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Original Articles

Basic Science/Biomechanics

Biomechanical Analysis Comparison of Different Cervical Posterior Screw Fixation Techniques: A Finite Element Study
Joonoh Seo, Woo-Seok Jung, Tae Hyun Park, Sung-Jae Lee, Ji-Won Kwon, Kyung-Soo Suk, Byung Ho Lee
Neurospine 2026;23(1):187-201.   Published online January 31, 2026
DOI: https://doi.org/10.14245/ns.2551470.735

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Biomechanical Analysis Comparison of Different Cervical Posterior Screw Fixation Techniques: A Finite Element Study
Neurospine. 2026;23(1):187-201.   Published online January 31, 2026
DOI: https://doi.org/10.14245/ns.2551470.735
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Biomechanical Analysis Comparison of Different Cervical Posterior Screw Fixation Techniques: A Finite Element Study
Neurospine. 2026;23(1):187-201.   Published online January 31, 2026
DOI: https://doi.org/10.14245/ns.2551470.735
Close
Objective
To biomechanically compare the stress distribution of established posterior cervical fixation techniques—conventional pedicle screw (PS), Abumi technique, unicortical lateral mass screw (LMS), and bicortical LMS—with a novel PS method, the Lee point technique, using finite element modeling (FEM).
Methods
A patient-specific FEM of C5–6 was developed using high-resolution computed tomography scan data of a degenerative cervical spine. Five fixation models were constructed: Lee point, Abumi, conventional PS, unicortical LMS, and bicortical LMS. Screw dimensions were ø3.5×28 mm for PS and ø3.5×14/18 mm for LMS. A pure moment of 1.0 N·m was applied in flexion, extension, axial rotation, and lateral bending, and the peak von Mises stress (PVMS) of both the vertebrae and implants was recorded for each loading condition.
Results
Abumi technique showed the highest PVMS at C5–6 (23.09–43.22 MPa and 24.96–39.91 MPa), with stress concentrated at the pedicle entry and medial wall. Lee point and conventional PS demonstrated more evenly distributed stress across the pedicle and near cortex of the lateral mass. Unicortical and bicortical LMS showed stress mainly at the entry point, with overall lower and more uniform magnitudes. Implant stress was greatest in Abumi construct (up to 295 MPa), moderate in Lee and conventional PS, and lowest in LMS models.
Conclusion
Abumi technique showed higher localized stress concentrations that may warrant careful patient selection, particularly in those with compromised bone quality. Lee point technique achieved a balanced stress profile comparable to conventional PS, suggesting a favorable biomechanical profile for posterior cervical fixation.
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Biomechanics

Biomechanical Impact of Cement Augmentation on Pedicle Screw Fixation and Adjacent Segment Disease in Multilevel Lumbar Fusion: A Finite Element Analysis
Min-Young Jo, Sung-Jae Lee, Je-Hoon An, Young-Hoon Kim, Jun-Seok Lee, Hyung-Youl Park
Neurospine 2025;22(3):763-773.   Published online September 30, 2025
DOI: https://doi.org/10.14245/ns.2550294.147

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Biomechanical Impact of Cement Augmentation on Pedicle Screw Fixation and Adjacent Segment Disease in Multilevel Lumbar Fusion: A Finite Element Analysis
Neurospine. 2025;22(3):763-773.   Published online September 30, 2025
DOI: https://doi.org/10.14245/ns.2550294.147
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Biomechanical Impact of Cement Augmentation on Pedicle Screw Fixation and Adjacent Segment Disease in Multilevel Lumbar Fusion: A Finite Element Analysis
Neurospine. 2025;22(3):763-773.   Published online September 30, 2025
DOI: https://doi.org/10.14245/ns.2550294.147
Close
Objective
Cement augmentation is widely used to enhance pedicle screw fixation, particularly in osteoporotic patients. However, its effects on adjacent segment disease (ASD) and implant failure in multilevel lumbar interbody fusion remain unclear. This study aimed to assess the effectiveness of cement augmentation in preventing implant failure and its impact on ASD risk using finite element analysis (FEA).
Methods
A FEA of L2–S1 multilevel lumbar interbody fusion was performed to evaluate the biomechanical effects of cement augmentation. Three models were analyzed under normal and osteoporotic conditions: type 1 (no augmentation), type 2 (upper instrumented vertebra [UIV] augmentation), and type 3 (UIV and UIV+1 augmentation). Range of motion (ROM), intradiscal pressure (IDP), screw pull-out risk, and implant failure were assessed.
Results
Cement augmentation significantly reduced screw pull-out risk, particularly in osteoporotic conditions, where type 1 exhibited a failure rate of 91.5%, while type 2 and type 3 remained below 39%. Cement augmentation did not demonstrate a substantial impact on ASD development, as ROM and IDP changes remained within a minimal range in this FEA model. However, osteoporosis was associated with a substantial increase in IDP, with a result as high as 809%. Despite its benefits, augmentation at UIV+1 increased the risk of pedicle screw breakage and vertebral body fracture, with L1 (UIV+1) lower endplate fracture rate of 82.7% in type 3, compared to 56.6% in type 2 and 52.8% in type 1.
Conclusion
Cement augmentation effectively improves screw fixation and does not appear to significantly increase ASD risk based on this FEA study. Limiting cement augmentation to the UIV level in lumbar multilevel fusion may help reduce the risk of implant failure, though further clinical validation is required to confirm these biomechanical findings.

