Numerical Evaluation of Spinal Stability after Posterior Spinal Fusion with Various Fixation Segments and Screw Types in Patients with Osteoporotic Thoracolumbar Burst Fracture Using Finite Element Analysis

Abstract

The aim of this study was to analyze the spinal stability and safety after posterior spinal fusion with various fixation segments and screw types in patients with an osteoporotic thoracolumbar burst fracture based on finite element analysis (FEA). To realize various osteoporotic vertebral fracture conditions on T12, seven cases of Young's modulus, namely 0%, 1%, 5%, 10%, 25%, 50%, and 100% of the Young's modulus, for vertebral bones under intact conditions were considered. Four types of fixation for thoracolumbar fracture on T12 (fixed with T11-L1, T10-T11-L1, T11-L1-L2, and T10-T11-L1-L2) were applied to the thoracolumbar fusion model. The following screw types were considered: pedicle screw (PS) and cortical screw (CS). Using FEA, four motions were performed on the fixed spine, and the stress applied to the screw, peri-implant bone (PIB), and intervertebral disc (IVD) and the range of motion (ROM) were calculated. The lowest ROM calculated corresponded to the T10-T11-L1-L2 model, while the closest to the intact situation was achieved in the T11-L1-L2 fixation model using PS. The lowest stress in the screw and PB was detected in the T10-T11-L1-L2 fixation model.