Nekhlopochyn O. S., Verbov V. V., Cheshuk I. V., Karpinsky M. Yu., Yaresko O. V.

BIOMECHANICAL CHARACTERISTICS OF THORACOLUMBAR JUNCTION UNDER ROTATIONAL LOADING AFTER DECOMPRESSION-STABILIZATION SURGERY

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Nekhlopochyn O. S., Verbov V. V., Cheshuk I. V., Karpinsky M. Yu., Yaresko O. V.

Heading:

CLINICAL AND EXPERIMENTAL MEDICINE

Type of article:

Scientific article

Annotation:

Internal fixation is the most common method of surgical correction of most traumatic spinal injuries. The introduction of telescopic body replacement implants into clinical practice has significantly optimised the surgical treatment of fractures of the thoracolumbar junction, but the biomechanical features of such stabilisation have been little studied. This study aimed to conduct a detailed analysis of the load distribution in the simulation of resection of the Th12 vertebral body with its subsequent replacement with interbody support and additional stabilisation with an 8-screw transpedicular system. One of the most biomechanical unfavourable loading variants, rotational impact, was studied. The analysis was carried out using a finite element model developed in the biomechanics laboratory of the State Institution "Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine". Different variants of transpedicular fixation were considered: using standard monocortical transpedicular screws or elongated bicortical screws. In addition, the effect of the presence of two transverse rod-to-rod ties was studied. As a result of the analysis, it was found that under rotational loads, the greatest stress is concentrated on the interbody support and the vertebral closure plates in contact with it. At the same time, the inclusion of 2 transverse ties in the stabilising transpedicular system allows for a significant normalisation of the load distribution, reducing the critical stress in the most vulnerable areas. At the same time, the use of long bicortical screws does not have a significant effect on the stress-strain state. The obtained results should be evaluated in combination with the analysis of other loading patterns to identify the most biomechanically favourable and stable variant of surgical intervention.

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Bibliography:

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Publication of the article:

«Bulletin of problems biology and medicine», 2023 Issue 3, 170, 233-244 pages, index UDC 612.76:616.711.5/.6-001-089.22

DOI:

10.29254/2077-4214-2023-3-170-233-244