Application and progress of finite element analysis in the treatment of thoracolumbar fractures with pedicle screw fixation
Zheng Xiaobo, Yang Sheng, Wang Fengyun
Zhongshan Hospital Affiliated to Dalian University, Dalian 116000, Liaoning Province, China
Abstract: BACKGROUND: Pedicle screw fixation is widely used in the treatment of thoracolumbar fractures because of its simplicity and easy operation. It has always been a research hotspot to find a method that can preoperatively simulate and evaluate the safety of posterior pedicle screw fixation in the treatment of thoracolumbar fractures. Finite element analysis is currently a common method for evaluating long-segment and short-segment pedicle screw fixation models and analyzing their safety.
OBJECTIVE: It is hoped that a suitable, safe and effective finite element model of thoracolumbar fractures can be found by analyzing the existing finite element studies of pedicle screw fixation for thoracolumbar fractures.
METHODS: In the PubMed database, “finite element analysis, pedicle screw, thoracolumbar fractures” were used as the key words to carry out the relevant literature search. In the CNKI database, the relevant literature search was carried out with the key words of “finite element analysis, pedicle screw, thoracolumbar fractures”. The articles that were not closely related to the topic were excluded by quickly browsing the article titles and abstracts. Finally, 57 articles were screened out for intensive reading and writing.
RESULTS AND CONCLUSION: So far, there is no established standard for simulating thoracolumbar fractures through three-dimensional finite element models. The models of previous related studies are relatively simplified and out of touch with clinical practice, so they cannot accurately display the real situation of injured vertebrae, and the repeatability is poor. The finite element model of moderate and severe fractures based on the load sharing classification scoring system is more in line with the actual situation, because the quantitative assessment of the degree of vertebral body injury, the extent and displacement of the fracture fragments, and the correction of the kyphosis of the injured vertebra can all be determined by the finite element method. The method is well simulated. Therefore, the finite element study of pedicle fixation for thoracolumbar fractures based on this fracture model is also closer to clinical practice.
Key words: finite element analysis, pedicle screw, thoracolumbar fracture, pedicle screw fixation, review