Citations

Citations to this article as recorded by  Crossref logo
  • Enhancing Predictive Accuracy in Finite Element Analysis of Cement Augmentation: Methodological Considerations – A Commentary on “Biomechanical Impact of Cement Augmentation on Pedicle Screw Fixation and Adjacent Segment Disease in Multilevel Lumbar Fusio
    Fan Mo, Shaoqi He
    Neurospine.2026; 23(2): 500.     CrossRef
  • Reply Letter: A Commentary on “Biomechanical Impact of Cement Augmentation on Pedicle Screw Fixation and Adjacent Segment Disease in Multilevel Lumbar Fusion: A Finite Element Analysis”
    Hyung-Youl Park
    Neurospine.2026; 23(2): 502.     CrossRef
  • 5,298 View
  • 64 Download
  • 2 Crossref

Regular Issue

Biomechanical Study of Atlanto-occipital Instability in Type II Basilar Invagination: A Finite Element Analysis
Junhua Ye, Qinguo Huang, Qiang Zhou, Hong Li, Lin Peng, Songtao Qi, Yuntao Lu
Neurospine 2024;21(3):1014-1028.   Published online September 30, 2024
DOI: https://doi.org/10.14245/ns.2448622.311

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Biomechanical Study of Atlanto-occipital Instability in Type II Basilar Invagination: A Finite Element Analysis
Neurospine. 2024;21(3):1014-1028.   Published online September 30, 2024
DOI: https://doi.org/10.14245/ns.2448622.311
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Biomechanical Study of Atlanto-occipital Instability in Type II Basilar Invagination: A Finite Element Analysis
Neurospine. 2024;21(3):1014-1028.   Published online September 30, 2024
DOI: https://doi.org/10.14245/ns.2448622.311
Close
Objective
Recent studies indicate that 3 morphological types of atlanto-occipital joint (AOJ) exist in the craniovertebral junction and are associated with type II basilar invagination (BI) and atlanto-occipital instability. However, the actual biomechanical effects remain unclear. This study aims to investigate biomechanical differences among AOJ types I, II, and III, and provide further evidence of atlanto-occipital instability in type II BI.
Methods
Models of bilateral AOJ containing various AOJ types were created, including I-I, I-II, II-II, II-III, and III-III models, with increasing AOJ dysplasia across models. Then, 1.5 Nm torque simulated cervical motions. The range of motion (ROM), ligament and joint stress, and basion-dental interval (BDI) were analyzed.
Results
The C0–1 ROM and accompanying rotational ROM increased progressively from model I-I to model III-III, with the ROM of model III-III showing increases between 27.3% and 123.8% indicating ultra-mobility and instability. In contrast, the C1–2 ROM changes were minimal. Meanwhile, the stress distribution pattern was disrupted; in particular, the C1 superior facet stress was concentrated centrally and decreased substantially across the models. The stress on the C0–1 capsule ligament decreased during cervical flexion and increased during bending and rotating loading. In addition, BDI gradually decreased across the models. Further analysis revealed that the dens showed an increase of 110.1% superiorly and 11.4% posteriorly, indicating an increased risk of spinal cord impingement.
Conclusion
Progressive AOJ incongruity critically disrupts supportive tissue loading, enabling incremental atlanto-occipital instability. AOJ dysplasia plays a key biomechanical role in the pathogenesis of type II BI.
  • 6,247 View
  • 116 Download

Regular Issue

Multilevel Pedicle Subtraction Osteotomy for Correction of Thoracolumbar Kyphosis in Ankylosing Spondylitis: Clinical Effect and Biomechanical Evaluation
Xin Lv, Yelidana Nuertai, Qiwei Wang, Di Zhang, Xumin Hu, Jiabao Liu, Ziliang Zeng, Renyuan Huang, Zhihao Huang, Qiancheng Zhao, Wenpeng Li, Zhilei Zhang, Liangbin Gao
Neurospine 2024;21(1):231-243.   Published online January 31, 2024
DOI: https://doi.org/10.14245/ns.2347118.559

