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Research Papers

A Novel Anterior Transpedicular Screw Artificial Vertebral Body System for Lower Cervical Spine Fixation: A Finite Element Study

[+] Author and Article Information
Weidong Wu

Department of Anatomy,
Guangdong Provincial Medical Biomechanical Key Laboratory,
Academy of Orthopedics of Guangdong Province,
Southern Medical University,
Guangzhou 510515, China;
Wuhan Concrete Technology Company Limited,
Gaoxin Avenue 818,
Wuhan 430200, Hubei, China
e-mail: wu315129181@163.com

Chun Chen

Department of Orthopedics,
The First Affiliated Hospital of Wenzhou Medical University,
Wenzhou 325000, Zhejiang, China
e-mail: chenchunkk@163.com

Jinpei Ning

Department of Orthopedics,
Wuzhou Red Cross Hospital,
Wuzhou 543002, Guangxi, China
e-mail: njp008@sina.com

Peidong Sun

Department of Anatomy,
Guangdong Provincial Medical Biomechanical Key Laboratory,
Academy of Orthopedics of Guangdong Province,
Southern Medical University,
Guangzhou 510515, China
e-mail: spdwwf@126.com

Jinyuan Zhang

Department of Anatomy,
Guangdong Provincial Medical Biomechanical Key Laboratory,
Academy of Orthopedics of Guangdong Province,
Southern Medical University,
Guangzhou 510515, China
e-mail: 553545578@qq.com

Changfu Wu

Department of Orthopedic Surgery,
The Affiliated Hospital of Putian University,
Putian 351100, Fujian, China;
Department of Orthopedic Surgery,
The Affiliated Putian Hospital of Southern Medical University,
Putian 351100, Fujian, China
e-mail: wuchangfu360@163.com

Zhenyu Bi

Department of Anatomy,
Guangdong Provincial Medical Biomechanical Key Laboratory,
Academy of Orthopedics of Guangdong Province,
Southern Medical University,
Guangzhou 510515, China
e-mail: lybimail@126.com

Jihong Fan

Department of Anatomy,
Guangdong Provincial Medical Biomechanical Key Laboratory,
Academy of Orthopedics of Guangdong Province,
Southern Medical University,
Guangzhou 510515, China
e-mail: 793649633@qq.com

Xianliang Lai

Department of Orthopedic Surgery,
Wenzhou Hospitals of Traditional Chinese and Western Medicine,
Wenzhou 325000, Zhejiang, China
e-mail: 303476292@qq.com

Jun Ouyang

Professor
Department of Anatomy,
Guangdong Provincial Medical Biomechanical Key Laboratory,
Academy of Orthopedics of Guangdong Province,
Southern Medical University,
No. 1023 Shatai Road,
Baiyun District,
Guangzhou 510515, China
e-mail: jouyang@126.com

1W. Wu and C. Chen contributed equally to this work.

2Corresponding author.

Manuscript received December 1, 2016; final manuscript received March 19, 2017; published online April 18, 2017. Assoc. Editor: Brian D. Stemper.

J Biomech Eng 139(6), 061003 (Apr 18, 2017) (8 pages) Paper No: BIO-16-1489; doi: 10.1115/1.4036393 History: Received December 01, 2016; Revised March 19, 2017

A finite element model was used to compare the biomechanical properties of a novel anterior transpedicular screw artificial vertebral body system (AVBS) with a conventional anterior screw plate system (ASPS) for fixation in the lower cervical spine. A model of the intact cervical spine (C3–C7) was established. AVBS or ASPS constructs were implanted between C4 and C6. The models were loaded in three-dimensional (3D) motion. The Von Mises stress distribution in the internal fixators was evaluated, as well as the range of motion (ROM) and facet joint force. The models were generated and analyzed by mimics, geomagic studio, and ansys software. The intact model of the lower cervical spine consisted of 286,382 elements. The model was validated against previously reported cadaveric experimental data. In the ASPS model, stress was concentrated at the connection between the screw and plate and the connection between the titanium mesh and adjacent vertebral body. In the AVBS model, stress was evenly distributed. Compared to the intact cervical spine model, the ROM of the whole specimen after fixation with both constructs is decreased by approximately 3 deg. ROM of adjacent segments is increased by approximately 5 deg. Facet joint force of the ASPS and AVBS models was higher than those of the intact cervical spine model, especially in extension and lateral bending. AVBS fixation represents a novel reconstruction approach for the lower cervical spine. AVBS provides better stability and lower risk for internal fixator failure compared with traditional ASPS fixation.

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Figures

Grahic Jump Location
Fig. 1

Construction of a geometrical model of the lower cervical spine and fixators: (a) model of the cervical spine reconstructed by mimics 14.0, (b) model of the lower cervical spine in geomagic v2013, (c) ASPS: anterior plate, (d) ASPS, titanium mesh, (e) artificial vertebral body, (f) vertebral body screw, (g) anterior transpedicular screw, (h) ligament connections, (i) sagittal view of a disk, (j) annulus matrix and fibers, and (k) cortical and cancellous bone

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Fig. 2

Modeling and calibration of the lower cervical spine: (a) calibration of flexion–extension, (b) calibration of lateral bending, (c) calibration of axial rotation, (d) intact model, (e) ASPS model, and (f) AVBS model

Grahic Jump Location
Fig. 3

Stress contour map under conditions of axial loading and extension–flexion: (a) maximum stress of fixators in the ASPS and AVBS models, (b) stress distribution in the ASPS model under axial loading, (c) stress distribution in the AVBS model under axial loading, (d) stress distribution in the ASPS model under flexion, (e) stress distribution in the AVBS model under flexion, (f) stress distribution in the ASPS model under extension, and (g) stress distribution in the AVBS model under extension

Grahic Jump Location
Fig. 4

Facet joint force of the intact cervical spine, ASPS, and AVBS models. EX—extension; BD—lateral bending; RT—axial rotation.

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