Finite element model, thoracolumbar junction, corpectomy, bicortical transpdicular stabilization, cross-links, lateroflexion


The paradigm shift in surgery of the injured spine during the last few decades is characterized by the active implementation of the principle of stabilization without fusion. This approach significantly expands the possibilities of surgical interventions in terms of the completeness of decompression and spinal axis restoration, but also it determines higher requirements for the reliability of the fixation systems and the uniformity of load distribution on both metal systems and bone structures. Objective. To determine the features of load distribution in the area of the thoracolumbar junction after resection of one vertebra, as well as the effect of the transpedicular screw length and cross-links of the stabilization system. Methods. Mathematical finite-element model of the thoracolumbar human spine was developed. The model simulated the state after surgical treatment of a traumatic injury to the thoracolumbar junction with significant damage to the body of the ThXII vertebra. We studied 4 variants of transpedicular fixation (using monocortical screws and long bicortical screws, as well as two cross-links and without them). Results. When analyzing the stress-stain state of the model, we found that the most loaded bone structures during lateroflexion are the vertebral bodies. For the LII vertebral body, the load values were 17.2, 16.2, 16.3, and 15.5 MPa, respectively, for models with monocortical screws without cross-links, bicortical screws without cross-links, monocortical screws and cross-links, and bicortical screws and cross-links. The peak loads on the transpedicular screws were recorded on those implanted in the body of the ThXI vertebra (24.8, 25.7, 22.8 and 24.3 MPa, respectively, for the considered models) and in the body of the LII vertebra (20.2, 24.6, 19, 7 and 23.7 MPa). Conclusions. The use of long transpedicular screws causes less stress on the bony elements than the short screws. At that time stresses on the screws themselves and the bone tissue around them increase. Сross-links help to reduce stress at all control points on models with both short and long transpedicular screws.

