A new low elastic modulus of beta titanium alloy Ti2448 spinal pedicle screw fixation affects thoracic stability: biomechanical analysis

doi:10.3969/j.issn.2095-4344.2017.07.009

Abstract

Abstract:

BACKGROUND: A new type of medical titanium alloy Ti2448 (Ti-24Nb-4Zr-7.9Sn) is by far the lowest initial modulus of titanium alloy, with the initial modulus of about 40 GPa, the average Young’s modulus < 20 GPa, and tensile strength of about 900 MPa; human tissue biocompatibility and mechanical compatibility are excellent.

OBJECTIVE: To investigate the biomechanical properties of a new low elastic modulus spinal pedicle screw fixation system and compare it with Ti6Al4V pedicle screw.

METHODS: Totally 60 fresh human cadaveric thoracic vertebrae were randomly selected: on one side, pedicle new low modulus Ti2448 pedicle screws, as the experimental group; on the other side, pedicle screw Ti6Al4V, as control group. The maximum bending load and maximum load displacement, maximum torque and maximum axial pulling force of the two groups were detected.

RESULTS AND CONCLUSION: There was no significant difference in the maximum bending load, maximum load displacement, maximum torque and maximum pulling force between the two groups. The results show that the maximum bending strength, the maximum torque and maximum pullout force in low elastic modulus of Ti2448 pedicle screw fixation system are consistent with the Ti6Al4V screws, which can meet the needs of internal fixation on spinal biomechanics strength.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Prosthesis, Implant, Spine, Biomechanics, Tissue Engineering

CLC Number:

R318

Huang Xiang-wang, Liu Hong-zhe. A new low elastic modulus of beta titanium alloy Ti2448 spinal pedicle screw fixation affects thoracic stability: biomechanical analysis[J]. Chinese Journal of Tissue Engineering Research, 2017, 21(7): 1031-1035.

Figures/Tables 3

References

[1] 邓海涛,王清.椎弓根螺钉置入内固定治疗胸腰段骨折脱位后脊柱的生物力学变化[J].中国组织工程研究, 2014,18(13): 2055-2058.

[2] Lee JK,Jang JW,Kim TW,et al.Percutaneous short-segment pedicle screw placement without fusion in the treatment of thoracolumbar burst fractures: Is it effective?: Comparative study with open short-segment pedicle screw fixation with posterolateral fusion.Acta Neurochirurgica. 2013;155(12): 2305-2312.

[3] 雷伟,吴子祥,李明全,等.膨胀式脊柱椎弓根螺钉固定的生物力学研究[J].中国脊柱脊髓杂志,2004,14(11):669-672.

[4] 杜炜,钱明权.椎弓根螺钉置入椎体深度与其稳定性的生物力学分析[J].中国组织工程研究,2016,20(9):1289-1294.

[5] 杨锐,郝玉琳.高强度低模量医用钛合金Ti2448的研制与应用[J].新材料产业,2009,11(6):10-13.

[6] 裴晓东.两种不同的胸椎椎弓根螺钉固定技术的应用解剖与生物力学研究[D].内蒙古:内蒙古医学院,2006.

[7] Kim YJ,Lenke LG,Bridwell KH,et al.Free hand pedicle screw placement in the thoracic spine:is it safe.Spine (Phila Pa 1976). 2004;29(3):333-342.

[8] 徐德利,林浩,陶海鹰,等.双侧椎弓根螺钉置入内固定修复腰椎间盘突出：椎间高度恢复的影像学评估[J].中国组织工程研究, 2015, 19(26):4191-4196.

[9] [Huang DG,Hao DJ.Answer to the Letter to the Editor concerning "Is the 4 mm height of the vertebral artery groove really a limitation of C1 pedicle screw insertion" by Da-Geng Huang, et al. Eur Spine J (2014) 23(5):1109-1114.Eur Spine J.2014;23(9):2011.

[10] 辛大奇,霍洪军,杨学军,等.中上胸椎椎弓根-肋骨复合体应用不同截面积螺钉的力学特点[J].中国组织工程研究, 2014,18(9): 1356-1361.

[11] 曾红生,陈子华,陈建威,等.经伤椎椎弓根螺钉置入内固定修复胸腰椎骨折：远期效果及生物力学分析[J].中国组织工程研究, 2016,20(4):571-576.

[12] Wu ZH,Zheng Y,Yin QS,et al.Anterior pedicle screw fixation of C2: An anatomic analysis of axis morphology and simulated surgical fixation.Eur Spine J.2014;23(2):356-361.

[13] 王祥善,鲍朝辉,赵卫东,等.膨胀式脊柱内固定系统椎弓根螺钉翻修作用的生物力学研究[J].中国脊柱脊髓杂志, 2005,15(7): 436-439.

