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Tang SJ, Dong RC, Cheng X, Liu YT, Wang ZL, Zhang PB. Effect of anteroposterior vibration frequency on the risk of lumbar injury in seated individuals. ERGONOMICS 2024:1-13. [PMID: 39150052 DOI: 10.1080/00140139.2024.2391591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 08/06/2024] [Indexed: 08/17/2024]
Abstract
Few studies investigate the impact of anterior-posterior excitation frequency on the time-domain vibrational response and injury risk of the lumbar spine in seated individuals. Firstly, this study utilised a previously developed finite element model of an upright seated human body on a rigid chair without a backrest to investigate the modes that affect the anterior-posterior vibrations of the seated body. Subsequently, transient dynamic analysis was employed to calculate the lumbar spine's time-domain responses (displacement, stress, and pressure) and risk factors under anteroposterior sinusoidal excitation at varying frequencies (1-8 Hz). Modal analysis suggested the frequencies significantly affecting the lumbar spine's vibration were notably at 4.7 Hz and 5.5 Hz. The transient analysis results and risk factor assessment indicated that the lumbar responses were most pronounced at 5 Hz. In addition, risk factor assessment showed that long-term exposure to 8 Hz vibration was associated with a greater risk of lumbar injury.
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Affiliation(s)
- Sheng-Jie Tang
- School of Mechanical Engineering, Shandong University of Technology, Zibo, PR China
| | - Rui-Chun Dong
- School of Mechanical Engineering, Shandong University of Technology, Zibo, PR China
| | - Xiang Cheng
- School of Mechanical Engineering, Shandong University of Technology, Zibo, PR China
| | - Yi-Tang Liu
- School of Mechanical Engineering, Shandong University of Technology, Zibo, PR China
| | - Zong-Liang Wang
- Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun, PR China
| | - Pei-Biao Zhang
- Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun, PR China
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Jiang JH, Zhao CM, Zhang J, Xu RM, Chen L. Biomechanical effects of posterior lumbar interbody fusion with vertical placement of pedicle screws compared to traditional placement. World J Clin Cases 2024; 12:4108-4120. [PMID: 39015896 PMCID: PMC11235545 DOI: 10.12998/wjcc.v12.i20.4108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 04/24/2024] [Accepted: 05/31/2024] [Indexed: 06/30/2024] Open
Abstract
BACKGROUND The pedicle screw technique is widely employed for vertebral body fixation in the treatment of spinal disorders. However, traditional screw placement methods require the dissection of paraspinal muscles and the insertion of pedicle screws at specific transverse section angles (TSA). Larger TSA angles require more force to pull the muscle tissue, which can increase the risk of surgical trauma and ischemic injury to the lumbar muscles. AIM To study the feasibility of zero-degree TSA vertical pedicle screw technique in the lumbosacral segment. METHODS Finite element models of vertebral bodies and pedicle screw-rod systems were established for the L4-S1 spinal segments. A standard axial load of 500 N and a rotational torque of 10 N/m were applied. Simulated screw pull-out experiment was conducted to observe pedicle screw resistance to pull-out, maximum stress, load-displacement ratio, maximum stress in vertebral bodies, load-displacement ratio in vertebral bodies, and the stress distribution in pedicle screws and vertebral bodies. Differences between the 0-degree and 17-degree TSA were compared. RESULTS At 0-degree TSA, the screw pull-out force decreased by 11.35% compared to that at 17-degree TSA (P < 0.05). At 0-degree and 17-degree TSA, the stress range in the screw-rod system was 335.1-657.5 MPa and 242.8-648.5 MPa, separately, which were below the fracture threshold for the screw-rod system (924 MPa). At 0-degree and 17-degree TSA, the stress range in the vertebral bodies was 68.45-78.91 MPa and 39.08-72.73 MPa, separately, which were below the typical bone yield stress range for vertebral bodies (110-125 MPa). At 0-degree TSA, the load-displacement ratio for the vertebral bodies and pedicle screws was slightly lower compared to that at 17-degree TSA, indicating slightly lower stability (P < 0.05). CONCLUSION The safety and stability of 0-degree TSA are slightly lower, but the risks of screw-rod system fracture, vertebral body fracture, and rupture are within acceptable limits.