Author Biographies

Oleksii Nekhlopochyn, Romodanov Neurosurgery Institute, Kyiv, Ukraine


Vadim Verbov, Romodanov Neurosurgery Institute, Kyiv, Ukraine


Ievgen Cheshuk, Romodanov Neurosurgery Institute, Kyiv, Ukraine



  1. Hu, R., Mustard, C. A., & Burns, C. (1996). Epidemiology of Incident Spinal Fracture in a Complete Population. Spine, 21 (4), 492–499.
  2. Leucht, P., Fischer, K., Muhr, G., & Mueller, E. J. (2009). Epidemiology of traumatic spine fractures. Injury, 40 (2), 166–172.
  3. Vos, T., Lim, S. S., Abbafati, C., Abbas, K. M., Abbasi, M., Abbasifard, M., Abbasi-Kangevari, M., Abbastabar, H., Abd-Allah, F.,Abdelalim, A., Abdollahi, M., Abdollahpour, I., Abolhassani, H., Aboyans, V., Abrams, E. M., Abreu, L. G., Abrigo, M. R. M., Abu-Raddad, L. J., Abushouk, A. I., ... Murray, C. J. L. (2020). Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet, 396 (10258), 1204–1222.
  4. Martin, B. W. (2004). Patterns and risks in spinal trauma. Archives of Disease in Childhood, 89 (9), 860–865.
  5. Meara, J. G., Leather, A. J. M., Hagander, L., Alkire, B. C., Alonso, N., Ameh, E. A., Bickler, S. W., Conteh, L., Dare, A.J.,Davies, J., Merisier, E. D., El-Halabi, S., Farmer, P. E., Gawande, A., Gillies, R., Greenberg, S. L. M., Grimes, C. E., Gruen, R. L., Ismail, E. A., ... Yip, W. (2015). Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development. The Lancet, 386 (9993), 569–624.
  6. Weiser, T. G., Haynes, A. B., Molina, G., Lipsitz, S. R., Esquivel, M.M., Uribe-Leitz, T., Fu, R., Azad, T., Chao, T.E., Berry, W. R.,& Gawande, A. A. (2015). Estimate of the global volume of surgery in 2012: an assessment supporting improved health outcomes. The Lancet, 385, S11.
  7. Chen, C.-S., Chen, W.-J., Cheng, C.-K., Jao, S.-H. E., Chueh, S.-C., & Wang, C.-C. (2005). Failure analysis of broken pedicle screws on spinal instrumentation. Medical Engineering & Physics, 27 (6), 487–496.
  8. Nekhlopochyn, O., Verbov, V., Cheshuk, I., Karpinsky, M., & Yaresko, O. (2023). Mathematical modeling of variants of transpedicular fixation at the thoracolumbar junction after тhхіі vertebrectomy during trunk backward bending. Orthopaedics, traumatology and prosthetics, 2 (631), 43–49.
  9. Nekhlopochyn, O. S., Verbov, V. V., Cheshuk, I. V., Karpinsky, M. Y., & Yaresko, O. V. (2023). Finite element analysis of thoracolumbar junction transpedicular fixation variants after resection of the 12th vertebra while forward bending. Bulletin of Problems Biology and Medicine, 1 (2), 281.
  10. Cowin, S. C. (2001). Bone Mechanics Handbook. (2nd ed.). Boca Raton: CRC Press.
  11. Boccaccio, A., & Pappalettere, C. (2011). Mechanobiology of Fracture Healing: Basic Principles and Applications in Orthodontics and Orthopaedics. In V. Klika (Ed.), Theoretical Biomechanics. Intechopen.
  12. Niinomi, M. (2008). Mechanical biocompatibilities of titanium alloys for biomedical applications. Journal of the Mechanical Behavior of Biomedical Materials, 1 (1), 30–42.
  13. Rao, S. S. (2005). Finite Element Method in Engineering. Elsevier, Butterworth-Heinemann.
  14. Kurowski, P. M. (2007). Engineering Analysis with COSMOSWorks 2007. Schroff Development Corporation.
  15. Verheyden, A. P., Spiegl, U. J., Ekkerlein, H., Gercek, E., Hauck, S., Josten, C., Kandziora, F., Katscher, S., Kobbe, P., Knop, C., Lehmann, W., Meffert, R. H., Müller, C.
  16. W., Partenheimer, A., Schinkel, C., Schleicher, P., Scholz, M., Ulrich, C., & Hoelzl, A. (2018). Treatment of Fractures of the Thoracolumbar Spine: Recommendations of the Spine Section of the German Society for Orthopaedics and Trauma (DGOU). Global Spine Journal, 8 (2_suppl), 34S–45S.
  17. Verlaan, J. J., Diekerhof, C. H., Buskens, E., van der Tweel, I., Verbout, A. J., Dhert, W. J. A., & Oner, F. C. (2004). Surgical Treatment of Traumatic Fractures of the Thoracic and Lumbar Spine. Spine, 29 (7), 803–814.
  18. Zhu, Q., Shi, F., Cai, W., Bai, J., Fan, J., & Yang, H. (2015). Comparison of Anterior Versus Posterior Approach in the Treatment of Thoracolumbar Fractures: A Systematic Review. International Surgery, 100 (6), 1124–1133.
  19. Han, Y., Wang, X., Wu, J., Xu, H., Zhang, Z., Li, K., Song, Y., & Miao, J. (2021). Biomechanical finite element analysis of vertebral column resection and posterior unilateral vertebral resection and reconstruction osteotomy. Journal of Orthopaedic Surgery and Research, 16 (1).
  20. Elmasry, S., Asfour, S., & Travascio, F. (2016). Implications of spine fixation on the adjacent lumbar levels for surgical treatment of thoracolumbar burst fractures: a finite element analysis. Journal of Spine Care, 1 (1).
  21. Park, W. M., Park, Y.-S., Kim, K., & Kim, Y. H. (2009). Biomechanical comparison of instrumentation techniques in treatment of thoracolumbar burst fractures: a finite element analysis. Journal of Orthopaedic Science, 14 (4), 443–449.
  22. Kakadiya, G., Gandbhir, V., Soni, Y., Gohil, K., & Shakya, A. (2020). Osteoporotic burst fracture-clinical, radiological and functional outcome of three-column reconstruction using single posterior approach (Instrumentation, Corpectomy, Arthroscope Assisted Transpedicular Decompression and Mesh Cage). North American Spine Society Journal (NASSJ), 1, 100009.
  23. Kwok, M., Zhang, A. S., DiSilvestro, K. J., Younghein, J. A., Kuris, E. O., & Daniels, A. H. (2021). Dual expandable interbody cage utilization for enhanced stability in vertebral column reconstruction following thoracolumbar corpectomy: A report of two cases. North American Spine Society Journal (NASSJ), 8, 100081.
  24. Sasani, M., & Özer, A. F. (2009). Single-Stage Posterior Corpectomy and Expandable Cage Placement for Treatment of Thoracic or Lumbar Burst Fractures. Spine, 34 (1), E33–E40.
  25. Alizadeh, M. (2018). Biomechanical Evaluation of Segmental Pedicle Screw Fixation in Thoracolumbar Fracture: A Finite Element Study. Orthopedics and Rheumatology Open Access Journal, 12 (3).
  26. Bolesta, M. J., Caron, T., Chinthakunta, S. R., Vazifeh, P. N., & Khalil, S. (2012). Pedicle screw instrumentation of thoracolumbar burst fractures: Biomechanical evaluation of screw configuration with pedicle screws at the level of the fracture. The International Journal of Spine Surgery, 6 (1), 200–205.

How to Cite