Chinese Journal of Tissue Engineering Research ›› 2026, Vol. 30 ›› Issue (9): 2145-2152.doi: 10.12307/2025.873

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Tail anchoring technique of vertebroplasty in treatment of osteoporotic vertebral compression fractures with intravertebral cleft: a finite element analysis

Chen Huiting, Zeng Weiquan, Zhou Jianhong, Wang Jie, Zhuang Congying, Chen Peiyou, Liang Zeqian, Deng Weiming   

  1. Department of Spine Orthopedics, Zengcheng District Traditional Chinese Medicine Hospital, Guangzhou 510000, Guangdong Province, China
  • Received:2024-08-30 Accepted:2025-01-17 Online:2026-03-28 Published:2025-08-20
  • Contact: Deng Weiming, Attending physician, Department of Spine Orthopedics, Zengcheng District Traditional Chinese Medicine Hospital,Guangzhou 510000, Guangdong Province, China
  • About author:Chen Huiting, Associate chief physician, Department of Spine Orthopedics, Zengcheng District Traditional Chinese Medicine Hospital, Guangzhou 510000,Guangdong Province, China

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Abstract:

BACKGROUND: Percutaneous vertebroplasty is an effective surgical method for treating osteoporotic vertebral compression fractures. However, for patients with vertebral compression fractures accompanied by intravertebral clefts, how to reduce cement loosening and displacement after vertebroplasty has become one of the difficulties for spinal surgeons.
OBJECTIVE: To explore the biomechanical stability of tail anchoring technique in the treatment of vertebral compression fractures with intravertebral cleft. 
METHODS: A finite element model of the T10-L2 segment was established using CT scan data from a patient with osteoporotic vertebral compression fractures. On Solidwork software, the intravertebral intravertebral cleft was simulated and five sets of three-dimensional models were constructed: (1) osteoporotic vertebral compression fractures model with intravertebral cleft; (2) percutaneous vertebroplasty model of 2.5 mL bone cement; (3) 2.5 mL bone cement + percutaneous vertebroplasty model with trailing anchoring; (4) percutaneous vertebroplasty model of 4.6 mL bone cement; (5) 4.6 mL bone cement + trailing anchored percutaneous vertebroplasty model. Then, the model was imported into Ansys software, and structures such as ligaments were added and assigned values for finite element analysis. The loading conditions were as follows: a 400 N vertical downward load was applied to the upper surface of T10 vertebral body to simulate the weight of the upper body, and a moment of 7.5 N·m was applied in different directions to simulate movements such as spinal flexion, extension, and rotation. The differences in motion range, deformation degree, maximum equivalent stress, and bone cement stress were compared between different models. 
RESULTS AND CONCLUSION: (1) In terms of the range of motion of fractured vertebral bodies, osteoporotic vertebral compression fractures models with intravertebral clefts had the greatest range of motion, reaching 4°-7° in all directions. Although the 2.5 mL bone cement model and the 2.5 mL bone cement + trailing anchor model could partially reduce abnormal movement of fractured vertebrae, their stability was still poor, with a motion range of up to 3°-4° during flexion, extension, and rotation. In the 4.6 mL bone cement + trailing anchor model, the mobility of fractured vertebral bodies was significantly reduced and relatively stable. The motion range of fractured vertebrae decreased by 81%, 83%, 77%, 69%, 76%, and 79% compared with the osteoporotic vertebral compression fractures model with intravertebral cleft, indicating that it had the best biomechanical stability. (2) In terms of the maximum equivalent stress and deformation degree of fractured vertebral bodies, the results were as follows: osteoporotic vertebral compression fractures model with intravertebral cleft > 2.5 mL bone cement model > 2.5 mL bone cement + trailing anchor model > 4.6 mL bone cement model > 4.6 mL bone cement + trailing anchor model, indicating that when there was a small amount of bone cement, the use of only trailing anchoring technology could not effectively stabilize fractured vertebrae. When the amount of bone cement in front of the vertebral body reached 4.6 mL, combined with trailing anchoring technology, it could significantly reduce the maximum equivalent stress and deformation degree of the vertebral body. (3) It is noteworthy that in both sets of tail-anchored models, the maximum equivalent stress of bone cement significantly increased, primarily concentrated in the mid-to-posterior region of the trailing bone cement. (4) In general, with a certain amount of bone cement in the vertebral body, the trailing anchoring technique could significantly enhance the stability of fractured vertebrae and reduce their abnormal movement and stress concentration within the vertebral body. It is a surgical technique worth trying. However, it should be noted that the stress of bone cement in the trailing anchoring part increases significantly. If patients do not pay attention to protection after surgery, there may be a risk of fracture of bone cement at the anchoring site.

Key words: osteoporosis, thoracolumbar compression fracture, intravertebral cleft, tail anchoring sign, finite element analysis, orthopedic implant

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