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Affiliation(s)
- Ji-Hong Jiang
- Department of Orthopedic Surgery, Zhejiang University Mingzhou Hospital, Ningbo 315000, Zhejiang Province, China
| | - Chang-Ming Zhao
- Department of Orthopedic Surgery, Zhejiang University Mingzhou Hospital, Ningbo 315000, Zhejiang Province, China
| | - Jun Zhang
- Department of Orthopedic Surgery, Zhejiang University Mingzhou Hospital, Ningbo 315000, Zhejiang Province, China
| | - Rong-Ming Xu
- Department of Orthopedic Surgery, Zhejiang University Mingzhou Hospital, Ningbo 315000, Zhejiang Province, China
| | - Lei Chen
- Department of Orthopedic Surgery, Zhejiang University Mingzhou Hospital, Ningbo 315000, Zhejiang Province, China
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Zhou LP, Zhang RJ, Wang JQ, Zhang HQ, Shang J, Gao Y, Jia CY, Ding JY, Zhang L, Shen CL. Medium and long-term radiographic and clinical outcomes of Dynesys dynamic stabilization versus instrumented fusion for degenerative lumbar spine diseases. BMC Surg 2023; 23:46. [PMID: 36855117 PMCID: PMC9976523 DOI: 10.1186/s12893-023-01943-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 02/21/2023] [Indexed: 03/02/2023] Open
Abstract
BACKGROUND Dynesys stabilization (DS) is utilized to preserve mobility at the instrumental segments and prevent adjacent segment pathology in clinical practice. However, the advantages of DS method in medium and long-term follow-up remain controversial. OBJECTIVE To compare the radiographic and clinical outcomes between DS and instrumented fusion in the treatment of degenerative lumbar spine disease with or without grade I spondylolisthesis with a minimum follow-up period of 2 years. METHODS We conducted a comprehensive search of PubMed, EMBASE, Cochrane, and Web of Science databases, Chinese National Knowledge Databases, and Wanfang Database for potentially eligible articles. Clinical outcomes were assessed in terms of VAS and ODI scores, screw loosening and breakage, and surgical revision. Radiographic outcomes were assessed in terms of postoperative range of movement (ROM) and disc heigh. Moreover, adjacent segment degeneration (ASDeg) and adjacent segment disease (ASDis) were evaluated. RESULTS Seventeen studies with 1296 patients were included in the meta-analysis. The DS group was associated with significantly lower postoperative VAS scores for low-back and leg pain, and lower rate of surgical revision than the fusion group. Moreover, the Dynesys group showed significantly less ASDeg than the fusion group but showed no significant advantage over the fusion group in terms of preventing ASDis. Additionally, the ROM at the stabilized segments of the fusion group decreased significantly and that at the adjacent segments increased significantly compared with those of the DS group. CONCLUSION DS showed comparable clinical outcomes and provided benefits in preserving the motion at the stabilized segments, thus limiting the hypermobility at the adjacent segments and preventing ASDeg compared with the fusion method in degenerative disease with or without grade I spondylolisthesis.
