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European Spine Journal
Published in: European Spine Journal 8/2016

01-08-2016 | Original Article

Biomechanical analysis of Ponte and pedicle subtraction osteotomies for the surgical correction of kyphotic deformities

Authors: Giuditta Salvi, Carl-Eric Aubin, Franck Le Naveaux, Xiaoyu Wang, Stefan Parent

Published in: European Spine Journal | Issue 8/2016

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Abstract

Purpose

Biomechanical analysis of Ponte (PO) and pedicle subtraction osteotomies (PSO) in kyphotic deformity instrumentation.

Methods

Patient-specific biomechanical model was used to computationally simulate seven hyperkyphotic instrumentation cases with three osteotomy strategies—1-level PSO, 3-level PO, or 6-level PO; forces within the instrumented spine were assessed and results were analyzed through rANOVA tests.

Results

Corrections with multi-level PO were close to those with one-level PSO. In upright position, average implant forces were from 225 to 280 N and rod bending moments were around 10 Nm with no significant difference between the three strategies (p < 0.05). In simulations of 30° flexion, rod bending moments increased by 38, 2, and 8 %, implant forces increased by 28, 23 and 26 % for the 1-level PSO, 3-level PO, and 6-level PO, respectively. Correction per vertebral level was smaller than the maximum correction allowed by PO and PSO.

Conclusions

Multi-level PO allows similar kyphotic correction to 1-level PSO in spinal deformities with mixed indications for PO and PSO. Loads on the instrumentation constructs in PSO were higher than multi-level PO and higher in 6-level PO than 3-level PO. High loads were located more on the osteotomy sites. The rod shape should be adapted to the anticipated spine correction on the osteotomy sites.
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Metadata
Title
Biomechanical analysis of Ponte and pedicle subtraction osteotomies for the surgical correction of kyphotic deformities
Authors
Giuditta Salvi
Carl-Eric Aubin
Franck Le Naveaux
Xiaoyu Wang
Stefan Parent
Publication date
01-08-2016
Publisher
Springer Berlin Heidelberg
Published in
European Spine Journal / Issue 8/2016
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-015-4279-1

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