PhD Scientific Days 2024
Budapest, 9-10 July 2024
Surgical Medicine
Comparison of anterior column reconstruction techniques after en bloc spondylectomy: a finite element study
Előadó neve
Mr. Pokorni, Agoston Jakab
Neptun code
YEU5AU
Előadó munkahelye
National Center for Spinal Disorders, In Silico Biomechanics Laboratory
Előadó telefonszáma
+36306776269
Előadó e-mail címe
pokorni.agoston@gmail.com
Az előadás címe
Comparison of anterior column reconstruction techniques after en bloc spondylectomy: a finite element study
Szerző(k) neve és munkahelye
Agoston Jakab Pokorni1, Mate Turbucz1, Rita Maria Kiss2, Peter Endre Eltes1,3, Aron Lazary1,3
1: In Silico Biomechanics Laboratory, National Center for Spinal Disorders, Buda Health Center, Budapest
2: Department of Mechatronics, Optics and Mechanical Engineering Informatics, Faculty of Mechanical Engineering, Budapest University of Technology and Economics, Budapest
3: Department of Spine Surgery, Department of Orthopaedics, Semmelweis University, Budapest
Bemutatás módja
Szóbeli
Szekció
Surgical Medicine
Language of the presentation
Hungarian
Preferred session
Surgical Medicine
Összefoglaló szövege
Introduction
Total en bloc spondylectomy (TES) effectively treats spinal tumors. The surgery requires a vertebral body replacement (VBR), for which several solutions were developed, whereas the biomechanical differences between these devices still need to be completely understood.
Aims
This study aimed to compare a femur graft (FEM-GRAFT-C), a polyetheretherketone implant (PEEK-IMP-C), a titan mesh cage (MESH-C), and a polymethylmethacrylate replacement (PMMA-C) using a finite element model of the lumbar spine after a TES of L3.
Methods
The models with different VBRs were compared under the same loads. The lower endplate of the L5 vertebra was fixed, while a follower load of 400 N and a moment of 7.5 Nm were applied through the upper endplate of the L1 vertebra to simulate the effect of upper body weight and muscle force in flexion-extension, lateral bending, and axial rotation. The comparison evaluated the rotational stiffness of the structure, the segmental range of motion, and the distribution and maximum of the von Mises stress in the bony endplates of the L2 and L4 vertebrae adjacent to the vertebral replacements.
Result
All models provided adequate initial stability by increasing the rotational stiffness and decreasing the ROM between L2 and L4. The PMMA-C had the highest stiffness for flexion-extension, lateral bending, and axial rotation (215%, 216%, and 170% of intact model), and it had the lowest segmental ROM in the instrumented segment (0.2°,0.5°, and 0.7°, respectively). Maximum endplate stress was similar for PMMA-C and PEEK-IMP-C but lower for both compared to MESH-C across all loading directions.
Conclusion
These results suggest that MESH-C has the highest risk of subsidence and that PMMA-C had similar or better primary spinal stability than other VBRs, which may be related to the larger contact surface and the potential to adapt to the patient’s anatomy.
Funding
This work was supported by the János Bolyai Research Scholarship of the Hungarian Academy of Sciences, by the Hungarian Scientific Research Fund grant Budapest, Hungary (OTKA FK123884), by the New National Excellence Program (ÚNKP-21-5) and by the Doctoral Student Scholarship Program (C1014064) of the Co-operative Doctoral Program of the Ministry of Innovation and Technology, Hungary, financed from the National Research, Development and Innovation Fund.
University
Semmelweis University
Supervisor
Peter Endre Eltes
Publication of my abstract
I do not give consent to the publication of my abstract on the website of the congress.
Kind
Szabad
Status
elfogadva
Accepted presentation method
szóbeli
Előadás fájl jóváhagyás
nem rendelkezett róla
Előadó
7407
Start
14:45
End
14:55