title: Effect of bone material properties on effective region in screw-bone model: an experimental and finite element study.
abstract: BACKGROUND
  There have been numerous studies conducted to investigate the pullout force of pedicle screws in bone with different material properties. However, fewer studies have investigated the region of effect (RoE), stress distribution and contour pattern of the cancellous bone surrounding the pedicle screw.
  
  
  METHODS
  Screw pullout experiments were performed from two different foams and the corresponding reaction force was documented for the validation of a computational pedicle screw-foam model based on finite element (FE) methods. After validation, pullout simulations were performed on screw-bone models, with different bone material properties to model three different age groups (<50, 50-75 and >75 years old). At maximum pullout force, the stress distribution and average magnitude of Von Mises stress were documented in the cancellous bone along the distance beyond the outer perimeter pedicle screw. The radius and volume of the RoE were predicted based on the stress distribution.
  
  
  RESULTS
  The screw pullout strengths and the load-displacement curves were comparable between the numerical simulation and experimental tests. The stress distribution of the simulated screw-bone vertebral unit showed that the radius and volume of the RoE varied with the bone material properties. The radii were 4.73 mm, 5.06 mm and 5.4 mm for bone properties of ages >75, 75 > ages >50 and ages <50 years old, respectively, and the corresponding volumes of the RoE were 6.67 mm3, 7.35 mm3 and 8.07 mm3, respectively.
  
  
  CONCLUSIONS
  This study demonstrated that there existed a circular effective region surrounding the pedicle screw for stabilization and that this region was sensitive to the bone material characteristics of cancellous bone. The proper amount of injection cement for augmentation could be estimated based on the RoE in the treatment of osteoporosis patients to avoid leakage in spine surgery.
authors: Shuai
authors: S
authors: Liu
authors: Wei
authors: W
authors: Qi
authors: Yang
authors: Y
authors: Zhang
authors: Zi-Xiang
authors: ZX
authors: Wu
authors: Department of Orthopaedics, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, P,R, China. yanyabo@gmail.com.
authors: Ya-Bo
authors: YB
authors: Yan
authors: Wei
authors: W
authors: Lei
mesh_terms: D000368:Aged; D001863:Bone Screws; D001842:Bone and Bones / Q000601:surgery*; D020342:Finite Element Analysis; D006801:Humans; D008422:Materials Testing; D055595:Mechanical Phenomena; D008875:Middle Aged; D008954:Models, Biological; D015203:Reproducibility of Results; D013314:Stress, Mechanical