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Multilevel Pedicle Subtraction Osteotomy for Correction of Thoracolumbar Kyphosis in Ankylosing Spondylitis: Clinical Effect and Biomechanical Evaluation
Neurospine. 2024;21(1):231-243.   Published online January 31, 2024
DOI: https://doi.org/10.14245/ns.2347118.559
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Multilevel Pedicle Subtraction Osteotomy for Correction of Thoracolumbar Kyphosis in Ankylosing Spondylitis: Clinical Effect and Biomechanical Evaluation
Neurospine. 2024;21(1):231-243.   Published online January 31, 2024
DOI: https://doi.org/10.14245/ns.2347118.559
Close
Objective
To compare the clinical outcomes and biomechanical characteristics of 1-, 2-, and 3-level pedicle subtraction osteotomy (PSO), and establish selection criteria based on preoperative radiographic parameters.
Methods
Patients undergone PSO to treat ankylosing spondylitis from February 2009 to May 2019 in Sun Yat-sen Memorial Hospital of Sun Yat-sen University were enrolled. According to the quantity of osteotomy performed, the participants were divided into group A (1-level PSO, n = 24), group B (2-level PSO, n = 19), and group C (3-level PSO, n = 11). Clinical outcomes were assessed before surgery and at the final follow-up. Comparisons of the radiographic parameters and quality-of-life indicators were performed among and within these groups, and the selection criteria were established by regression. Finite element analysis was conducted to compare the biomechanical characteristics of the spine treated with different quantity of osteotomies under different working conditions.
Results
Three-level PSO improved the sagittal parameters more significantly, but resulted in longer operative time and greater blood loss (p < 0.05). Greater stress was found in the proximal screws and proximal junction area of the vertebra in the model simulating 1-level PSO. Larger stress of screws and vertebra was observed at the distal end in the model simulating 3-level PSO.
Conclusion
Multilevel PSO works better for larger deformity correction than single-level PSO by allowing greater sagittal parameter correction and obtaining a better distribution of stress in the hardware construct, although with longer operation time and greater blood loss. Three-level osteotomy is recommended for the patients with preoperative of global kyphosis > 85.95°, T1 pelvic angle > 62.3°, sagittal vertical alignment > 299.55 mm, and pelvic tilt+ chin-brow vertical angle > 109.6°.

Citations

Citations to this article as recorded by  Crossref logo
  • Optimizing osteotomy in ankylosing spondylitis-induced kyphosis: anatomical insights and novel instrumentation
    Jiabao Liu, Qiwei Wang, Ziliang Zeng, Xumin Hu, Yelidana Nuertai, Zhihao Huang, Xin Lv, Liangbin Gao
    BMC Musculoskeletal Disorders.2026;[Epub]     CrossRef
  • A novel pre-contoured V-shaped rod in one-level pedicle subtraction osteotomy for the treatment of rigid lumbar kyphosis caused by ankylosing spondylitis: technical note and case series
    Hongtao Ding, Cheng Zeng, Andrew Y. Xu, Audrey Y. Su, Jeffrey J. Yeung, Xin Chen, Huadong Wang, Yanbin Zhang, Kai Yan, Yonggang Xing, Da He, Bin Xiao
    BMC Musculoskeletal Disorders.2025;[Epub]     CrossRef
  • Advances in Molecular Research on Hip Joint Impingement—A Vascular Perspective
    Riana Maria Huzum, Marius Valeriu Hînganu, Bogdan Huzum, Delia Hînganu
    Biomolecules.2024; 14(7): 784.     CrossRef
  • 6,819 View
  • 145 Download
  • 3 Web of Science
  • 3 Crossref

Regular Issue

Biomechanical Evaluation of 2 Endoscopic Spine Surgery Methods for Treating Lumbar Disc Herniation: A Finite Element Study
Yang Zou, Shuo Ji, Hui Wen Yang, Tao Ma, Yue Kun Fang, Zhi Cheng Wang, Miao Miao Liu, Ping Hui Zhou, Zheng Qi Bao, Chang Chun Zhang, Yu Chen Ye
Neurospine 2024;21(1):273-285.   Published online January 31, 2024
DOI: https://doi.org/10.14245/ns.2347076.538

