University of Twente Student Theses
Correcting sagittal balance : Design and validation of a novel osteotomy concept with a patient-specific fixation system
Ezendam, E.L. (2024) Correcting sagittal balance : Design and validation of a novel osteotomy concept with a patient-specific fixation system.
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| Abstract: | Introduction: Loss of lumbar lordosis (LL) disrupts sagittal balance, causing chronic back pain and reduced mobility. To address limitations of current surgical options, this thesis introduces the Y-osteotomy, a novel approach aimed at improving stability and reducing posterior fracture risks, combined with a patient-specific fixation system. Methods: The Y-osteotomy was designed by combining an open- and closed wedge osteotomy techniques. A fixation system, involving a patient-specific plate and lag screw, was developed to stabilize the osteotomy. Biomechanical analysis, including free body diagrams and finite element analysis, were used to assess the system’s performance under load. The concept was validated and tested on practical feasibility through a saw bone test simulating surgical conditions as closely as possible. Results: The biomechanical analysis demonstrated that the fixation system withstood the calculated forces in extreme loading conditions, providing the necessary stability for the Y-osteotomy. The saw bone test confirmed improved posterior bone contact and, consequently, greater stability compared to previous methods. Additionally, the saw bone test further confirmed the feasibility of the surgical procedure, although some technical challenges remain, particularly in guiding tool precision. Conclusion: The Y-osteotomy offers a promising alternative for the BEPO concept to correct sagittal balance by improving stability and reducing the risk of fractures. However, further clinical testing and refinement of the guiding tools are necessary. Additionally, the stability of the complete construct should be further tested. Keywords: Sagittal imbalance; Pelvic osteotomy; Biomechanical analysis; Internal fixation system; Patient-specific; Loss of lumbar lordosis. |
| Item Type: | Essay (Master) |
| Clients: | UMCU, Utrecht, Netherlands |
| Faculty: | ET: Engineering Technology |
| Subject: | 33 physics, 42 biology, 44 medicine, 50 technical science in general, 52 mechanical engineering |
| Programme: | Biomedical Engineering MSc (66226) |
| Link to this item: | https://purl.utwente.nl/essays/103751 |
| Export this item as: | BibTeX EndNote HTML Citation Reference Manager |
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