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Finite element analysis comparing a PEEK posterior fixation device versus pedicle screws for lumbar fusion – Lumbar Fusion

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The article discusses a finite element analysis comparing the biomechanical properties of a novel cortico-pedicular posterior fixation (CPPF) device with a conventional pedicle screw system (PSS) for lumbar fusion procedures. The study found that the CPPF device provided significant reductions in flexion, extension, lateral bending, and torsion compared to the intact spine. The stability provided by the CPPF device was comparable to the PSS, but the total anterior load transfer was higher with the CPPF device. The findings suggest that cortico-pedicular fixation may offer comparable stability and less anterior column stress shielding compared to pedicle screws, but further clinical studies are needed to confirm these findings

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most advanced treatment clinic on Harley Street UK

Published article

: Under the modeled conditions, cortico-pedicular fixation for supplementing anterior or lateral interbody devices between L4 and S1 resulted in comparable stability based on range of motion measures and less anterior column stress shielding based on total anterior load transfer measures compared to PSS. Clinical studies are needed to confirm these finite element analysis findings.

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J Orthop Surg Res. 2023 Nov 10;18(1):855. doi: 10.1186/s13018-023-04349-5.ABSTRACTBACKGROUND: Pedicle screw loosening and breakage are common causes of revision surgery after lumbar fusion. Thus, there remains a continued need for supplemental fixation options that offer immediate stability without the associated failure modes. This finite element analysis compared the biomechanical properties of a novel cortico-pedicular posterior,

J Orthop Surg Res. 2023 Nov 10;18(1):855. doi: 10.1186/s13018-023-04349-5.

ABSTRACT

BACKGROUND: Pedicle screw loosening and breakage are common causes of revision surgery after lumbar fusion. Thus, there remains a continued need for supplemental fixation options that offer immediate stability without the associated failure modes. This finite element analysis compared the biomechanical properties of a novel cortico-pedicular posterior fixation (CPPF) device with those of a conventional pedicle screw system (PSS).

METHODS: The CPPF device is a polyetheretherketone strap providing circumferential cortical fixation for lumbar fusion procedures via an arcuate tunnel. Using a validated finite element model, we compared the stability and load transfer characteristics of CPPF to intact conditions under a 415 N follower load and PSS conditions under a 222 N preload. Depending on the instrumented levels, two different interbody devices were used: a lateral lumbar interbody device at L4-5 or an anterior lumbar interbody device at L5-S1. Primary outcomes included range of motion of the functional spinal units and anterior load transfer, defined as the total load through the disk and interbody device after functional motion and follower load application.

RESULTS: Across all combinations of interbody devices and lumbar levels evaluated, CPPF consistently demonstrated significant reductions in flexion (ranging from 90 to 98%), extension (ranging from 88 to 94%), lateral bending (ranging from 75 to 80%), and torsion (ranging from 77 to 86%) compared to the intact spine. Stability provided by the CPPF device was comparable to PSS in all simulations (range of motion within 0.5 degrees for flexion-extension, 0.6 degrees for lateral bending, and 0.5 degrees for torsion). The total anterior load transfer was higher with CPPF versus PSS, with differences across all tested conditions ranging from 128 to 258 N during flexion, 89-323 N during extension, 135-377 N during lateral bending, 95-258 N during torsion, and 82-250 N during standing.

: Under the modeled conditions, cortico-pedicular fixation for supplementing anterior or lateral interbody devices between L4 and S1 resulted in comparable stability based on range of motion measures and less anterior column stress shielding based on total anterior load transfer measures compared to PSS. Clinical studies are needed to confirm these finite element analysis findings.

PMID:37950318 | DOI:10.1186/s13018-023-04349-5

The London Spine Unit : most advanced treatment clinic on Harley Street UK

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Finite element analysis comparing a PEEK posterior fixation device versus pedicle screws for lumbar fusion

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J Orthop Surg Res. 2023 Nov 10;18(1):855. doi: 10.1186/s13018-023-04349-5.ABSTRACTBACKGROUND: Pedicle screw loosening and breakage are common causes of revision surgery after lumbar fusion. Thus, there remains a continued need for supplemental fixation options that offer immediate stability without the associated failure modes. This finite element analysis compared the biomechanical properties of a novel cortico-pedicular posterior
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