ArticleNeurospine2020
Bicortical Screw Purchase at Upper Instrumented Vertebra (UIV) Can Cause UIV Fracture After Adult Spinal Deformity Surgery: A Finite Element Analysis Study.
Article in Neurospine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed, 26 citations in OpenAlex.
- Evaluation of a Novel Flexible Cage System for C5-C6 Fixation: A Finite Element Study Against Conventional ACDF Implants.Bioengineering (Basel, Switzerland) · 2026Article
- Direction-dependent biomechanical effects of transverse process hooks versus pedicle screws at the uppermost instrumented vertebra in adult spinal deformity: a finite element analysis.Frontiers in bioengineering and biotechnology · 2026Article
- Comparing zero-profile and conventional cage and plate in anterior cervical discectomy and fusion using finite-element modeling.Scientific reports · 2023Article
- Longer Screws Can Reduce the Stress on the Upper Instrumented Vertebra With Long Spinal Fusion Surgery: A Finite Element Analysis Study.Global spine journal · 2023Article
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- Pediatric Spine Trauma.Journal of Korean Neurosurgical Society · 2022Article
- The Last Touched Vertebra on Supine Radiographs Can Be the Optimal Lower Instrumented Vertebra in Adolescent Idiopathic Scoliosis Patients.Neurospine · 2022Article
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- Systematic Review of Reciprocal Changes after Spinal Reconstruction Surgery : Do Not Miss the Forest for the Trees.Journal of Korean Neurosurgical Society · 2021Article
- Clinical, Radiographic, and Genetic Analyses in a Population-Based Cohort of Adult Spinal Deformity in the Older Population.Neurospine · 2021Article
- Article
- Adolescent Idiopathic Scoliosis Treated by Posterior Spinal Segmental Instrumented Fusion : When Is Fusion to L3 Stable?Journal of Korean Neurosurgical Society · 2021Article
- Article
- Selection of Fusion Level for Adolescent Idiopathic Scoliosis Surgery : Selective Fusion versus Postoperative Decompensation.Journal of Korean Neurosurgical Society · 2021Article
- The Fate of Proximal Junctional Vertebral Fractures after Long-Segment Spinal Fixation : Are There Predictable Radiologic Characteristics for Revision surgery?Journal of Korean Neurosurgical Society · 2021Article
- Surgical Impacts of Metastatic Non-small Cell Lung Cancer to the Thoracic and Lumbar Spine.Journal of Korean medical science · 2021Article
- Surgical Outcomes and Complications Following All Posterior Approach for Spinal Deformity Associated with Neurofibromatosis Type-1.Journal of Korean Neurosurgical Society · 2020Article
- Surgical Impact on Global Sagittal Alignment and Health-Related Quality of Life Following Cervical Kyphosis Correction Surgery: Systematic Review.Neurospine · 2020Article
- Spinal Anaesthesia in Non-instrumented Lumbar Spine Surgery: Does it Work?Journal of the West African College of SurgeonsArticle
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo examine the biomechanical stress distribution at the upper instrumented vertebra (UIV) according to unicortical- and bicortical purchase model by finite element analysis (FEA).
methodsA T8 to Sacrum with implant finite element model was developed and validated. The pedicle screws were unicortically or bicortically inserted from T10 to L5, and each model was compared and the von Mises (VM) yield stress of T10 was calculated. According to the motion (flexion, extension, lateral bending, and axial rotation) of spine, boundary condition values were set as 15°, 15°, 10°, 4°.
resultsAlthough the 2 stress values did not show a significant difference between the unicortical- and bicortical purchase models in the flexion and extension, bicortical purchase model showed a larger stress distribution. However, the asymmetric behavior was significantly greater in the case of lateral bending (0.802 MPa vs. 0.489 MPa) and the rotation (5.545 MPa vs. 4.905 MPa). The greater stress was observed on the spinal body surface abutting the implanted screw. Although the maximum stress was observed around the implanted screw in the bicortical purchase model under axial loading, the VM stress of both models was not significantly different.
conclusionBicortical purchase model showed a larger stress distribution than the unicortical model, especially in the case of lateral bending and the rotation behavior. Our biomechanical simulation by FEA indicates that bicortical fixation at UIV can be a risk factor for early UIV compression fracture after adult spinal deformity surgery.
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