Biomechanical comparison of spinal column shortening ‑ a finite element study

BMC Musculoskeletal Disorders, 2022 · DOI: https://doi.org/10.1186/s12891-022-06047-5 · Published: December 1, 2022

Simple Explanation

This study uses computer modeling (finite element analysis) to investigate the biomechanical effects of shortening the spine during surgery. Spinal shortening is a technique used to correct deformities or remove tumors. The models simulate different degrees of spinal shortening to see how it affects the stability of the spine, stress on the implants (screws and rods), and pressure on the adjacent spinal segments. The goal is to find the optimal amount of spinal shortening that provides stability and minimizes complications such as spinal cord injury, implant failure, and adjacent segment disease.

Study Duration

Not specified

Participants

FE model based on a 24-year-old adult male

Evidence Level

Not specified

Key Findings

1
Increasing spinal shortening distance generally increased stress on internal rods and the range of motion and intradiscal pressure of adjacent segments.
2
Greater spinal shortening distances decreased stress on the endplate at the interface between the titanium cage and the L4 upper endplate.
3
All surgical models demonstrated good stability in the operated segments, especially in posterior extension and left-right bending.

Research Summary

The study investigates the biomechanical effects of spinal shortening using finite element analysis to determine the optimal shortening distance during surgery. The results suggest that increasing spinal shortening can increase stress on internal rods and adjacent segments, while decreasing stress on the endplate at the cage interface. The conclusion recommends minimizing spinal shortening distance when spinal correction needs are met to prevent complications like spinal cord injury and implant failure.

Practical Implications

Surgical Planning

Surgeons should carefully consider the degree of spinal shortening to balance spinal stability with the risk of complications.

Implant Design

The findings can inform the design of spinal implants that can better withstand the stresses associated with spinal shortening.

Post-operative Care

Increased monitoring of adjacent segment health may be warranted in patients undergoing significant spinal shortening.

Study Limitations

1
The finite element model data were based on a single 24-year-old adult male.
2
The material properties of each structure were assumed to be isotropic.
3
The analysis did not include biomechanical studies on the spinal cord and spinal nerves.

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