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- 저자 : Muzammil Mumtaz (검색결과 2 건)
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Muzammil Mumtaz,Justin Mendoza,Ardalan Seyed Vosoughi,Anthony S. Unger,Vijay K. Goel 대한척추신경외과학회 2021 Neurospine Vol.18 No.3
Objective: The objective of this study was to compare the biomechanical differences of different rod configurations following anterior column realignment (ACR) and pedicle subtraction osteotomy (PSO) for an optimal correction technique and rod configuration that would minimize the risk of rod failure. Methods: A validated spinopelvic (L1-pelvis) finite element model was used to simulate ACR at the L3–4 level. The ACR procedure was followed by dual-rod fixation, and for 4-rod constructs, either medial/lateral accessory rods (connected to primary rods) or satellite rods (directly connected to ACR level screws). The range of motion (ROM), maximum von Mises stress on the rods, and factor of safety (FOS) were calculated for the ACR models and compared to the existing literature of different PSO rod configurations. Results: All of the 4-rod ACR constructs showed a reduction in ROM and maximum von Mises stress compared to the dual-rod ACR construct. Additionally, all of the 4-rod ACR constructs showed greater percentage reduction in ROM and maximum von Mises stress compared to the PSO 4-rod configurations. The ACR satellite rod construct had the maximum stress reduction i.e., 47.3% compared to dual-rod construct and showed the highest FOS (4.76). These findings are consistent with existing literature that supports the use of satellite rods to reduce the occurrence of rod fracture. Conclusion: Our findings suggest that the ACR satellite rod construct may be the most beneficial in reducing the risk of rod failure compared to all other PSO and ACR constructs.
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Biomechanical Study on Three Screw-Based Atlantoaxial Fixation Techniques: A Finite Element Study
Erbulut Deniz Ufuk,Mumtaz Muzammil,Zafarparandeh Iman,Özer Ali Fahir 대한척추외과학회 2022 Asian Spine Journal Vol.16 No.6
Study Design: This is a finite element study.Purpose: This study is aimed to compare the biomechanical behaviors of three screw-based atlantoaxial fixation techniques.Overview of Literature: Screw-based constructs that are widely used to stabilize the atlantoaxial joint come with their own challenges in surgery. Clinical and in vitro studies have compared the effectiveness of screw-based constructs in joint fixation. Nevertheless, there is limited information regarding the biomechanical behavior of these constructs, such as the stresses and strains they experience.Methods: A finite element model of the upper cervical spine was developed. A type II dens fracture was induced in the intact model to produce the injured model. The following three constructs were simulated on the intact and injured models: transarticular screw (C1– C2TA), lateral mass screw in C1 and pedicle screw in C2 (C1LM1–C2PD), and lateral mass screw in C1 and translaminar screw in C2 (C1LM1–C2TL).Results: In the intact model, flexion–extension range of motion (ROM) was reduced by up to 99% with C11–C2TA and 98% with C1LM1–C2PD and C1LM1–C2TL. The lateral bending ROM in the intact model was reduced by 100%, 95%, and 75% with C11–C2TA, C1LM1–C2PD, and C1LM1–C2TL, respectively. The axial rotation ROM in the intact model was reduced by 99%, 98%, and 99% with C11–C2TA, C1LM1–C2PD, and C1LM1–C2TL, respectively. The largest maximum von Mises stress was predicted for C1LM1–C2TL (332 MPa) followed by C1LM1–C2PD (307 MPa) and C11–C2TA (133 MPa). Maximum stress was predicted to be at the lateral mass screw head of the C1LM1–C2TL construct.Conclusions: Our model indicates that the biomechanical stability of the atlantoaxial joint in lateral bending with translaminar screws is not as reliable as that with transarticular and pedicle screws. Translaminar screws experience large stresses that may lead to failure of the construct before the required bony fusion occurs.
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