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Affiliation(s)
- Lu-Ping Zhou
- grid.412679.f0000 0004 1771 3402Department of Orthopedics and Spine Surgery, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, 230022 Anhui China
| | - Ren-Jie Zhang
- grid.412679.f0000 0004 1771 3402Department of Orthopedics and Spine Surgery, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, 230022 Anhui China
| | - Jia-Qi Wang
- grid.412679.f0000 0004 1771 3402Department of Orthopedics and Spine Surgery, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, 230022 Anhui China
| | - Hua-Qing Zhang
- grid.412679.f0000 0004 1771 3402Department of Orthopedics and Spine Surgery, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, 230022 Anhui China
| | - Jin Shang
- grid.411395.b0000 0004 1757 0085Department of Radiology, The First Affiliated Hospital of University of Science and Technology of China, 107 Huanhudong Road, Hefei, 230031 Anhui China
| | - Yang Gao
- grid.488137.10000 0001 2267 2324Outpatient Department, The 55th Retired Cadres of the Beijing Garrison of PLA, 4 Wanshou Road, Beijing, 100036 China
| | - Chong-Yu Jia
- grid.412679.f0000 0004 1771 3402Department of Orthopedics and Spine Surgery, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, 230022 Anhui China
| | - Jing-Yu Ding
- grid.412679.f0000 0004 1771 3402Department of Orthopedics and Spine Surgery, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, 230022 Anhui China
| | - Lai Zhang
- grid.412679.f0000 0004 1771 3402Department of Orthopedics and Spine Surgery, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, 230022 Anhui China
| | - Cai-Liang Shen
- Department of Orthopedics and Spine Surgery, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, 230022, Anhui, China.
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Zhang C, Guo LX. Effect of whole-body vibration at different frequencies on the lumbar spine: A finite element study based on a whole human body model. Proc Inst Mech Eng H 2022; 236:1752-1761. [DOI: 10.1177/09544119221135688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Many previous studies have found that occupational drivers commonly suffered from low back pain, and low back pain and degeneration of the intervertebral disc might be associated with vibration conditions. However, the biomechanical mechanisms of whole-body vibration that caused pain and injury were not clear. In this study, a validated whole human body finite element model was used, and vibration loads at frequencies of 3, 5, 7 and 9 Hz were loaded to evaluate the frequency effects on the spine. The results showed that the responses of the spine were strong at the 5 Hz vibration load. Vibration loads would produce alternating stresses and bulges in the annulus fibrosus and change the direction of the pressure in the nucleus pulposus. The posterior region of the intervertebral disc showed greater stress fluctuations than the anterior region. The Risk Factors showed that long-term exposure to whole-body vibrations at 5 and 7 Hz might have greater adverse effects on the spine. The findings of this study confirmed that vibrations near the resonance frequency of the human body would cause more injuries to the spine than other frequencies. Alternating stress and bulge might cause fatigue and the degeneration of the intervertebral disc, which might be the mechanisms of spinal injury caused by whole-body vibration, and the posterior regions of the intervertebral disc were more susceptible to degeneration. Some appropriate measures should be taken to reduce the adverse effects of whole-body vibration on spinal health.
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Affiliation(s)
- Chi Zhang
- School of Mechanical Engineering and Automation, Northeastern University, Shenyang, China
| | - Li-Xin Guo
- School of Mechanical Engineering and Automation, Northeastern University, Shenyang, China
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Jain P, Khan MR. Comparison of novel stabilisation device with various stabilisation approaches: A finite element based biomechanical analysis. Int J Artif Organs 2022; 45:514-522. [PMID: 35393885 DOI: 10.1177/03913988221088334] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The treatment of spinal failure requires suitable instrumentation, which is based on numerous concepts such as rigid fixation, semi-rigid and dynamic stabilisation. In the present work, the biomechanical investigation of various fixation systems on the lumbar segment L2-L3 was performed employing finite element analysis. Different devices were considered: novel stabilisation device (NSD), rigid implant (RI) and existing dynamic stabilisation device (EDSD). All instrumented models were loaded with a condition of 400 N compressive force with a moment of 10Nm during flexion, extension, lateral bending and axial rotation. The results of range of motion change (RMC), von-Mises stress and strain were compared. The spinal biomechanics post instrumentation resulted significantly sensitive to the geometrical feature of the implant. The obtained results showed that NSD has intermediate motion characteristics in between dynamic stabilisation and rigid fixation. However, the optimum features of a novel stabilisation device for the treatment of spinal failure still need to be verified employing in-vivo, in-vitro studies.
