Biomechanical Evaluation of an Adaptive-Motion Pedicle Screw Fixation System: Experimental and Numerical Analysis.

Rigid fixation is mostly used in thoracolumbar spine surgery, which restricts the thoracolumbar spine segments moving and is not conducive to postoperative rehabilitation. We developed an adaptive-motion pedicle screw and established a finite element model of the T12-L3 segments of the thoracolumbar spine in osteoporosis patients based on the CT image data. A variety of internal fixation finite element models were established for mechanical simulation analysis and comparison. The simulation results showed that compared with the conventional internal fixation system, the mobility of the new adaptive-motion internal fixation system was improved by about 13.8% and 7.7% under the classic conditions such as lateral bending and flexion. in vitro experiments were conducted simultaneously with fresh porcine thoracolumbar spine vertebrae, and the axial rotation condition was taken as an example to analyze the mobility. The in vitro results showed that the mobility of the adaptive-motion internal fixation system had better mobility characteristics under axial rotation conditions, which was consistent with the finite element analysis. The adaptive-motion pedicle screws can preserve a certain degree of vertebral mobility, and avoid excessive vertebral restriction. It also increases the stress value of the intervertebral disk, which is closer to the normal mechanical transmission of the human body, avoiding stress masking and slowing down the degeneration of the intervertebral disk. The adaptive-motion pedicle screws can reduce the peak stress of the implant and avoid surgical failure due to implant fracture.