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The Use of X-Shaped Cross-Link in Posterior Spinal Constructs Improves Stability in Thoracolumbar Burst Fracture: A Finite Element Analysis
Journal of Orthopaedic Research (2013)
  • Alizadeh M
  • Kadir MR
  • Fadhli MM
  • Fallahiarezoodar A
  • Azmi B
  • Murali Malliga Raman, University of Malaya
  • Kamarul T, University of Malaya
Abstract

Posterior instrumentation is a common fixation method used to treat thoracolumbar burst fractures. However, the role of different cross-link configurations in improving fixation stability in these fractures has not been established. A 3D finite element model of T11-L3 was used to investigate the biomechanical behavior of short (2 level) and long (4 level) segmental spine pedicle screw fixation with various cross-links to treat a hypothetical L1 vertebra burst fracture. Three types of cross-link configurations with an applied moment of 7.5 Nm and 200 N axial force were evaluated. The long construct was stiffer than the short construct irrespective of whether the cross-links were used (p < 0.05). The short constructs showed no significant differences between the cross-link configurations. The XL cross-link provided the highest stiffness and was 14.9% stiffer than the one without a cross-link. The long construct resulted in reduced stress to the adjacent vertebral bodies and screw necks, with 66.7% reduction in bending stress on L2 when the XL cross-link was used. Thus, the stability for L1 burst fracture fixation was best achieved by using long segmental posterior instrumentation constructs and an XL cross-link configuration. Cross-links did not improved stability when a short structure was used.

Keywords
  • biomechanics,
  • finite element analysis,
  • orthopedic,
  • pedicle screw instrumentation,
  • burst fracture
Publication Date
2013
Citation Information
Alizadeh M, Kadir MR, Fadhli MM, Fallahiarezoodar A, et al.. "The Use of X-Shaped Cross-Link in Posterior Spinal Constructs Improves Stability in Thoracolumbar Burst Fracture: A Finite Element Analysis" Journal of Orthopaedic Research Vol. 31 Iss. 9 (2013)
Available at: http://works.bepress.com/muralimalligaraman/18/