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Biomechanical Evaluation of 2 Endoscopic Spine Surgery Methods for Treating Lumbar Disc Herniation: A Finite Element Study
Neurospine. 2024;21(1):273-285.   Published online January 31, 2024
DOI: https://doi.org/10.14245/ns.2347076.538
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Biomechanical Evaluation of 2 Endoscopic Spine Surgery Methods for Treating Lumbar Disc Herniation: A Finite Element Study
Neurospine. 2024;21(1):273-285.   Published online January 31, 2024
DOI: https://doi.org/10.14245/ns.2347076.538
Close
Objective
This study aimed to evaluate the effects of 2 endoscopic spine surgeries on the biomechanical properties of normal and osteoporotic spines.
Methods
Based on computed tomography images of a healthy adult volunteer, 6 finite element models were created. After validating the normal intact model, a concentrated force of 400 N and a moment of 7.5 Nm were exerted on the upper surface of L3 to simulate 6 physiological activities of the spine. Five types of indices were used to assess the biomechanical properties of the 6 models, range of motion (ROM), maximum displacement value, intervertebral disc stress, maximum stress value, and articular protrusion stress, and by combining them with finite element stress cloud.
Results
In normal and osteoporotic spines, there was no meaningful change in ROM or disc stress in the 2 surgical models for the 6 motion states. Model N1 (osteoporotic percutaneous transforaminal endoscopic discectomy model) showed a decrease in maximum displacement value of 20.28% in right lateral bending. Model M2 (unilateral biportal endoscopic model) increased maximum displacement values of 16.88% and 17.82% during left and right lateral bending, respectively. The maximum stress value of L4–5 increased by 11.72% for model M2 during left rotation. In addition, using the same surgical approach, ROM, maximum displacement values, disc stress, and maximum stress values were more significant in the osteoporotic model than in the normal model.
Conclusion
In both normal and osteoporotic spines, both surgical approaches were less disruptive to the physiologic structure of the spine. Furthermore, using the same endoscopic spine surgery, normal spine biomechanical properties are superior to osteoporotic spines.

Citations

Citations to this article as recorded by  Crossref logo
  • The Biomechanical Landscape of Lumbar Disc Herniation: Mechanobiological Insights Into Injury and Regeneration
    Gianluca Vadala, Fabrizio Russo, In-Ho Han, Amit Jain, Javad Tavakoli
    Neurospine.2026; 23(1): 159.     CrossRef
  • Biomechanical analysis of the interlaminar dynamic stabilization system (IntraSPINE) in unilateral biportal endoscopic discectomy for huge lumbar disc herniation: a finite element study
    Zhiwu Zhang, Jiashen Shao, Shuning Liu, Hai Meng, Zihan Fan, Jisheng Lin, Yong Yang, Qi Fei
    BMC Musculoskeletal Disorders.2026;[Epub]     CrossRef
  • Biomechanical analysis of lumbar oblique manipulation for lumbar disc herniation with different protrusion subtypes
    Linling Zhang, Zhen Deng, Xuanzong Zhang, Kuan Wang, Maohua Lin, Zhongxiang Yu, Hongsheng Zhan, Yongfang Zhao, Frank Vrionis, Huihao Wang
    Mechanobiology in Medicine.2026; 4(2): 100188.     CrossRef
  • Cost-effectiveness analysis of extended endoscopic lumbar foraminotomy (EELF) and transforaminal lumbar interbody fusion (TLIF): a prospective observational study
    Jun-Hoe Kim, Hangeul Park, Chang-Hyun Lee, Chi Heon Kim
    Scientific Reports.2025;[Epub]     CrossRef
  • Far-Lateral Transforaminal Unilateral Biportal Endoscopic Lumbar Discectomy for Upper Lumbar Disc Herniations
    Jin Seop Hwang, Sang Hyub Lee, Dain Jeong, Jae-Won Jang, Yong Eun Cho, Dong-Geun Lee, Choon Keun Park, Chung Kee Chough
    Neurospine.2025; 22(1): 14.     CrossRef
  • Evidence-Based Clinical Practice Guidelines for Patients With Lumbar Disc Herniation With Radiculopathy in South Korea
    Jong Joo Lee, Min Cheol Chang, Dong Ah Shin, Jin Hoon Park, Miyoung Choi, Hyung-Youl Park, In Soo Kim, Jung-Kil Lee, Chung-Kee Chough, Seung Hwan Yoon, Seong-Soo Choi, Sung-Woo Choi
    Neurospine.2025; 22(2): 366.     CrossRef
  • Impact of BMI, osteoporosis, and disc degeneration on post-UBE lumbar stability: a finite element analysis of nonlinear synergistic effects
    Jingbo Ma, Tusheng Li, Rigbat Rozi, Jiaheng Han, Qiang Jiang, Hanshuo Zhang, Xuyan Song, Guotong Zhao, Yu Ding
    Frontiers in Bioengineering and Biotechnology.2025;[Epub]     CrossRef
  • Biomechanical changes in lumbar intervertebral discs after percutaneous endoscopic transforaminal discectomy surgery at different Body Mass Index (BMI) categories
    Xiaohai Zhang, Jinghui Lin, Chen Liu, Shuangtao Xue, Mengying Wu, Zongsheng Yin
    Journal of Orthopaedic Surgery and Research.2024;[Epub]     CrossRef
  • 6,716 View
  • 169 Download
  • 8 Web of Science
  • 8 Crossref
A Comparative Biomechanical Analysis of Various Rod Configurations Following Anterior Column Realignment and Pedicle Subtraction Osteotomy
Muzammil Mumtaz, Justin Mendoza, Ardalan Seyed Vosoughi, Anthony S. Unger, Vijay K. Goel
Neurospine 2021;18(3):587-596.   Published online September 30, 2021
DOI: https://doi.org/10.14245/ns.2142450.225

