{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T01:37:32Z","timestamp":1782697052484,"version":"3.54.5"},"reference-count":55,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,3,1]],"date-time":"2023-03-01T00:00:00Z","timestamp":1677628800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81973646"],"award-info":[{"award-number":["81973646"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>At present, a variety of posterior lumbar internal fixation implantation methods have been developed, which makes it difficult for spine surgeons to choose. The stress distribution of the internal fixation system is one of the important indexes to evaluate these technologies. Common insertion technologies include Roy Camille, Magerl, Krag, AO, and Weinstein insertion techniques. This study aimed to compare the distribution of von Mises stresses in different screw fixation systems established by these insertion technologies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Here, the three\u2010dimensional finite element (FE) method was selected to evaluate the postoperative stress distribution of internal fixation. Following different pedicle screw insertion techniques, five single\u2010segment transforaminal lumbar interbody fusion (TLIF) models were established after modeling and validation of the L1\u2010S1 vertebrae FE model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>By analyzing the data, we found that stress concentration phenomenon was in all the models. Additionally, Roy\u2010Camille, Krag, AO, and Weinstein insertion techniques led to the great stress on lumbar vertebra, intervertebral disc, and screw\u2010rod fixation systems. Therefore, we hope that the results can provide ideas for clinical work and development of pedicle screws in the future. It is worth noting that flexion, unaffected side lateral bending, and affected side axial rotation should be limited for the patients with cages implanted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Overall, our method obtained the results that Magerl insertion technique was the relatively safe approach for pedicle screw implantation due to its relatively dispersive stress in TLIF models.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.13671","type":"journal-article","created":{"date-parts":[[2023,3,1]],"date-time":"2023-03-01T08:25:34Z","timestamp":1677659134000},"page":"1153-1164","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Stress Distribution of Different Pedicle Screw Insertion Techniques Following Single\u2010Segment <scp>TLIF<\/scp>: A Finite Element Analysis Study"],"prefix":"10.1111","volume":"15","author":[{"given":"Simengge","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Orthopaedics The First Affiliated Hospital of Dalian Medical University  Dalian China"},{"name":"Department of Orthopedics The Second Xiangya Hospital of Central South University  Changsha China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6646-1040","authenticated-orcid":false,"given":"Tianze","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics The First Affiliated Hospital of Dalian Medical University  Dalian China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liwen","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics The First Affiliated Hospital of Dalian Medical University  Dalian 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Hospital of Dalian Medical University  Dalian China"},{"name":"Department of Orthopaedics The Third Affiliated Hospital of Dalian Medical University  Dalian China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,3]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(18)30480-x"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2016.5688"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2005.08.003"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2018.04.085"},{"issue":"1","key":"e_1_2_12_6_1","first-page":"65","article-title":"Biomechanical comparison of three total artificial discs: SB\u2010CHARITE iii\u00ae, PRODISC\u2010l\u00ae and maverick\u00ae reinforced by a posterior fixation system IN the spinal column: a three\u2010dimensional finite element analysis BIOMEHANI\u010cKO PORE\u0110ENJE tri 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