Abstract:

BACKGROUND: For the surgical treatment of congenital scoliosis caused by hemivertebrae, the choice of anterior, posterior approach and long, short segment fixation, is mainly based on clinical experience of doctors. The biomechanical studies are insufficient. There are no reports about finite element modeling and simulating on congenital scoliosis caused by hemivertebrae.
OBJECTIVE: To establish an individual three-dimensional finite element model to simulate three-dimensional correction surgery, and to investigate correction effectiveness and biological characteristics with different surgical methods.
METHODS: A finite element model of a congenital scoliosis caused by hemivertebrae was constructed using finite element software, and then the individual finite element model was applied to simulate hemivertebra resection with different instrumentation strategies, and pull out the correction effects.
RESULTS AND CONCLUSION: Posterior instrumented fusion was better than anterior instrumented fusion after hemivertebrae resection, especially for the kyphosis angle correction, and the ratio was all above 50%; and the differences between posterior short-segment fixation and long-segment after hemivertebrae resection were not obvious within 5°. The surgical simulations showed that posterior short-segment fixation with hemivertebrae resection is the better treatment strategy, which can obtain satisfactory corrective rate with fewer fixed segments for the congenital scoliosis patient caused by hemivertebrae.