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A Comparative Biomechanical Analysis of Various Rod Configurations Following Anterior Column Realignment and Pedicle Subtraction Osteotomy
Neurospine. 2021;18(3):587-596.   Published online September 30, 2021
DOI: https://doi.org/10.14245/ns.2142450.225
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A Comparative Biomechanical Analysis of Various Rod Configurations Following Anterior Column Realignment and Pedicle Subtraction Osteotomy
Neurospine. 2021;18(3):587-596.   Published online September 30, 2021
DOI: https://doi.org/10.14245/ns.2142450.225
Close
Objective
The objective of this study was to compare the biomechanical differences of different rod configurations following anterior column realignment (ACR) and pedicle subtraction osteotomy (PSO) for an optimal correction technique and rod configuration that would minimize the risk of rod failure.
Methods
A validated spinopelvic (L1-pelvis) finite element model was used to simulate ACR at the L3–4 level. The ACR procedure was followed by dual-rod fixation, and for 4-rod constructs, either medial/lateral accessory rods (connected to primary rods) or satellite rods (directly connected to ACR level screws). The range of motion (ROM), maximum von Mises stress on the rods, and factor of safety (FOS) were calculated for the ACR models and compared to the existing literature of different PSO rod configurations.
Results
All of the 4-rod ACR constructs showed a reduction in ROM and maximum von Mises stress compared to the dual-rod ACR construct. Additionally, all of the 4-rod ACR constructs showed greater percentage reduction in ROM and maximum von Mises stress compared to the PSO 4-rod configurations. The ACR satellite rod construct had the maximum stress reduction i.e., 47.3% compared to dual-rod construct and showed the highest FOS (4.76). These findings are consistent with existing literature that supports the use of satellite rods to reduce the occurrence of rod fracture.
Conclusion
Our findings suggest that the ACR satellite rod construct may be the most beneficial in reducing the risk of rod failure compared to all other PSO and ACR constructs.

