Objective To develop FE models of osteotomized spine and evaluate whether cross-link (CL) improves the instrumentation stiffness and decrease the risk of complications. Methods Firstly, a finite element model without CL was established based on CT images of postoperative male patients with thoracolumbar kyphosis. Secondly, five models were established according to the different numbers and positions of CL. Four loading conditions (flexion, extension, lateral bending, and axial rotation) were applied to the model. The range of motion (ROM), the maximum value and distribution of the implants, and vertebrae stress were compared between models. Results With number of CL increasing, the ROM of instrumented segments was reduced. When loading axial rotation condition, the ROM was reduced by 21.98%. The peak stresses were located on rods during axial rotation, on proximal pedicle screws during flexion, and on the osteotomy site during extension and lateral bending. The CLs had an effect of dispersing stress concentration. Conclusions The application of CLs is able to enhance the rigidity of the construct. With the number of CL increasing, the ROM of the construct is reducing, especially in axial rotation. CLs can also make stress concentration dispersed.
Finite element analysis Spine Biomechanics Osteotomy Cross-link
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Lehman RA, Kang DG, Wagner SC, Paik H, Cardoso MJ, Bernstock JD et al (2015) Biomechanical stability of transverse connectors in the setting of a thoracic pedicle subtraction osteotomy. Spine J 15:1629–1635CrossRefGoogle Scholar
Wood KB, Wentorf FA, Ogilvie JW, Kim KT (2000) Torsional rigidity of scoliosis constructs. Spine (Phila Pa 1976) 25:1893–1898CrossRefGoogle Scholar
Brodke DS, Bachus KN, Mohr RA, Nguyen BK (2001) Segmental pedicle screw fixation or cross-links in multilevel lumbar constructs. A Biomech Anal Spine J 1:373–379Google Scholar
Valdevit A, Kambic HE, McLain RF (2005) Torsional stability of cross-link configurations: a biomechanical analysis. Spine J 5:441–445CrossRefGoogle Scholar
Kuklo TR, Dmitriev AE, Cardoso MJ, Lehman RA, Erickson M, Gill NW (2008) Biomechanical contribution of transverse connectors to segmental stability following long segment instrumentation with thoracic pedicle screws. Spine (Phila Pa 1976) 33:E482–487CrossRefGoogle Scholar
Alizadeh M, Kadir MR, Fadhli MM et al (2013) The use of X-shaped cross-link in posterior spinal constructs improves stability in thoracolumbar burst fracture: a finite element analysis. J Orthop Res 31(9):1447–1454CrossRefGoogle Scholar
Liao JC, Chen WP, Wang H (2017) Treatment of thoracolumbar burst fractures by short-segment pedicle screw fixation using a combination of two additional pedicle screws and vertebroplasty at the level of the fracture: a finite element analysis. BMC Musculoskelet Disord 18:262CrossRefGoogle Scholar
Schwab F, Blondel B, Chay E, Demakakos J, Lenke L, Tropiano P, et al (2015) The comprehensive anatomical spinal osteotomy classification. Neurosurgery 76(Suppl 1):S33–41Google Scholar
Wang Y, Lenke LG (2011) Vertebral column decancellation for the management of sharp angular spinal deformity. Eur Spine J 20:1703–1710CrossRefGoogle Scholar
Holzapfel GA, Schulze-Bauer CA, Feigl G, Regitnig P (2005) Single lamellar mechanics of the human lumbar anulus fibrosus. Biomech Model Mechanobiol 3:125–140CrossRefGoogle Scholar
Gzik M, Wolanski W, Tejszerska D (2008) Experimental determination of cervical spine mechanical properties. Acta Bioeng Biomech 10:49–54Google Scholar
Shirazi-Adl SA, Shrivastava SC, Ahmed AM (1894) Stress analysis of the lumbar disc-body unit in compression. A three-dimensional nonlinear finite element study. Spine (Phila Pa 1976) 9:120–134CrossRefGoogle Scholar
Yamamoto I, Panjabi MM, Crisco T, Oxland T (1989) Three-dimensional movements of the whole lumbar spine and lumbosacral joint. Spine (Phila Pa 1976) 14:1256–1260CrossRefGoogle Scholar