Comparison of surgical strategies and corrective efficacy score for AS kyphotic correction

Thoracolumbar kyphosis in ankylosing spondylitis poses multiple hazards to patients. To optimize the surgical correction of internal fixation, the biomechanical characteristics and corrective efficacy of different strategies for surgical correction of kyphosis were analyzed based on finite element analysis. The outcome revealed that there were significant deformational displacement differences and stress differences between the different orthopedic internal fixation schemes. Cortical bone track screw fixation significantly reduced the deformation displacement in flexion-extension and lateral flexion conditions. Among the proximal stresses, the cortical bone track screws had the highest stresses in the rotational condition, which could reach 446.661 MPa and 398.16 MPa. They were more resistant to pullout as the traditional all-pedicle screws. Different internal fixation protocols produced different orthopedic clinical outcomes. Patients in the experimental group of conventional all-pedicle screws versus cortical trajectory screw fixation had better Cobb angle, Oswestry incapacity index, sagittal equilibrium distance, and Scoliosis Research Society-22 patient questionnaire scores. This study may provide optimized recommendations for the development of surgical corrective internal fixation protocols and guide the development of surgical strategies, which in turn may promote patient recovery and reduce complications.