Evaluation of the Effect of Cervical Spine Bone Distribution on Fixation in Ankylosing Spondylitis

Wang, Beiyang; Tang, Jian; Wang, Zhiqiang; Deng, Chen; Lv, Junqiao; Gao, Fang; Xiong, Xiaoyan; Sun, Lin

doi:10.3389/fbioe.2025.1430047

ORIGINAL RESEARCH article

Front. Bioeng. Biotechnol.

Sec. Biomechanics

Volume 13 - 2025 | doi: 10.3389/fbioe.2025.1430047

Evaluation of the Effect of Cervical Spine Bone Distribution on Fixation in Ankylosing Spondylitis

Provisionally accepted

Beiyang Wang ¹

Jian Tang ²

Zhiqiang Wang ¹

Junqiao Lv ¹

¹ Shanxi Bethune Hospital, Shanxi Medical University, Taiyuan, China
² Taiyuan University of Technology, Taiyuan, Shanxi Province, China

The final, formatted version of the article will be published soon.

Purpose: The distribution of cervical bones in ankylosing spondylitis (AS) differs from that of the normal cervical spine, and traditional simulation methods often yield inaccurate results in finite element analysis. The distribution of cervical bones in ankylosing spondylitis (AS) differs from that of the normal cervical spine, and traditional simulation methods often yield inaccurate results in finite element analysis. This study aimed to develop ankylosing spondylitis cervical spine fracture (ASCF) models based on Hounsfield Unit (HU) values to analyze the effects of different fixation approaches.Methods: Quantitative HU measurements of cervical vertebrae and lateral masses were obtained from CT scans of 20 patients with AS. A finite element model of ASCF was constructed based on HU values and was compared with a traditional ASCF model from multiple perspectives. Additionally, three ASCF models were used to compare the effects of various fixation approaches. A meta-analysis of screw loosening rates was conducted to further validate the efficacy of the models.Results: The HU value of the cervical lateral mass in AS is higher than the corresponding of the vertebral body. Finite element analysis results indicated that the anterior approach is less stable compared to other approaches, as evidenced by the maximum stress (MS) value of the screw and the maximum displacement (MD) of the entire model. These findings were corroborated by the meta-analysis of screw loosening rates in ASCF.Conclusions: ASCF exhibits an uneven distribution of cervical bone, with more severe osteoporosis in the anterior cervical spine. Consequently, simple anterior approaches to fixation may lead to screw loosening in ASCF.Keywords: Finite element, Ankylosing spondylitis, Spine, Fracture, Osteoporosis

Keywords: Finite Element, ankylosing spondylitis, Spine, Fracture, Osteoporosis

Received: 09 May 2024; Accepted: 10 Feb 2025.

Copyright: © 2025 Wang, Tang, Wang, Deng, Lv, Gao, Xiong and Sun. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Lin Sun, Shanxi Bethune Hospital, Shanxi Medical University, Taiyuan, China

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