Computational study of a dorsolumbar complete burst fracture and its fixation methods

Abstract

PurposeDuring a fall, a significant part of the major forces is absorbed by the dorsolumbar column area. When the applied stresses exceed the yield strength of the bone tissue, fractures can occur in the vertebrae. Vertebral fractures constitute one of the leading causes of trauma-related hospitalizations, accounting for 15% of all admissions. Posterior pedicle screw fixation has become a common method for treating burst fractures. However, physicians remain divided on the number of fixed segments that are needed to improve clinical outcomes. The present work aims to understand the biomechanical impact of different fixation methods, improving surgical treatments.Design/methodology/approachA finite element model of the dorsolumbar spine (T11–L3) section, including cartilages, discs and ligaments, was created. The dorsolumbar stability was tested by comparing two different surgical orthopedic treatments for a fractured first lumbar vertebra on the L1 vertebra: the posterior short segment fixation with intermediate screws (PSS) and the posterior long segment fixation (PL). Distinct loads were applied to represent daily activities.FindingsResults show that both procedures provide acceptable segment fixation, with the PL offering less freedom of movement, making it more stable than the PSS. The PL approach can be the best choice for an unstable fracture as it leads to a stiffer spine segment.Originality/valueThis study introduces a novel computational model designed for the biomechanical analysis of dorsolumbar injuries, aiming to identify the optimal treatment approaches within both clinical and surgical contexts.