Open AccessBiomechanical Evaluation of Spinal Column after Percutaneous Cement Discoplasty: A Finite Element Analysis
Author(s) -
Li Shuang,
Xu Baoshan,
Liu Yancheng,
Zhang Jingyu,
Xu Guijun,
Shao Pengfei,
Li Xiaoye,
Hu Yongcheng,
Ma Xinlong
Publication year - 2022
Publication title -
orthopaedic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.666
H-Index - 23
eISSN - 1757-7861
pISSN - 1757-7853
DOI - 10.1111/os.13314
Subject(s) - finite element method , percutaneous , cement , spinal column , column (typography) , vertebral column , medicine , orthodontics , geology , structural engineering , materials science , surgery , engineering , composite material , connection (principal bundle)
Objective To compare the biomechanical properties of percutaneous cement discoplasty (PCD) in the spinal column between different implant‐endplate friction. Methods A validated L3‐Scarumfinite element (FE) model was modified for simulation. In the PCD model, the L4/5 level was modified based on model 1 (M1) and model 2 (M2). In M1, the interaction between bone cement and endplate was defined as face‐to‐face contact with a friction coefficient of 0.3; in M2, the contact was defined as a Tie constraint. 7.5 N m moments of four physiological motions and axial load of 15, 100 and 400 N preload were imposed at the top of L3. The range of motion (ROM) and interface stress analysis of endplates, annulus fibrosus and bone cement of the operated level were calculated for comparisons among the three models. Results The ROM of M1 and M2 increased when compared with the intact model during flexion (FL) (17.5% vs 10.0%), extension (EX) (8.8% vs −8.8%), left bending (LB) (19.0% vs −17.2%) and left axial rotation (LR) (34.6% vs −3.8%). The stress of annulus fibrosus in M1 and M2 decreased in FL (−48.4% vs −57.5%), EX (−25.7% vs −14.7%), LB (−47.5% vs −52.4%), LR (−61.4% vs −68.7%) and axis loading of 100 N (−41.5% vs −15.3%), and 400 N (−27.9% vs −27.3%). The stress of upper endplate of M1 and M2 increased in FL (24.6% vs 24.7%), LB (82.2% vs 89.5%), LR (119% vs 62.4%) and axis loading of 100 N (64.6% vs 45.5%), and 400 N (58.2% vs 24.3%), but was similar in EX (2.9% vs 0.3%). The stress of lower endplate of M1 and M2 increased in FL (170.9% vs 175.0%), EX (180.8% vs 207.7%), LB (302.6% vs 274.7%), LR (332.4% vs 132.8%) and axis loading of 100 N (350.7% vs 168.6%), and 400 N (165.2% vs 106.7%). Conclusion Percutaneous cement discoplasty procedure could make effect on the mobility or stiffness. The fusion of bone cement and endplate might have more biomechanical advantages, including of the decreasing rate of implant subsidence and dislocation, and the increase spine stability.