Finite Element Analysis Comparing the Biomechanical Parameters in Multilevel Posterior Cervical Instrumentation Model Involving Lateral Mass Screw versus Transpedicular Screw Fixation at the C7 Vertebra

Basic research. This finite element (FE) analysis (FEA) aimed to compare the biomechanical parameters in multilevel posterior cervical fixation with the C7 vertebra instrumented by two techniques: lateral mass screw (LMS) vs. transpedicular screw (TPS). Very few studies have compared the biomechanic...

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Bibliographic Details
Published in:	Asian spine journal Vol. 18; no. 2; pp. 163 - 173
Main Authors:	Kulkarni, Arvind Gopalrao, Kumar, Priyambada, Shetty, Gautam Manjayya, Roy, Sandipan, Manickam, Pechimuthu Susai, Dhason, Raja, Chadalavada, Aditya Raghavendra Sai Siva, Adbalwad, Yogesh Madhavrao
Format:	Journal Article
Language:	English
Published:	Korea (South) Korean Society of Spine Surgery 01-04-2024 Korean Spine Society
Subjects:	Basic Study finite element analysis intervertebral disc stress lateral mass screw fixation posterior cervical fixation transpedicular screw fixation Intervertebral disc stress Finite element analysis Transpedicular screw fixation Posterior cervical fixation Lateral mass screw fixation
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Summary:	Basic research. This finite element (FE) analysis (FEA) aimed to compare the biomechanical parameters in multilevel posterior cervical fixation with the C7 vertebra instrumented by two techniques: lateral mass screw (LMS) vs. transpedicular screw (TPS). Very few studies have compared the biomechanics of different multilevel posterior cervical fixation constructs. Four FE models of multilevel posterior cervical fixation were created and tested by FEA in various permutations and combinations. Generic differences in fixation were determined, and the following parameters were assessed: (1) maximum moment at failure, (2) maximum angulation at failure, (3) maximum stress at failure, (4) point of failure, (5) intervertebral disc stress, and (6) influence of adding a C2 pars screw to the multilevel construct. The maximum moment at failure was higher in the LMS fixation group than in the TPS group. The maximum angulation in flexion allowed by LMS was higher than that by TPS. The maximum strain at failure was higher in the LMS group than in the TPS group. The maximum stress endured before failure was higher in the TPS group than in the LMS group. Intervertebral stress levels at C6-C7 and C7-T1 intervertebral discs were higher in the LMS group than in the TPS group. For both models where C2 fixation was performed, lower von Mises stress was recorded at the C2-C3 intervertebral disc level. Ending a multilevel posterior cervical fixation construct with TPS fixation rather than LMS fixation at the C7 vertebra provides a stiff and more constrained construct system, with higher stress endurance to compressive force. The constraint and durability of the construct can be further enhanced by adding a C2 pars screw in the fixation system.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1976-1902 1976-7846
DOI:	10.31616/asj.2023.0231