Identyfikatory
Warianty tytułu
Języki publikacji
Abstrakty
Purpose: Anterior cervical discectomy and fusion is a common surgical procedure performed to remove a degenerative or herniated disc in cervical spine. Unfortunately, clinical complications of anterior cervical plate (ACP) systems still occur, such as weak fixation stability and implant loosening. Previous researchers have attempted to ameliorate these complications by varying screw orientations, but the screw orientations are mainly determined according to the investigator’s experiences. Thus, the aim of this study was to discover the optimal screw orientations of ACP systems to achieve acceptable fixation stability using finite element simulations and engineering algorithms. Methods: Three-dimensional finite element models of C3-T2 multi-level segments with an ACP system were first developed to analyze the fixation stability using ANSYS Workbench 14.5. Then, artificial neural networks were applied to create one objective function, and the optimal screw orientations of an ACP system were discovered by genetic algorithms. Finally, the numerical models and the optimization study were validated using biomechanical tests. Results: The results showed that the optimal design of the ACP system had highest fixation stability compared with other ACP designs. The neuro-genetic algorithm has effectively reduced the time and effort required for discovering for the optimal screw orientations of an ACP system. Conclusions: The optimum screw orientation of the ACP system could be successfully discovered, and it revealed excellent fixation stability for the treatment of cervical degenerative disc disease. This study could directly provide the biomechanical rationale and surgical suggestion to orthopedic surgeons.
Czasopismo
Rocznik
Tom
Strony
59--66
Opis fizyczny
Bibliogr. 23 poz., rys., tab.
Twórcy
autor
- Department of Orthopedic Surgery, Mackay Memorial Hospital, Taipei 104, Taiwan, R.O.C
autor
autor
- Department of Mechanical Engineering, National Taiwan University of Science and Technology, Taipei 106, Taiwan, R.O.C.
Bibliografia
- [1] BAILEY R.W., BADGLEY R.E., Stabilization of the cervical spine by anterior fusion, J. Bone Joint Surg. Am., 1960, Vol. 42, 565–624.
- [2] BARNES B., HAID R.W., RODTS G., SUBACH B., KAISER M., Early results using the Atlantis anterior cervical plate system, Neurosurg. Focus, 2002, Vol. 12, 1–7.
- [3] BENSGHAIER A., ROMDHANE L., BENOUEZDOU F., Multiobjective optimization to predict muscle tensions in a pinch function using genetic algorithm, C R Mécanique, 2012, Vol. 340, 139–155.
- [4] CHAO C.K., HSU C.C., WANG J.L., LIN J., Increasing bending strength of tibial locking screws: Mechanical tests and finite element analyses, Clin. Biomech., 2007, Vol. 22, 59–66.
- [5] CHAO C.K., LIN J., PUTRA S.T., HSU C.C., A Neurogenetic Approach to a Multiobjective Design Optimization of Spinal Pedicle Screws, J. Biomech. Eng., 2010, Vol. 132, 091006.
- [6] CLAVENNA A., DOSSETT A.B., Anterior Cervical Diskectomy and Fusion, Oper. Tech. Sports Med., 2005, Vol. 13, 90–95.
- [7] DIPAOLA C.P., JACOBSON J.A., AWAD H., CONRAD B.P., RECHTINE G.R., Screw orientation and plate type (variablevs. fixed-angle) effect strength of fixation for in vitro biomechanical testing of the Synthes CSLP, Spine J., 2008, Vol. 8, 717–722.
- [8] DIPAOLA C.P., JACOBSON J.A., AWAD H., CONRAD B.P., RECHTINE II G.R., Screw Pull-out Force is Dependent on Screw Orientation in an Anterior Cervical Plate Construct, J. Spinal Disord. Tech., 2007, Vol. 20, 369–373
- [9] FAIZAN A., GOEL V.K., BIYANI A., GARFIN S.R., BONO C.M., Adjacent level effects of bi level disc replacement, bi level fusion and disc replacement plus fusion in cervical spine – a finite element based study, Clin. Biomech., 2012, Vol. 27, 226–233.