[14] Raley DA,Mobbs RJ.Retrospective computed tomography scan analysis of percutaneously inserted pedicle screws for posterior transpedicular stabilization of the thoracic and lumbar spine: Accuracy and complication rates.Spine (Phila Pa 1976).2012;37(12):1092-1100.

[15] Ploss C,Maier B,Mack MG,et al.Accuracy of CT-assisted pedicle screw placement after CT-controlled, presurgical guide wire implantation in traumatic and pathological fractures in the thoracic spine.Eur J Trauma Emerg Surg.2011;37(2):121-126.

[16] Amato V,Giannachi L,Irace C,et al.Accuracy of pedicle screw placement in the lumbosacral spine using conventional technique: Computed tomography postoperative assessment in 102 consecutive patients-Clinical article.J Neurosurg Spine. 2010;12(3):306-313.

[17] 李书纲,邱贵兴,翁习生,等.通用型脊柱内固定系统椎弓根螺钉翻修作用的生物力学研究[J].中华骨科杂志,2002,22(11):648-652.

[18] Huang DG,He SM,Pan JW,et al.Is the 4 mm height of the vertebral artery groove really a limitation of C1 pedicle screw insertion?Eur Spine J.2014;23(5):1109-1114.

[19] 李熙雷,车武,董健,等.经伤椎单节段椎弓根螺钉固定治疗胸腰椎爆裂骨折的生物力学研究[J].中华创伤骨科杂志,2012,14(3):225-227.

[20] 刘达,伍红桦,郑伟,等.骨质疏松尸体腰椎中膨胀式椎弓根螺钉与骨水泥强化椎弓根螺钉固定稳定性的比较研究[J].中国脊柱脊髓杂志,2014,24(7):638-642,643.

[21] 朱爱国,张烽,陈向东,等.两种内固定物置入增强前路椎间融合后腰椎即刻稳定性的差异[J].中国组织工程研究与临床康复, 2010, 14(39):7243-7245.

[22] 车武,姜允琦,马易群,等.单节段椎弓根螺钉固定联合上方棘突间Coflex置入的生物力学评价[J].中国脊柱脊髓杂志,2015, 25(1): 62-66.

[23] Lieberman IH,Hardenbrook MA,Wang JC,et al.Assessment of pedicle screw placement accuracy, procedure time, and radiation exposure using a miniature robotic guidance system.J Spinal Disord Tech.2012;25(5):241-248.

[24] Ling JM,Dinesh SK,Pang BC,et al.Routine spinal navigation for thoraco-lumbar pedicle screw insertion using the O-arm three-dimensional imaging system improves placement accuracy.J Clin Neurosci.2014;21(3):493-498.

[25] 朱如森,冯世庆,刘岩,等.脊柱内固定椎弓根螺钉置入后生物力学的稳定性[J].中国组织工程研究,2013,17(17):3156-3163.

[26] Patel RD,Rosas HG,Steinmetz MP,et al.Repair of pars interarticularis defect utilizing a pedicle and laminar screw construct: A new technique based on anatomical and biomechanical analysis-Laboratory investigation.J Neurosurg Spine.2012;17(1):61-68.

[27] Magerl FP.Stabilization of the lower thoracic and lumbar spine with external skeletal fixation.Clin Orthop Relat Res.1984; (189):125-141.

[28] Roy-Camille R,Saillant G,Mazel C.Internal fixation of the lumbar spine with pedicle screw plating.Clin Orthop Relat Res.1986;(203):7-17.

[29] 唐天驷.胸腰椎骨折患者的椎弓根短节段脊柱内固定器治疗[J].苏州大学学报(医学版),1986,27(3):272-275.

[30] Krag MH,Beynnon BD,Pope MH,et al.Depth of insertion of transpedicular vertebral screws into human vertebrae: effect upon screw-vertebra interface strength.J Spinal Disord. 1988; 1(4):287-294.

[31] 韦兴,侯树勋,赵卫东,等.胸椎椎弓根螺钉抗拔出强度的生物力学测试[J].中国临床解剖学杂志,2002,20(5):329-330.

[32] Kwok AW,Finkelstein JA,Woodside T,et al.Insertional torque and pull-out strengths of conical and cylindrical pedicle screws in cadaveric bone.Spine (Phila Pa 1976). 1996; 21(21):2429-2434.

[33] Ryken TC,Clausen JD,Traynelis VC,et al.Biomechanical analysis of bone mineral density, insertion technique, screw torque, and holding strength of anterior cervical plate screws. J Neurosurg.1995;83(2):325-329.