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学科主题: 临床医学
题名:
Double pedicle screw instrumentation in the osteoporotic spine - A biomechanical feasibility study
作者: Steffen, Thomas1; Jiang, Liang1; Arlet, Vincent1; Beckman, Lorne1
关键词: biomechanics ; osteoporosis ; pedicle screw ; fixation strength ; surgical technique
刊名: JOURNAL OF SPINAL DISORDERS & TECHNIQUES
发表日期: 2007-08-01
卷: 20, 期:6, 页:430-435
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Clinical Neurology ; Orthopedics
研究领域[WOS]: Neurosciences & Neurology ; Orthopedics
关键词[WOS]: BONE-MINERAL DENSITY ; COMPRESSION FRACTURES ; IN-VITRO ; FIXATION ; HOOK
英文摘要:

Study Design: A biomechanical feasibility test.

Objective: To assess the overall feasibility, safety, and mechanical effectiveness of an intrapedicular double-screw construct in the thoracolumbar spine.

Summary of Background Data: The bony purchase of the pedicle screw fixation is often not strong enough in elderly patients with osteoporosis. Our hypothesis was that the elliptical cross-section of the pedicle would allow the insertion of 2 smaller diameter pedicle screws resulting in a bony purchase superior to the standard single-screw technique.

Methods: Thirty-six double-screw constructs (5 turn diameter AOUSS and 5 mm Schanz screw) and 36 standard single pedicle screws (6 mm diameter AOUSS screw) were placed. Screw pullout, multiaxial flexibility, and axial failure load testing was performed.

Results: Visual inspection, palpation, and radiograph confirmed that there were no pedicle breaches. In the double-screw group, all but 2 constructs had ideal direction. Pullout strength of the double-screw construct was no different than that of the single-screw construct. However, stiffness increased considerably in all testing modes. Axial load to failure, adjusted for bone mineral density, and dimensional variation, also increased. All differences were statistically significant except for axial rotation that was only marginally significant.

Conclusions: The double-screw construct appears feasible and safe in the thoracolumbar spine. In this study, the new technique demonstrates a mechanical advantage over the standard single-screw technique. Further in vitro cadaveric safety studies with better adapted instrumentation are needed before the technique can be widely recommended.

语种: 英语
WOS记录号: WOS:000248691700004
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/50351
Appears in Collections:北京大学第三临床医学院_骨科_期刊论文

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作者单位: 1.Peking Univ, Hosp 3, Dept Orthopaed, Beijing 100871, Peoples R China
2.Univ Virginia, Div Spine Surg, Charlottesville, VA 22903 USA
3.McGill Univ, Div Orthopaed Surg, Orthopaed Res Lab, Montreal, PQ, Canada

Recommended Citation:
Steffen, Thomas,Jiang, Liang,Arlet, Vincent,et al. Double pedicle screw instrumentation in the osteoporotic spine - A biomechanical feasibility study[J]. JOURNAL OF SPINAL DISORDERS & TECHNIQUES,2007,20(6):430-435.
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