{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T11:08:12Z","timestamp":1781003292987,"version":"3.54.1"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2024,8,20]],"date-time":"2024-08-20T00:00:00Z","timestamp":1724112000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,8,20]],"date-time":"2024-08-20T00:00:00Z","timestamp":1724112000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Spine Deform"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>To assess the effect of various pelvic fixation techniques and number of rods on biomechanics of the proximal junction of long thoracolumbar posterior instrumented fusions.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A validated spinopelvic finite-element (FE) model was instrumented with L5\u2013S1 ALIF and one of the following 9 posterior instrumentation configurations: (A) one traditional iliac screw bilaterally (\u201c2 Iliac\/2 Rods\u201d); (B) T10 to S1 (\u201cSacral Only\u201d); (C) unilateral traditional iliac screw (\u201c1 Iliac\/2 Rods\u201d); (D) one traditional iliac screw bilaterally with one midline accessory rod (\u201c2 Iliac\/3 rods\u201d); (E) S2AI screws connected directly to the midline rods (\u201c2 S2AI\/2 Rods\u201d); and two traditional iliac screws bilaterally with two lateral accessory rods connected to the main rods at varying locations (F1: T10\u201311, F2: T11\u201312, F3: T12\u2013L1, F4: L1\u20132) (\u201c4 Iliac\/4 Rods\u201d). Range of motions (ROM) at T10\u2013S1 and T9\u2013T10 were recorded and compared between models. The T9\u2013T10 intradiscal pressures and stresses of the T9\u201310 disc\u2019s annulus in addition to the von Mises stresses of the T9 and T10 vertebral bodies were recorded and compared.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>For T10\u2013S1 ROM, 4 iliac\/4 rods had lowest ROM in flexion and extension, while 2 S2AI\/2 rods showed lowest ROM in rotation. Constructs with 3 or 4 rods had lower stresses on the primary rods compared to 2-rod constructs. At the proximal adjacent disc (T9\u201310), 4 iliac\/4 rods showed lowest ROM, lowest intradiscal pressures, and lowest annular stress in all directions (most pronounced in flexion\u2013extension). Under flexion and extension, 4 iliac\/4 rods also showed the lowest von Mises stresses on the T10 vertebral body but the highest stresses on the T9 vertebral body.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Dual iliac screws with 4 rods across the lumbosacral junction and extending to the thoracolumbar junction demonstrated the lowest T10\u2013S1 ROM, the lowest adjacent segment disc (T9\u2013T10) ROM, intradiscal pressures, and annular stresses, and the lowest UIV stresses, albeit with the highest UIV\u2009+\u20091 stresses. Additional studies are needed to confirm whether these biomechanical findings dictate clinical outcomes and effect rates of proximal junctional kyphosis and failure.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s43390-024-00932-w","type":"journal-article","created":{"date-parts":[[2024,8,20]],"date-time":"2024-08-20T07:05:00Z","timestamp":1724137500000},"page":"1571-1582","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Effects of pelvic fixation strategies and multi-rod constructs on biomechanics of the proximal junction in long thoracolumbar posterior instrumented fusions: a finite-element analysis"],"prefix":"10.1007","volume":"12","author":[{"given":"Muzammil","family":"Mumtaz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew P.","family":"Collins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niloufar","family":"Shekouhi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karthika","family":"Varier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sudharshan","family":"Tripathi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher P.","family":"Ames","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vedat","family":"Deviren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron J.","family":"Clark","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijay K.","family":"Goel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6170-2813","authenticated-orcid":false,"given":"Alekos A.","family":"Theologis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,8,20]]},"reference":[{"issue":"6","key":"932_CR1","doi-asserted-by":"publisher","first-page":"E198","DOI":"10.1097\/BRS.0b013e3181c142bf","volume":"35","author":"BW Cunningham","year":"2010","unstructured":"Cunningham BW, Sefter JC, Hu N, Kim SW, Bridwell KH, McAfee PC (2010) Biomechanical comparison of iliac screws versus interbody femoral ring allograft on lumbosacral kinematics and sacral screw strain. 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