Finite element analysis comparing short-segment instrumentation with conventional pedicle screws and the Schanz pedicle screw in lumbar 1 fractures.

Abstract

Previous finite element studies of thoracolumbar fractures were mostly based on simulation analysis of one single object, which was difficult to objectively evaluate the differences between conventional pedicle screws and Schanz pedicle screws. The aim of this study was to evaluate the stress of screw and injured vertebrae displacement using the finite element model of conventional pedicle screw and Schanz pedicle screw instrumentation for the treatment of lumbar 1 fractures. Data of eight healthy volunteers were used to simulate the finite element model. The instrumentation models were divided into four groups: moderate fracture conventional (MC), moderate fracture Schanz (MS), unstable/severe fracture conventional (UC), and unstable/severe fracture Schanz (US) pedicle screw groups. The maximum screw stress and lumbar 1 displacement/micro-motion in each group increased with the increase of torque and/or load. Under the same fracture, maximum von Mises stress of conventional pedicle screw (MC/UC) was larger than Schanz pedicle screw (MS/US) (P < 0.05) and lumbar 1 displacement/micro-motion of Schanz pedicle screw (MS/US) was larger than conventional pedicle screw (MC/UC) (P < 0.05). Under the same screws, the maximum von Mises stress and displacement/micro-motion of unstable fracture (UC/US) were larger than moderate fracture (MC/MS) (P < 0.05). Posterior short-segment instrumentation with Schanz pedicle screws were recommended for unstable fractures. The compression displacement/micro-motion of bony defect during flexion may lead to the postoperative re-collapse of injured vertebrae.