Citations

Citations to this article as recorded by  Crossref logo
  • Comparative Radiologic and Morphologic Analysis of Posterolateral Fusion and Percutaneous Pedicle Screw Fixation for Thoracolumbar Junction Burst Fractures
    Hyung-Rae Lee, Minseung Kang, Jae Min Park, Jae-Hyuk Yang
    Journal of Clinical Medicine.2025; 14(18): 6379.     CrossRef
  • High-Demand Spinal Deformity With Multi-Rod Constructs and Porous Fusion/Fixation Implants: A Finite Element Study
    Matteo Panico, Ruchi D. Chande, Derek P. Lindsey, Tomaso Maria Tobia Villa, Scott A. Yerby, Marco Brayda-Bruno, Tito Bassani, David W. Polly, Fabio Galbusera
    Global Spine Journal.2024; 14(4): 1328.     CrossRef
  • Wind-Induced Structural Response of Skylights: A Eurocode-Based Assessment
    Muhammad Tayyab Naqash, Salim Khoso, Ehsan Noroozinejad Farsangi
    Practice Periodical on Structural Design and Construction.2024;[Epub]     CrossRef
  • A Biomechanical Comparison of 2 Different Topping-off Devices and Their Influence on the Sacroiliac Joint Following Lumbosacral Fusion Surgery
    Wei Fan, Song Yang, Jie Chen, Li-Xin Guo, Ming Zhang
    Neurospine.2024; 21(1): 244.     CrossRef
  • Biomechanical Analysis of Hybrid Artificial Discs or Zero-Profile Devices for Treating 1-Level Adjacent Segment Degeneration in ACDF Revision Surgery
    Weishi Liang, Yihan Yang, Bo Han, Duan Sun, Peng Yin, Yong Hai
    Neurospine.2024; 21(2): 606.     CrossRef
  • Effects of pelvic fixation strategies and multi-rod constructs on biomechanics of the proximal junction in long thoracolumbar posterior instrumented fusions: a finite-element analysis
    Muzammil Mumtaz, Andrew P. Collins, Niloufar Shekouhi, Karthika Varier, Sudharshan Tripathi, Christopher P. Ames, Vedat Deviren, Aaron J. Clark, Vijay K. Goel, Alekos A. Theologis
    Spine Deformity.2024; 12(6): 1571.     CrossRef
  • Biomechanical Effects of Multi‐segment Fixation on Lumbar Spine and Sacroiliac Joints: A Finite Element Analysis
    Geng Zhao, Lianlei Wang, Hongwei Wang, Chao Li, Suomao Yuan, Junyuan Sun, Yonghao Tian, Xinyu Liu
    Orthopaedic Surgery.2024; 16(10): 2499.     CrossRef
  • The Influence of Accessory Rods and Connectors on the Quasi-Static and Dynamic Response of Spine Fixation
    M. Pekedis, M. Altan, T. Akgul, H. Yildiz
    Experimental Techniques.2023; 47(2): 493.     CrossRef
  • The Effect of Anterior-Only, Posterior-Only, and Combined Anterior Posterior Fixation for Cervical Spine Injury with Soft Tissue Injury: A Finite Element Analysis
    Norihiro Nishida, Sudharshan Tripathi, Muzammil Mumtaz, Amey Kelkar, Yogesh Kumaran, Takashi Sakai, Vijay K. Goel
    World Neurosurgery.2023; 171: e777.     CrossRef
  • Long-term Outcomes of Posterior Multilevel Crack Osteotomy: Revisional Surgery for Scoliosis With a Fusion Mass
    Mi Hyun Song, Jae Hyuk Yang, Dong-Gune Chang, Yunjin Nam, Seung Woo Suh
    Neurospine.2023; 20(3): 989.     CrossRef
  • Investigation into Cervical Spine Biomechanics Following Single, Multilevel and Hybrid Disc Replacement Surgery with Dynamic Cervical Implant and Fusion: A Finite Element Study
    Muzammil Mumtaz, Iman Zafarparandeh, Deniz Ufuk Erbulut
    Bioengineering.2022; 9(1): 16.     CrossRef
  • Mechanical Failure After Total En Bloc Spondylectomy and Salvage Surgery
    Shin Won Kwon, Chun Kee Chung, Young Il Won, Woon Tak Yuh, Sung Bae Park, Seung Heon Yang, Chang Hyun Lee, John M. Rhee, Kyoung-Tae Kim, Chi Heon Kim
    Neurospine.2022; 19(1): 146.     CrossRef
  • The Effect of Water-Binder Ratio and RHA on the Mechanical Performance of Sustainable Concrete
    S. Khoso, S. A. Abbasi, T. Ali, Z. Soomro, M. T. Naqash, A. A. Ansari
    Engineering, Technology & Applied Science Research.2022; 12(3): 8520.     CrossRef
  • Realistic Determination of Live Loads on Various Reinforced Concrete Structures
    Z. Soomro, S. Khoso, T. Ali, S. A. Abbasi, A. A. Ansari, M. T. Naqash
    Engineering, Technology & Applied Science Research.2022; 12(3): 8506.     CrossRef
  • Total disc replacement alters the biomechanics of cervical spine based on sagittal cervical alignment
    Muzammil Mumtaz, Justin Mendoza, Sudharshan Tripathi, Amey Kelkar, Norihiro Nishida, Ashish Sahai, Vijay K. Goel
    Journal of Craniovertebral Junction and Spine.2022; 13(3): 278.     CrossRef
  • 8,013 View
  • 143 Download
  • 18 Web of Science
  • 15 Crossref
Bicortical Screw Purchase at Upper Instrumented Vertebra (UIV) Can Cause UIV Fracture After Adult Spinal Deformity Surgery: A Finite Element Analysis Study
Seong-Hyun Wui, Seung-Jae Hyun, Bokku Kang, Ki-Jeong Kim, Tae-Ahn Jahng, Hyun Jib Kim
Neurospine 2020;17(2):377-383.   Published online July 11, 2019
DOI: https://doi.org/10.14245/ns.1938100.050

