrast Media & Molecular Imaging

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“…Filgueira et al reported in 2020 that LSC is safe and reliable when LSC is ≤6, and when LSC is ≥7, it is necessary to combine other evaluation criteria to select appropriate surgical methods [11]. Similarly, the author's finite element study on short-segment (T12 and L2) Schanz screw fixation for severe lumbar 1 fracture in 2021 also suggested that the scope/degree of posterior superior wall fracture of vertebral body is also one of the risk factors for fixation failure [12]. The authors believe that the evaluation of vertebral posterior superior wall injury should be increased when evaluating thoracolumbar fractures.…”

Section: Thoracolumbar Injury Score Criteriamentioning

confidence: 99%

“…Namely, the straight rod of Schanz screw can also play a certain function similar to PLC [8]. The authors' previous finite element studies suggest that the anterior flexion of fixation segments is also one of the risk factors for the failure of pedicle screw fixation [12,19]. Pedicle screws maintain the stability of fixed segments by bearing loads and conducting stresses.…”

Section: Advantages Of Schanz Pedicle Screwmentioning

confidence: 99%

“…Pedicle screws maintain the stability of fixed segments by bearing loads and conducting stresses. Compared with conventional screws, Schanz screws have better stress conduction and stronger unloading capacity, so that the screw can maintain the stability of the fixed segment without obvious stress increase (not exceeding the fatigue threshold of the screw) [8,12,19].…”

Section: Advantages Of Schanz Pedicle Screwmentioning

confidence: 99%

“…The author's series of studies on the treatment of thoracolumbar fractures with short-segment pedicle screw fixation since 2018 showed that [8,12,18,19,21]: the maximum stress of pedicle screws increased with the aggravation of fracture degree, and the increase of screw stress in forward flexion was the most obvious. In moderate thoracolumbar fracture (LSC score 4-6), the risk of screw breakage is low with both types of screws, so brace assistance is not required.…”

Section: Thoracolumbosacral Orthosis (Tlso)mentioning

confidence: 99%

See 2 more Smart Citations

Short-Segment Schanz Pedicle Screw Oblique Downward Fixation for Thoracolumbar Burst Fractures: A New Method for the Reduction of Intraspinal Bone Fragments

Yang¹,

Xia²

2022

Frontiers in Spinal Neurosurgery

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Short-segment pedicle screw internal fixation for thoracolumbar burst fracture has been widely used in clinic. When the fracture fragment enters the spinal canal seriously, it is often necessary to decompress. The authors pioneered the reduction of fracture fragments in the spinal canal by direct traction with pedicle screws implanted obliquely downward without lamina decompression. Compared with the previous pedicle screw parallel endplate fixation and lamina decompression, this new method has less trauma, better reduction and can remove the internal fixation after fracture healing. Compared with conventional pedicle screws, short-segment Schanz pedicle screws are more similar to normal posterior columns in structure and stress conduction and have better safety and stability, so the latter is more suitable for the treatment of severe burst fractures.

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Finite element study on whether posterior upper wall fracture is a risk factor for the failure of short-segment pedicle screw fixation in the treatment of L1 burst fracture

Cited by 2 publications

References 38 publications

Effect of Minimally Invasive Internal Arch Nailing Surgery on Tissue Traumatic Stress Response in Patients with Vertebral Fractures

Effect of Minimally Invasive Internal Arch Nailing Surgery on Tissue Traumatic Stress Response in Patients with Vertebral Fractures

Short-Segment Schanz Pedicle Screw Oblique Downward Fixation for Thoracolumbar Burst Fractures: A New Method for the Reduction of Intraspinal Bone Fragments

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