Finite element analysis of screw-bone anti-pullout in four models of anterior lower cervical fixation in children

doi:10.3969/j.issn.2095-4344.3843

Abstract

Abstract: BACKGROUND: Anterior internal fixation of lower cervical spine in children has been applied clinically. However, the unique developmental morphology, physiological characteristics and mechanical changes of children’s cervical vertebrae are significantly different from those of adults. It is easy for screw fixation to loosen, shift and pull-out in clinical application, so it is necessary to carry out screw-bone pull-out test analysis for different screw internal fixation methods in children.
OBJECTIVE: To compare the superiority of the four screw internal fixation systems in the anterior model of the lower cervical spine in children using finite element analysis.
METHODS: The cervical spine image data were collected from the multislice spiral CT scanning of corpse specimen of a 6-year-old normal girl (with informed consent of family members), and the three-dimensional finite element model of normal C4 was constructed by using software such as Mimics 16.01, Pro/E 5.0, Geomagic Studio 2015, Hypermesh 14.0 and Abaqus 6.14. On the basis of C4 model, four kinds of screw fixation models were established, i.e., anterior cervical bicortical pedicle screw internal fixation (ACBS), anterior cervical single cortical pedicle screw internal fixation (ACSS), anterior cervical vertebral screw internal fixation (ACVS) and anterior cervical Orion screw internal fixation (ACOS). The screw pull-out stress peak value and the stress value of each part of the screw were analyzed.
RESULTS AND CONCLUSION: (1) The stress peak of screw pull-out resistance was in order from high to low: ACBS group > ACSS group > ACVS group > ACOS group. (2) In the process of pulling out the screws of the four internal fixation models, the front part of the screw rod bore the greatest stress, and the stress was attenuated during the process of transferring to the tip. (3) The four internal fixation models had the highest stress peak in the vertebral body, and the pedicle internal fixation was more stable than the internal fixation alone. (4) The peak stress of the cervical spine and the peak of the screw stress in the ACBS group were higher than those of the other groups, and the holding power was better. The cervical spine stress peak and screw stress peak in ACSS group were higher than those in ACVS group and ACOS group, and there was no difference between ACVS group and ACOS group. (5) The results showed that bicortical pedicle screw internal fixation was superior to the anterior cervical screw extraction in children.

Key words: bone, internal fixation, lower cervical internal fixation, pedicle screw, bone-screw pullout force, finite element analysis, children

CLC Number:

Qu Xingyue, Zhou Jianqiang, Xu Xuebin, Zhang Shaojie, Li Zhijun, Wang Xing. Finite element analysis of screw-bone anti-pullout in four models of anterior lower cervical fixation in children[J]. Chinese Journal of Tissue Engineering Research, 2021, 25(18): 2816-2821.

Figures/Tables 10

References

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