- [10] HSU C.C., Shape optimization for the subsidence resistance of an interbody device using simulation-based genetic algorithms and experimental validation, J. Orthop. Res., 2013, Vol. 31, 1158–1163.
- [11] HUSSAIN M., NASSR A., NATARAJAN R.N., AN H.S., ANDERSSON G.B.J., Corpectomy versus discectomy for the treatment of multilevel cervical spine pathology: a finite element model analysis, Spine J., 2012, Vol. 12, 401–408.
- [12] ISMAIL M.S., MOGHAVVEMI M., MAHLIA T.M.I., Characterization of PV panel and global optimization of its model parameters using genetic algorithm, Energy Convers Manag., 2013, Vol. 73, 10–25.
- [13] JIN D., QU D., CHEN J., ZHANG H., One-stage anterior interbody autografting and instrumentation in primary surgical management of thoracolumbar spinal tuberculosis, Eur. Spine J., 2004, Vol. 13, 114–121.
- [14] LEE S.H., IM Y.J., KIM K.T., KIM Y.H., PARK W.M., KIM K., Comparison of Cervical Spine Biomechanics After Fixedand Mobile-Core Artificial Disc Replacement: A Finite Element Analysis, Spine, 2011, Vol. 36, 700–708.
- [15] LOWERY G.L., MCDONOUGH R.F., The Significance of Hardware Failure in Anterior Cervical Plate Fixation: Patients With 2- to 7-Year Follow-up, Spine, 1998, Vol. 23, 181–186.
- [16] MEHTA H., SANTOS E., LEDONIO C., SEMBRANO J., ELLINGSON A., PARE P., MURRELL B., NUCKLEY D.J., Biomechanical analysis of pedicle screw thread differential design in an osteoporotic cadaver model, Clin. Biomech., 2012, Vol. 27, 234–240.
- [17] MITCHELL M., An Introduction to Genetic Algorithms, Bradford, 1996.
- [18] PALEPU V., KIAPOUR A., GOEL V.K., MORAN J.M., A unique modular implant system enhances load sharing in anterior cervical interbody fusion: a finite element study, Biomed. Eng. Online, 2014, Vol. 13, 26.
- [19] PELOSI G., SELLERI S., TADDEI R., A Novel Multiobjective Taguchi's Optimization Technique for Multibeam Array Synthesis, Microw. Opt. Technol. Lett., 2013, Vol. 55, 1836–1840.
- [20] ROSLI R., ABDUL KADIR M.R., KAMARUL T., Stability of cervical spine after one-level corpectomy using different numbers of screws and plate systems, Proc. I. Mech. E., Part H: J. Eng. Med., 2014, Vol. 228, 342–349.
- [21] SCHMIDT H., GALBUSERA F., ROHLMANN A., ZANDER T., WILKE H.J., Effect of multilevel lumbar disc arthroplasty on spine kinematics and facet joint loads in flexion and extension: a finite element analysis, Eur. Spine J., 2012, Vol. 21, 663–674.
- [22] SELLER K., WAHL D., WILD A., KRAUSPE R., SCHNEIDER E., LINKE B., Pullout strength of anterior spinal instrumentation: a product comparison of seven screws in calf vertebral bodies, Eur. Spine J., 2007, Vol. 16, 1047–1054.
- [23] WANG J.C., MCDONOUGH P.W., ENDOW K.K., DELAMARTER R.B., EMERY S.E., Increased Fusion Rates With Cervical Plating for Two-Level Anterior Cervical Discectomy and Fusion, Spine, 2000, Vol. 25, 41–47.
Typ dokumentu
Bibliografia
Identyfikator YADDA
bwmeta1.element.baztech-5090aa4b-7a8b-46ab-833d-9cc58a9f94f2