Amin Joukar1, Ali Kiapour1,2, Anoli Shah1, Ardalan Seyed Vosoughi1, Vijay K Goel3. 1. Departments of Bioengineering and Orthopaedic Surgery, Engineering Center for Orthopaedic Research Excellence (E-CORE), Colleges of Engineering and Medicine, University of Toledo, 5046 NI, MS 303, Toledo, OH, 43606, USA. 2. Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA. 3. Departments of Bioengineering and Orthopaedic Surgery, Engineering Center for Orthopaedic Research Excellence (E-CORE), Colleges of Engineering and Medicine, University of Toledo, 5046 NI, MS 303, Toledo, OH, 43606, USA. vijay.goel@utoledo.edu.
Abstract
PURPOSE: This study's objective was to assess biomechanical parameters across fused and contralateral sacroiliac joints (SIJs) and implants during all spinal motions for both sexes. Various SIJ implant devices on the market are used in minimally invasive surgeries. These implants are placed across the joint using different surgical approaches. The biomechanical effects of fusion surgical techniques in males and females have not been studied. METHODS: The validated finite element models of a male, and a female spine-pelvis-femur were unilaterally instrumented across the SIJ using three screws for two SIJ implants, half threaded and fully threaded screws placed laterally and posteriorly to the joint, respectively. RESULTS: Motion and peak stress data at the SIJs showed that the female model exhibited lower stresses and higher reduction in motion at the contralateral SIJ in all motions than the male model predictions with 84% and 71% reductions in motion and stresses across the SIJ. CONCLUSION: Implants exhibited higher stresses in the female model compared to the male model. However, chances of SIJ implant failure in the female patients are still minimal, based on the calculated factor of safety which is still very high. Both lateral and posterior surgical approaches were effective in both sexes; however, the lateral approach may provide a better biomechanical response, especially for females. Moreover, implant design characteristics did not make a difference in the implants' biomechanical performance. SIJ stabilization was primarily provided by the implants which were the farthest from the sacrum rotation center.
PURPOSE: This study's objective was to assess biomechanical parameters across fused and contralateral sacroiliac joints (SIJs) and implants during all spinal motions for both sexes. Various SIJ implant devices on the market are used in minimally invasive surgeries. These implants are placed across the joint using different surgical approaches. The biomechanical effects of fusion surgical techniques in males and females have not been studied. METHODS: The validated finite element models of a male, and a female spine-pelvis-femur were unilaterally instrumented across the SIJ using three screws for two SIJ implants, half threaded and fully threaded screws placed laterally and posteriorly to the joint, respectively. RESULTS: Motion and peak stress data at the SIJs showed that the female model exhibited lower stresses and higher reduction in motion at the contralateral SIJ in all motions than the male model predictions with 84% and 71% reductions in motion and stresses across the SIJ. CONCLUSION: Implants exhibited higher stresses in the female model compared to the male model. However, chances of SIJ implant failure in the female patients are still minimal, based on the calculated factor of safety which is still very high. Both lateral and posterior surgical approaches were effective in both sexes; however, the lateral approach may provide a better biomechanical response, especially for females. Moreover, implant design characteristics did not make a difference in the implants' biomechanical performance. SIJ stabilization was primarily provided by the implants which were the farthest from the sacrum rotation center.
Entities:
Keywords:
Finite element analysis; Fusion; Sacroiliac joint; Sex; Surgical approach
Authors: Hector Soriano-Baron; Derek P Lindsey; Nestor Rodriguez-Martinez; Phillip M Reyes; Anna Newcomb; Scott A Yerby; Neil R Crawford Journal: Spine (Phila Pa 1976) Date: 2015-05-01 Impact factor: 3.468