The Effect of Lateral Wall Perforation on Screw Pull-out Strength: a Cadaveric Study

Overview

Journal J Orthop Surg Res

Publisher Biomed Central

Specialty Orthopedics

Date 2015 Jan 25

PMID 25616775

Citations 9

Authors

Nan Li

Da He

Yonggang Xing

Yanwei Lv

Wei Tian

Affiliations

Soon will be listed here.

Abstract

Background: Lateral pedicle wall perforations occur frequently during pedicle screw insertion. Although it is known that such an occurrence decreases the screw pull-out strength, the effect has not been quantified biomechanically.

Materials And Methods: Twenty fresh cadaveric lumbar vertebrae were harvested, and the bone mineral density (BMD) of each was evaluated with dual-energy radiography absorptiometry (DEXA). Twenty matched, 6.5-mm pedicle screws were inserted in two different manners in two groups, the control group and the experimental group. In the control group, the pedicle screw was inserted in a standard fashion taking adequate precaution to ensure there was no perforation of the wall. In the experimental group, the pedicle screw was inserted such that its trajectory perforated the lateral wall. Group assignments were done randomly, and the maximal fixation strength was recorded for each screw pull-out test with a material-testing system (MTS 858 II).

Results: The average BMD for both groups was 0.850 g/cm(2) (0.788-0.912 g/cm(2)). The average (and standard deviation) maximal pull-out forces were 1,015.8 ± 249.40 N for the experimental group and 1,326.0 ± 320.50 N for the control group. According to a paired t-test, the difference between the two groups was statistically significant (P < 0.001).

Conclusion: The results of this study confirm that the maximal pull-out strength of pedicle screws decreases by approximately 23.4% when the lateral wall is perforated.

Citing Articles

Pedicle Screw Pull-Out Strength Between the Jamshidi Needle and Pedicle Probe Techniques in an Osteoporotic Cancellous Bone Model: A Biomechanical Study.

Tharmaseelan S, Harun M, Mohamed Ramlee F, Abdullah M Cureus. 2024; 16(11):e74747.

PMID: 39735057 PMC: 11682839. DOI: 10.7759/cureus.74747.

A novel personalized homogenous finite element model to predict the pull-out strength of cancellous bone screws.

Rouyin A, Einafshar M, Arjmand N J Orthop Surg Res. 2024; 19(1):732.

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Design, fabrication, and evaluation of single- and multi-level 3D-printed non-covering cervical spinal fusion surgery templates.

Safahieh A, Nazemi H, Arjmand N, Azimi P, Khalaf K Front Bioeng Biotechnol. 2024; 12:1416872.

PMID: 39070162 PMC: 11272535. DOI: 10.3389/fbioe.2024.1416872.

Assessment of the tolerance angle for pedicle screw insertion.

Leblond L, Godio-Raboutet Y, Glard Y, La Greca R, Clement T, Evin M Med Biol Eng Comput. 2024; 62(4):1265-1275.

PMID: 38177833 DOI: 10.1007/s11517-023-03002-x.

Risk Factors for Clinically Relevant Loosening of Percutaneous Pedicle Screws.

Ohba T, Ebata S, Oba H, Koyama K, Haro H Spine Surg Relat Res. 2019; 3(1):79-85.

PMID: 31435556 PMC: 6690121. DOI: 10.22603/ssrr.2018-0018.

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