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Affiliation(s)
- Pushpdant Jain
- School of Mechanical Engineering, VIT Bhopal University, Sehore, Madhya Pradesh, India
| | - Mohammed Rajik Khan
- Department of Industrial Design, National Institute of Technology Rourkela, Rourkela, Odisha, India
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Zhao Y, Xu B, Qi L, Li C, Yue L, Yu Z, Wang S, Sun H. Hybrid surgery with PEEK rods for lumbar degenerative diseases: a 2-year follow-up study. BMC Musculoskelet Disord 2022; 23:4. [PMID: 34980059 PMCID: PMC8725535 DOI: 10.1186/s12891-021-04895-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 11/18/2021] [Indexed: 11/10/2022] Open
Abstract
Background Finite element analyses and biomechanical tests have shown that PEEK rods promote fusion and prevent adjacent segment degeneration. The purpose of this study was to evaluate the effects and complications of hybrid surgery with PEEK rods in lumbar degenerative diseases. Methods From January 2015-December 2017, 28 patients who underwent lumbar posterior hybrid surgery with PEEK rods were included in the study. The patients were diagnosed with lumbar disc herniation, lumbar spinal stenosis, or degenerative grade I spondylolisthesis. Before the operation and at the last follow-up, the patients completed lumbar anteroposterior and lateral X-ray, dynamic X-ray, MRI examinations. In addition, at the last follow-up the patients also completed lumbar CT examinations. The radiographic parameters, clinical visual analog scale (VAS) score and Oswestry disability index (ODI) score were compared. Results The average age of the patients was 44.8 ± 12.6 years, and the average follow-up duration was 26.4 ± 3.6 months. The VAS score improved from 6.3 ± 1.6 to 1.0 ± 0.9, and the ODI score decreased from 38.4 ± 10.8 to 6.8 ± 4.6. The fusion rate of the fused segment was 100%. There were no significant changes in the modified Pfirrmann classifications or disc height index for the nonfused segments and the upper adjacent segments from pre- to postoperatively. No cases of screw loosening, broken screws, broken rods or other mechanical complications were found. Conclusion Hybrid surgery with PEEK rods for lumbar degenerative diseases can yield good clinical results and effectively reduce the incidence of complications such as adjacent segment diseases. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-021-04895-1.
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Affiliation(s)
- Yao Zhao
- Department of Orthopaedics, Peking University First Hospital, Xicheng District, Beijing, 100034, China
| | - Beiyu Xu
- Department of Orthopaedics, Peking University First Hospital, Xicheng District, Beijing, 100034, China
| | - Longtao Qi
- Department of Orthopaedics, Peking University First Hospital, Xicheng District, Beijing, 100034, China
| | - Chunde Li
- Department of Orthopaedics, Peking University First Hospital, Xicheng District, Beijing, 100034, China.
| | - Lei Yue
- Department of Orthopaedics, Peking University First Hospital, Xicheng District, Beijing, 100034, China
| | - Zhengrong Yu
- Department of Orthopaedics, Peking University First Hospital, Xicheng District, Beijing, 100034, China
| | - Shijun Wang
- Department of Orthopaedics, Peking University First Hospital, Xicheng District, Beijing, 100034, China
| | - Haolin Sun
- Department of Orthopaedics, Peking University First Hospital, Xicheng District, Beijing, 100034, China
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Sayed D, Amirdelfan K, Naidu RK, Raji OR, Falowski S. A Cadaver-Based Biomechanical Evaluation of a Novel Posterior Approach to Sacroiliac Joint Fusion: Analysis of the Fixation and Center of the Instantaneous Axis of Rotation. MEDICAL DEVICES-EVIDENCE AND RESEARCH 2021; 14:435-444. [PMID: 34949942 PMCID: PMC8691588 DOI: 10.2147/mder.s347763] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 12/09/2021] [Indexed: 12/27/2022] Open
Abstract
Purpose The purpose of this study was to assess the stabilizing effect of a posterior joint fixation technique using a novel cortical allograft implant in unilateral and bilateral fixation constructs. We hypothesize that fixation would reduce the joint's range of motion during flexion-extension, axial rotation, and lateral bending loads. We also hypothesize that fixation would shift the center of the instantaneous axis of rotation during the predominant flexion-extension motions towards the implant's location, and that this shift would be correlated with the reduction in flexion-extension range of motion. Materials and Methods Six cadaveric sacroiliac joint specimens were tested under intact, unilateral