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Bicortical Screw Purchase at Upper Instrumented Vertebra (UIV) Can Cause UIV Fracture After Adult Spinal Deformity Surgery: A Finite Element Analysis Study
Neurospine. 2020;17(2):377-383.   Published online July 11, 2019
DOI: https://doi.org/10.14245/ns.1938100.050
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Bicortical Screw Purchase at Upper Instrumented Vertebra (UIV) Can Cause UIV Fracture After Adult Spinal Deformity Surgery: A Finite Element Analysis Study
Neurospine. 2020;17(2):377-383.   Published online July 11, 2019
DOI: https://doi.org/10.14245/ns.1938100.050
Close
Objective
To examine the biomechanical stress distribution at the upper instrumented vertebra (UIV) according to unicortical- and bicortical purchase model by finite element analysis (FEA).
Methods
A 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°.
Results
Although 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.
Conclusion
Bicortical 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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Comparative Finite Element Analysis of Lumbar Cortical Screws and Pedicle Screws in Transforaminal and Posterior Lumbar Interbody Fusion
Dong Ah Sin, Dong Hwa Heo
Neurospine 2019;16(2):298-304.   Published online April 12, 2019
DOI: https://doi.org/10.14245/ns.1836030.015

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Comparative Finite Element Analysis of Lumbar Cortical Screws and Pedicle Screws in Transforaminal and Posterior Lumbar Interbody Fusion
Neurospine. 2019;16(2):298-304.   Published online April 12, 2019
DOI: https://doi.org/10.14245/ns.1836030.015
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Comparative Finite Element Analysis of Lumbar Cortical Screws and Pedicle Screws in Transforaminal and Posterior Lumbar Interbody Fusion
Neurospine. 2019;16(2):298-304.   Published online April 12, 2019
DOI: https://doi.org/10.14245/ns.1836030.015
Close
Objective
Lumbar cortical screw fixation (CSF), rather than pedicle screw fixation (PSF), has recently been attempted in lumbar interbody fusion. The purpose of our study was to evaluate the biomechanical stability of lumbar CSF using a finite element (FE) model.
Methods
A 3-FE model, including the L1 to S1 levels, was designed to evaluate and compare the biomechanical stability of lumbar CSF and PSF in single-level lumbar interbody fusion at L4–5. Cortical or pedicle screws were inserted bilaterally, and posterior lumbar interbody fusion (PLIF) and transforaminal lumbar interbody fusion (TLIF) were modeled at L4–5, respectively. We compared the stability of CSF to that of PSF in these 2 different anatomic variations of PLIF, as well as in TLIF.
Results
Lumbar CSF showed less stability than PSF in PLIF when the midline posterior ligaments were not preserved, but demonstrated similar stability when the ligaments were preserved. The range of motion (ROM) at the treated level in CSF was larger than that observed for PSF, in all PLIF and TLIF models. Furthermore, the ROM in the posterior ligament-sacrificing PLIF with CSF model was larger than the ROM in the posterior ligament-preserving PLIF with CSF or PSF model.
Conclusion
Based on our FE analysis, the stability of CSF is comparable to that of PSF in PLIF and TLIF when the midline posterior ligaments are preserved.

Citations

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    Clinical Spine Surgery.2025;[Epub]     CrossRef
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    Global Spine Journal.2024; 14(7): 2053.     CrossRef
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    BMC Musculoskeletal Disorders.2022;[Epub]     CrossRef
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    Clinical Spine Surgery.2021; 34(7): 260.     CrossRef
  • Bicortical Screw Purchase at Upper Instrumented Vertebra (UIV) Can Cause UIV Fracture After Adult Spinal Deformity Surgery: A Finite Element Analysis Study
    Seong-Hyun Wui, Seung-Jae Hyun, Bokku Kang, Ki-Jeong Kim, Tae-Ahn Jahng, Hyun Jib Kim
    Neurospine.2020; 17(2): 377.     CrossRef
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    Medicine.2020; 99(44): e22878.     CrossRef
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  • 197 Download
  • 15 Web of Science
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Laboratory Investigation

Finite Element Analysis of the Biomechanical Effect of Coflex™ on the Lumbar Spine
Dong-Hak Byun, Dong Ah Shin, Jin-Myung Kim, So-Hee Kim, Hyoung-Ihl Kim
Korean J Spine 2012;9(3):131-136.   Published online September 30, 2012
DOI: https://doi.org/10.14245/kjs.2012.9.3.131

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Finite Element Analysis of the Biomechanical Effect of Coflex™ on the Lumbar Spine
Korean J Spine. 2012;9(3):131-136.   Published online September 30, 2012
DOI: https://doi.org/10.14245/kjs.2012.9.3.131
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Finite Element Analysis of the Biomechanical Effect of Coflex™ on the Lumbar Spine
Korean J Spine. 2012;9(3):131-136.   Published online September 30, 2012
DOI: https://doi.org/10.14245/kjs.2012.9.3.131
Close
Objective

The biomechanical properties of the Coflex™ (Paradigm Spine, NY, USA), a device designed to provide dynamic stabilization without lumbar fusion, have not been clearly defined. The purpose of this study was to determine the efficacy and biomechanical effect of Coflex™ using finite element model (FEM).

