Abstract
Pedicle Subtraction Osteotomy (PSO) is a technique for restoring the correct sagittal balance that achieves corrections up to 35°. The procedure still shows a high rate of complications (10–25%, usually rod breakage at the osteotomy level): in order to decrease this rate a computational comparative analysis investigating the effects of a set of variables on the instrumentation has been set up. In particular the number of rods, the material, the diameter, and the presence of an anterior support have been considered in an FE model of L1-S1 simulating a PSO at either L3 or L4. Standing was simulated using a follower load of 500 N and pure moments of ± 7.5 Nm in flexion, extension, lateral bending, and axial rotation evaluating the load sharing between the anterior part of the spine and the rods and the stress in the rods. Analyzing our results we can suggest the use of a multiple rod configuration, associated with the use of an anterior support in order to reduce the stresses on the instrumentation.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Bridwell KH, Lewis SJ, Lenke LG (2003) Pedicle subtraction osteotomy for the treatment of fixed sagittal imbalance. J Bone Jt Surg Am 85:454–463
Charosky S, Moreno P, Maxy P (2014) Instability and instrumentation failures after a PSO: a finite element analysis. Eur Spine J 23(11):2340–2349
Deviren V, Tang J-A, Scheer J-K, Buckley J-M, Pekmezci M, McClellan R-T, Ames C-P (2012) Construct rigidity after fatigue loading in pedicle subtraction osteotomy with or without adjacent interbody structural 6 cages. Glob Spine J 2(4):213–220
Hallager DW, Gehrchen M, Dahl B, Harris JA, Gudipally M, Jenkins S, Wu AM, Bucklen BS (2016) Use of supplemental short pre-contoured accessory rods and cobalt chrome alloy posterior rods reduces primary rod strain and range of motion across the pedicle subtraction osteotomy level: an in vitro biomechanical study. Spine 41(7):E388–E395
Luca A, Lovi A, Galbusera F, Brayda-Bruno M (2014) Revision surgery after PSO failure with rod breakage: a comparison of different techniques. Eur Spine J 23(Suppl 6):610–615
Luca A, Ottardi C, Sasso M, Prosdocimo L, La Barbera L, Brayda-Bruno M, Galbusera F, Villa T (2016) Instrumentation failure following pedicle subtraction osteotomy: the role of rod material, diameter, and multi-rod constructs. Eur Spine J. doi:10.1007/s00586-016-4859-8
Ottardi C, Galbusera F, Luca A, Prosdocimo L, Sasso M, Brayda-Bruno M, Villa T (2016) Finite element analysis of the lumbar destabilization following pedicle subtraction osteotomy. Med Eng Phys 38(5):506–509
Smith JS, Shaffrey E, Klineberg E, Shaffrey CI, Lafage V, Schwab FJ, Protopsaltis T, Scheer JK, Mundis GM, Fu K-MG, Gupta MC, Hostin R, Deviren V, Kebaish K, Hart R, Burton DC, Line B, Bess S, Ames CP (2014) Prospective multicenter assessment of risk factors for rod fracture following surgery for adult spinal deformity. J Neurosurg Spine 21(6):994–1003
Tang JA, Leasure JM, Smith JS, Buckley JM, Kondrashov D, Ames CP (2013) Effect of severity of rod contour on posterior rod failure in the setting of lumbar pedicle subtraction osteotomy (PSO): a biomechanical study. Neurosurgery 72(2):276–282
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG
About this paper
Cite this paper
Villa, T., Ottardi, C., La Barbera, L., Luca, A., Galbusera, F. (2018). Biomechanics of Implant Failure After PSO: Influence of the Hardware Configuration Through a Finite Element Analysis. In: Gefen, A., Weihs, D. (eds) Computer Methods in Biomechanics and Biomedical Engineering. Lecture Notes in Bioengineering. Springer, Cham. https://doi.org/10.1007/978-3-319-59764-5_28
Download citation
DOI: https://doi.org/10.1007/978-3-319-59764-5_28
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-59763-8
Online ISBN: 978-3-319-59764-5
eBook Packages: EngineeringEngineering (R0)