fixation, and bilateral fixation conditions. The total range of motion (ROM) of the sacroiliac joint in flexion-extension, lateral bending, and axial rotation were evaluated by an optical tracking system, in a multidirectional flexibility pure moment model, between ± 7.5 Nm applied moment loads. The centers of the instantaneous axis of rotation (cIAR) of the sacroiliac joint were evaluated during flexion-extension loading. A correlation analysis was performed between the ROM reduction in flexion-extension upon implantation and shift of the cIAR to the graft implantation site. Results Unilateral and bilateral fixations generated sacroiliac joint ROM reductions in flexion-extension, lateral bending, and axial rotation motions. Fixation shifted the cIAR to the graft implantation site. Reduction in the total range of motion had a moderate correlation with the shift of the cIAR. Conclusion Our novel posterior approach presents a multifaceted mechanism for stabilizing the joint: first, by the reduction of the total range of motion in all planes of motion; second, by shifting the centers of the instantaneous axis of rotation towards the implant's location in the predominant plane of motion, ensuring little to no motion at the implantation site, thus promoting fusion in this region.
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Affiliation(s)
- Dawood Sayed
- The University of Kansas Medical Center, Kansas City, KS, USA
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Ke W, Chen C, Wang B, Hua W, Lu S, Song Y, Luo R, Liao Z, Li G, Ma L, Shi Y, Wang K, Li S, Wu X, Zhang Y, Yang C. Biomechanical Evaluation of Different Surgical Approaches for the Treatment of Adjacent Segment Diseases After Primary Anterior Cervical Discectomy and Fusion: A Finite Element Analysis. Front Bioeng Biotechnol 2021; 9:718996. [PMID: 34532313 PMCID: PMC8438200 DOI: 10.3389/fbioe.2021.718996] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 08/13/2021] [Indexed: 12/31/2022] Open
Abstract
Symptomatic adjacent segment disease (ASD) is a common challenge after anterior cervical discectomy and fusion (ACDF). The objective of this study was to compare the biomechanical effects of a second ACDF and laminoplasty for the treatment of ASD after primary ACDF. We developed a finite element (FE) model of the C2-T1 based on computed tomography images. The FE models of revision surgeries of ACDF and laminoplasty were simulated to treat one-level and two-level ASD after primary ACDF. The range of motion (ROM) and intradiscal pressure (IDP) of the adjacent segments, and stress in the cord were analyzed to investigate the biomechanical effects of the second ACDF and laminoplasty. The results indicated that revision surgery of one-level ACDF increased the ROM and IDP at the C2–C3 segment, whereas two-level ACDF significantly increased the ROM and IDP at the C2–C3 and C7-T1 segments. Furthermore, no significant changes in the ROM and IDP of the laminoplasty models were observed. The stress in the cord of the re-laminoplasty model decreased to some extent, which was higher than that of the re-ACDF model. In conclusion, both ACDF and laminoplasty can relieve the high level of stress in the spinal cord caused by ASD after primary ACDF, whereas ACDF can achieve better decompression effect. Revision surgery of the superior ACDF or the superior and inferior ACDF after the primary ACDF increased the ROM and IDP at the adjacent segments, which may be the reason for the high incidence of recurrent ASD after second ACDF.
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Affiliation(s)
- Wencan Ke
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chao Chen
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Bingjin Wang
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenbin Hua
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Saideng Lu
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yu Song
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Rongjin Luo
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhiwei Liao
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Gaocai Li
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Liang Ma
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yunsong Shi
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kun Wang
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shuai Li
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xinghuo Wu
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yukun Zhang
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Cao Yang
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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