Methods

A 3D geometric model of the L3-L5 was created by integrating computerized tomography (CT) images. Based on the geometric model, a 3D FEM was created and the Coflex™ model was incorporated into the base model. Mechanical load dependent on the postural changes and boundary conditions, were imposed to simulate various 3D physiological states. The simulation analysis included stress and strain distributions, intervertebral disc deformation, and the range of motion of the facet joint and lumbar spinous process.

Results

Coflex™ significantly restrained displacement in extension, lateral bending and compression of joint between the L4-5 as one in the experimental group was observed -1.3% of flexion, -24.5% of extension, -44.5% of lateral bending and -37.2%. The average intradiscal pressure of the L4-5 decreased by 63% and the average facet contract force of the L4-5 decreased markedly by 34% in the experimental group. A load of 120 MPa from extension was observed at the base of spinous process in the experimental group.

Conclusion

The Coflex™ can be safely used for achieving functional dynamic stabilization of the lumbar vertebral column while preserving the intactness of the other components. However, the fatigue fracture of the L4 spinous process should be carefully monitored.

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    Long Chen, Xiaozhen Wang, Markus Kröber, Elhassan Abdelmonem, Xuan Wan
    BMC Musculoskeletal Disorders.2025;[Epub]     CrossRef
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    Gaiping Zhao, Zhehua Jiang, Eryun Chen, Tong Ma, Jie Wu, Chengli Song, Weiqi Li
    Clinical Biomechanics.2024; 116: 106270.     CrossRef
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    Neurospine.2024; 21(2): 536.     CrossRef
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    Kamran Aghayev, Utpal Kanti Dhar, Chi-Tay Tsai, Merdin Ahmedov, Frank D. Vrionis
    Spine Surgery and Related Research.2024; 8(4): 448.     CrossRef
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    Zhengpeng Liu, Shuyi Zhang, Jia Li, Hai Tang
    BMC Musculoskeletal Disorders.2022;[Epub]     CrossRef
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    Sungwook Kang, Chan-Hee Park, Hyunwoo Jung, Subum Lee, Yu-Sun Min, Chul-Hyun Kim, Mingoo Cho, Gu-Hee Jung, Dong-Hee Kim, Kyoung-Tae Kim, Jong-Moon Hwang
    Scientific Reports.2022;[Epub]     CrossRef
  • The Effects of Paraspinal Muscle Volume on Physiological Load on the Lumbar Vertebral Column
    Sungwook Kang, Min Cheol Chang, Hwanjin Kim, Jaewoong Kim, Youngjae Jang, Donghwi Park, Jong-moon Hwang
    Spine.2021; 46(19): E1015.     CrossRef
  • Biomechanical changes of degenerated adjacent segment and intact lumbar spine after lumbosacral topping-off surgery: a three-dimensional finite element analysis
    Liangliang Cao, Yumei Liu, Wei Mei, Jianguang Xu, Shi Zhan
    BMC Musculoskeletal Disorders.2020;[Epub]     CrossRef
  • Effect of different designs of interspinous process devices on the instrumented and adjacent levels after double-level lumbar decompression surgery: A finite element analysis
    Hao-Ju Lo, Hung-Ming Chen, Yi-Jie Kuo, Sai-Wei Yang, Osama Farouk
    PLOS ONE.2020; 15(12): e0244571.     CrossRef
  • Finite element analysis of a ball‐and‐socket artificial disc design to suppress excessive loading on facet joints: A comparative study with ProDisc
    Jisoo Choi, Dong‐Ah Shin, Sohee Kim
    International Journal for Numerical Methods in Biomedical Engineering.2019;[Epub]     CrossRef
  • Biomechanical Comparison of Spinal Fusion Methods Using Interspinous Process Compressor and Pedicle Screw Fixation System Based on Finite Element Method
    Jisoo Choi, Sohee Kim, Dong-Ah Shin
    Journal of Korean Neurosurgical Society.2016; 59(2): 91.     CrossRef
  • Obesity Effect on the Spine
    Samir Zahaf, Bensmaine Mansouri, A. Belarbi, Zitouni Azari
    Advances in Bioscience and Biotechnology.2015; 06(08): 556.     CrossRef
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