{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T06:04:25Z","timestamp":1789452265689,"version":"build-2803163510"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study aimed to explore the three-dimensional finite element analysis and clinical effect of the pivot forward combined leveraging technique in the treatment of thoracolumbar fracture.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Two internal fixation models were designed based on the pivot forward combined leveraging technique and traditional fixation technique for finite element analysis. Data of 47 patients who underwent pivot forward combined leveraging technique for thoracolumbar fracture were retrospectively analyzed. The vertebral body index (VBI), height of the anterior margin of injured vertebra (HAMIV), injured vertebra angle (IVA), kyphotic Cobb angle (KCA), the main outcome function included visual analog scale (VAS), and Oswestry disability index (ODI) before, after and at the last follow-up were measured.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The finite element results showed that the nail rod stress and nucleus pulposus stress measured in pivot forward combined leveraging technique group were significantly lower than those in the traditional fixation group. Clinically, the procedure of pivot forward combined leveraging technique was successfully completed in 47 cases. The patients' preoperative VBI, HAMIV, IVA, KCA, VAS and ODI scores were 0.64\u2009\u00b1\u20090.07, 0.60\u2009\u00b1\u20090.09, 23.70\u00b0\u2009\u00b1\u20093.26\u00b0, 11.37\u00b0\u2009\u00b1\u20099.53\u00b0, 8.04\u2009\u00b1\u20090.83, and 51.81\u2009\u00b1\u20099.21, respectively. Postoperative measurements were 0.93\u2009\u00b1\u20090.04, 0.96\u2009\u00b1\u20090.04, 4.22\u00b0\u2009\u00b1\u20092.32\u00b0, \u22121.71\u00b0\u2009\u00b1\u20098.07\u00b0, 3.26\u2009\u00b1\u20090.64 and 21.15\u2009\u00b1\u20095.52, respectively. At the last follow\u2043up, the measurements were 0.91\u2009\u00b1\u20090.04, 0.94\u2009\u00b1\u20090.04, 5.49\u00b0\u2009\u00b1\u20092.32\u00b0, 0.18\u00b0\u2009\u00b1\u20098.25\u00b0, 1.00\u2009\u00b1\u20090.78, and 6.49\u2009\u00b1\u20091.90, respectively. Notably, a marked difference was obtained between the preoperative and postoperative data, as well as the preoperative and the last follow\u2043up data (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The pivot forward combined leveraging technique has high biomechanical stability and can restore the height of the injured vertebra and correct the kyphosis angle of the injured vertebra.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2026.1941333","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T05:33:55Z","timestamp":1789450435000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Application of the pivot forward combined leveraging technique in the treatment of thoracolumbar fractures: a finite element analysis and clinical study"],"prefix":"10.3389","volume":"13","author":[{"given":"Yan","family":"Zhou","sequence":"first","affiliation":[{"name":"Department of Spine Surgery, Renmin Hospital of Wuhan University","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianghua","family":"Ming","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, Renmin Hospital of Wuhan University","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming","family":"Deng","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, Renmin Hospital of Wuhan University","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yonggang","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, Renmin Hospital of Wuhan University","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,15]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"112050","DOI":"10.1016\/j.injury.2024.112050","article-title":"Pelvic fractures and thoracolumbar spine injury: a critical overlook in high-impact vehicular trauma management","volume":"56","author":"Mohs","year":"2025","journal-title":"Injury"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1592","DOI":"10.1111\/os.14090","article-title":"The comparison between spinal facet joint toothed plate and traditional pedicle screw-rod on reduction of thoracolumbar fracture","volume":"16","author":"Qiu","year":"2024","journal-title":"Orthop Surg"},{"key":"B3","doi-asserted-by":"publisher","first-page":"e807","DOI":"10.1016\/j.wneu.2024.07.009","article-title":"A prediction nomogram for fractured vertebra recollapse after posterior reduction and pedicle screw fixation in thoracolumbar fractures","volume":"189","author":"Xiong","year":"2024","journal-title":"World Neurosurg"},{"key":"B4","doi-asserted-by":"publisher","first-page":"515","DOI":"10.1016\/j.spinee.2024.10.017","article-title":"Which spinal fixation technique achieves which degree of stability after thoracolumbar trauma? 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