Abstract：
BACKGROUND CONTEXT:Screw loosening has been reported for non-fusion devices. Forces on pedicle screws could be related to kinematic parameters as the interpedicular displacement (ID), which consists of the displacement between superior and inferior screw heads from full extension to full flexion. PURPOSE:To investigate the relationship between ID and screw loosening for different designs of posterior implants using a finite element model. METHODS:An L3-sacrum previously validated spine FE model was used. Three-rod designs were considered in L4-L5 segment: a rigid screw-rod implant, a flexible one and a specific design with a sliding rod providing limited restrain in ID. In order to simulate intermediate configurations, the friction coefficient between the sliding rods and connectors were varied. The sacrum was rigidly fixed. Rotations (flexion-extension, lateral bending and axial rotation) were applied to L3, for each modeled configuration: intact, injured, injured with different implants. Model consistency was checked with existing experimental in vitro data on intact and instrumented segments. Screw loads were computed as well as ID. RESULTS:In flexion-extension, the ID was less than 2mm for rigid (R) and flexible (F) constructs and 5.5mm for intact spine and the sliding implant (S3). Screw's shear forces were 272N, 153N, 43N respectively for R, F and S3 constructs. CONCLUSIONS:Implants that allow ID presented lower screws loads. A compromise between the ability of the implant to withstand compressive forces, which requires longitudinal stiffness, and its ability to allow ID could be important for future implant designs in order to prevent screw loosening.
journal_name
Orthop Traumatol Surg Resjournal_title
Orthopaedics & traumatology, surgery & research : OTSRauthors
Lima LVPC,Charles YP,Rouch P,Skalli Wdoi
10.1016/j.otsr.2017.05.004subject
Has Abstractpub_date
2017-09-01 00:00:00pages
721-726issue
5issn
1877-0568pii
S1877-0568(17)30146-9journal_volume
103pub_type
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journal_title：Orthopaedics & traumatology, surgery & research : OTSR
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journal_title：Orthopaedics & traumatology, surgery & research : OTSR
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