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Novel 3D-navigated screw corridors for posterior pelvic ring stabilization: a finite element analysis
Eftychios Bolierakis1,2, Maximilian Praster3, Hatem Alabdulrahman3
1Department of Orthopaedics, Trauma and Reconstructive Surgery, Medical Faculty, RWTH Aachen University, Pauwelsstraße 30, 52074, Aachen, Germany. ebolierakis@ukaachen.de.
Summary
New 3D navigation techniques allow for novel screw placements in posterior pelvic ring stabilization. Some new oblique screw pathways show biomechanical advantages over traditional methods, warranting further study.
Area of Science:
- Orthopedic surgery
- Biomechanical engineering
- Medical imaging
Background:
- Posterior pelvic ring stabilization presents surgical challenges due to complex anatomy and limited bone access.
- Conventional fluoroscopy restricts screw trajectory options.
Purpose of the Study:
- To investigate novel screw trajectories for posterior pelvic ring stabilization using 3D navigation.
- To compare the biomechanical performance of navigated oblique screw pathways against conventional methods.
Main Methods:
- A finite element (FE) model of a pelvis was created.
- Seven screw configurations were simulated, including three novel oblique navigated pathways.
- A 600 N vertical load was applied to assess stress distribution and von Mises stresses.
Main Results:
- Conventional transsacral screws (Variants I-II) showed the most uniform stress distribution and lowest peak stresses (7.17 MPa).
- Navigated Variant III demonstrated favorable load transfer and reduced shear stresses.
- Variant IV exhibited the highest stress (17.80 MPa), with Variant V showing intermediate results.
Conclusions:
- 3D-navigated oblique screw pathways are anatomically feasible for posterior pelvic stabilization.
- These novel pathways may offer biomechanical benefits in specific clinical scenarios.
- Further cadaveric and clinical validation is recommended.
