Comparison of short-segment monoaxial and polyaxial pedicle screw fixation combined with intermediate screws in traumatic thoracolumbar fractures: a finite element study and clinical radiographic review

Nov 22, 2017Clinics (Sao Paulo, Brazil)

Comparing two types of short-segment spinal screw fixation with extra screws in traumatic middle-back fractures using modeling and X-ray analysis

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Abstract

The largest maximal von Mises stress values were 376.8 MPa for monoaxial screws and 439.9 MPa for rods in the fixation models.

  • Maximal intradiscal pressures in the upper adjacent segments were higher than in the lower adjacent segments.
  • The monoaxial pedicle screw fixation model demonstrated larger intradiscal pressures compared to the normal model.
  • Final follow-up radiographic evaluations indicated the least loss of correction in the sagittal Cobb's angle, vertebral body angle, and anterior vertebral body height in the intermediate monoaxial pedicle screw fixation group.
  • Adjacent segment degeneration was less frequently observed in the intermediate polyaxial pedicle screw fixation group compared to the intermediate monoaxial group.
  • The polyaxial screw model showed smaller von Mises stress and lower intradiscal pressure in adjacent segments compared to monoaxial models.

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