Evidence map›Paper›PMID 34620170›Full record

ArticleBiomedical engineering online2021

Influence of posterior pedicle screw fixation at L4-L5 level on biomechanics of the lumbar spine with and without fusion: a finite element method.

Emre Sengul, Ramazan Ozmen, Mesut Emre Yaman, Teyfik Demir

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Biomedical engineering online, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 1 pooled it
3.5field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 1 synthesis or guideline pooled it, 30 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Article
  6. Article
  7. Article
  8. Article
  9. Article
  10. Article
  11. Article
  12. Article
  13. Article
  14. Article
  15. Article
  16. Article
  17. Article
  18. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 3 institutions in 1 country.

Emre SengulDepartment of Mechanical Engineering, TOBB University of Economics and Technology, Çankaya, Ankara, Turkey. e.sengul@etu.edu.tr.ORCID http://orcid.org/0000-0002-3325-3528
Ramazan OzmenDepartment of Mechanical Engineering, Karabük University, Merkez, Karabük, Turkey.
Mesut Emre YamanDepartment of Neurosurgery, Gazi University School of Medicine, Ankara, Turkey.
Teyfik DemirDepartment of Mechanical Engineering, TOBB University of Economics and Technology, Çankaya, Ankara, Turkey.
TOBB University of Economics and Technology · TRGazi University · TRKarabük University · TR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPosterior pedicle screw (PS) fixation, a common treatment method for widespread low-back pain problems, has many uncertain aspects including stress concentration levels, effects on adjacent segments, and relationships with physiological motions. A better understanding of how posterior PS fixation affects the biomechanics of the lumbar spine is needed. For this purpose, a finite element (FE) model of a lumbar spine with posterior PS fixation at the L4-L5 segment level was developed by partially removing facet joints (FJs) to imitate an actual surgical procedure. This FE study aimed to investigate the influence of the posterior PS fixation system on the biomechanics of the lumbar spine before and after fusion by determining which physiological motions have the most increase in posterior instrumentation (PI) stresses and FJ loading.

resultsIt was determined that posterior PS fixation increased FJ loading by approximately 35% and 23% at the L3-L4 adjacent level with extension and lateral bending motion, respectively. This increase in FJ loading at the adjacent level could point to the possibility that adjacent segment disease has developed or progressed after posterior lumbar interbody fusion. Furthermore, analyses of peak von Mises stresses on PI showed that the maximum PI stresses of 272.1 MPa and 263.7 MPa occurred in lateral bending and flexion motion before fusion, respectively.

conclusionsThe effects of a posterior PS fixation system on the biomechanics of the lumbar spine before and after fusion were investigated for all physiological motions. This model could be used as a fundamental tool for further studies, providing a better understanding of the effects of posterior PS fixation by clearing up uncertain aspects.

Indexed as

Pedicle ScrewsSpinal FusionBiomechanical PhenomenaFinite Element AnalysisLumbar VertebraeRange of Motion, ArticularBiomechanicsFinite element methodLumbar spinePosterior pedicle screw

Identifiers

PMID34620170
PMCPMC8499536
OpenAlexW3203602666

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.