Skip to main content
SpringerLink
Log in

Biomechanical evaluation of lumbosacral reconstruction after subtotal sacrectomy: A three-dimensional finite element analysis

  • Published:
The Chinese-German Journal of Clinical Oncology

Abstract

Objective

The aim of this study was to investigate the biomechanical property of lumbosacral reconstruction after subtotal sacrectomy.

Methods

Three three-dimensional finite element models of lumbosacral region were established: (1) An intact model (INT); (2) A defective model (DEF) on which subtotal sacrectomy was performed cephalad to the S1 foramina; (3) A reconstructed model (REC). These models were validated by compared with literature. Upright posture was stimulated under a compression load of 925N. A finite element analysis was performed to account for the displacement and stress on the models. The REC model was calculated twice, with the material property of reconstruction instrument set as titanium and stainless steel, respectively.

Results

The displacements of anchor point on the L3 vertebrae in INT, DEF and REC model were 6.63 mm, 10.62 mm, 4.29 mm (titanium) and 3.86 mm (stainless steel), respectively. The stress distribution of the instrument in REC model showed excessively concentration on caudal spinal rod, which may cause rod failure between spine and ilia. The maximum von Mise stress of stainless steel instrument was higher than that of titanium instruments (992 MPa vs 655 MPa), and the value of stress of anchor point around sacroiliac joint in REC model were 26.4 MPa with titanium instruments and 23.9 MPa with stainless steel instruments.

Conclusion

Lumbosacral reconstruction can significantly increase the stiffness of spino-pelvis of the patient who underwent subtotal sacrectomy. However, the rod between L5 and ilia is the weakest region of all the instruments. It is suggested that the bending of rod should be conducted carefully and smoothly to avoid significant stress concentration so as to reduce the risk of rod failure. And stainless steel instrument has higher maximum stress and significantly greater stress shielding effect than titanium instrument, which means stainless steel instruments are of higher risk of rod failure and less favorable for lumboiliac arthrodesis than titanium instruments.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Kawahara N, Murakami H, Yoshida A, et al. Reconstruction after total sacrectomy using a new instrumentation technique. Spine, 2003, 28: 1567–1572.

    Article  PubMed  Google Scholar 

  2. Polikeit A, Ferguson SJ, Nolte LP, et al. Factors influencing stresses in the lumbar spine after the insertion of intervertebral cages: finite element analysis. Eur Spine J, 2002, 12: 413–420.

    Article  PubMed  Google Scholar 

  3. Hugate RR Jr, Dickey ID, Phimolsarnti R, et al. Mechanical effects of partial sacrectomy: when is reconstruction necessary? Clin Orthop Relat Res, 2006, 450: 82–88.

    Article  PubMed  Google Scholar 

  4. Sato K, Kikuchi S, Yonezawa T. In vivo intradiscal pressure measurement in healthy individuals and in patients with ongoing back problems. Spine, 1999, 24: 2468–2474.

    Article  CAS  PubMed  Google Scholar 

  5. Gokaslan ZL, Romsdahl MM, Kroll SS, et al. Total sacrectomy and Galveston L-rod reconstruction for malignant neoplasms. J Neurosurg, 1997, 87: 781–787.

    Article  CAS  PubMed  Google Scholar 

  6. Wang ST, Goel VK, Fu CY, et al. Posterior instrumentation reduces differences in spine stability as a result of different cage orientations: an in vitro study. Spine, 2005, 30: 62–67.

    Article  PubMed  Google Scholar 

  7. Yamamoto I, Panjabi MM, Crisco T, et al. Three-dimensional movement of the whole spine and lumbosacral joint. Spine, 1989, 14: 1256–1260.

    Article  CAS  PubMed  Google Scholar 

  8. Localio SA, Eng K, Ranson JH. Abdominosacral approach for retrorectal tumors. Ann Surg, 1980, 191: 555–560.

    Article  CAS  PubMed  Google Scholar 

  9. Gennari L, Azzarelli A, Quagliuolo V. A posterior approach for the excision of sacral chordoma. J Bone Joint Surg Br, 1987, 69: 565–568.

    CAS  PubMed  Google Scholar 

  10. Gunterberg B, Romanus B, Stener B. Pelvic strength after major amputation of the sacrum. An exerimental study. Acta Orthop Scand, 1976, 47: 635–642.

    CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopedics, Changhai Hospital, Second Military Medical University, Shanghai, 200433, China

    Quan Li & Longpo Zheng

  2. Department of Orthopedics, The Forth Affiliated Hospital of China Medical Nuiversity, Shenyang, 110032, China

    Zhiyu Zhang

  3. Department of Orthopedics, Shanghai Tenth People’s Hospital, Shanghai, 200072, China

    Zhengdong Cai

Authors
  1. Quan Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Longpo Zheng
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Zhiyu Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Zhengdong Cai
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Zhengdong Cai.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Li, Q., Zheng, L., Zhang, Z. et al. Biomechanical evaluation of lumbosacral reconstruction after subtotal sacrectomy: A three-dimensional finite element analysis. Chin. -Ger. J. Clin. Oncol. 8, 638–641 (2009). https://doi.org/10.1007/s10330-009-0114-7

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10330-009-0114-7

Key words

Search

Navigation