Feasibility and biomechanical performance of a novel transdiscal screw system for one level in non-spondylolisthetic lumbar fusion: an in vitro investigation

Aghayev, Kamran; Gonzalez-Blohm, Sabrina A.; Doulgeris, James; Lee, William; Waddell, Jason K.; Vrionis, Frank D.

doi:10.1016/j.spinee.2013.08.033

Cited by 12 publications

(12 citation statements)

References 26 publications

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“…In an in vitro compression investigation, St Clair et al [33] found that loaded with bending motion the screw was easy to pierce from the anterior part of upper vertebra. Another in vitro biomechanical investigation by Aghayev et al [15] reported that TPTD screw system had been proven with immediate stabilisation; however, the data of TPTD screw with the interbody cage were unavailable, which was investigated by our present study. Besides, we also provided detailed information about stress and ROM.…”

Section: Discussionmentioning

confidence: 71%

“…Birkenmaier et al [14] combined this technique with robot-assisted navigation for advantages of minimal invasion. Aghayev et al [15] reported a novel designed transpedicular transdiscal (TPTD) screws combining with transforaminal lumbar body fusion technique for nonspondylolisthesis and found that transdiscal and pedicle screw system had comparable immediate stabilisation in an in vitro biomechanical model, but without data of transdiscal screws–cage model. Wu et al [16] also reported that TPTD screws could be used in nonspondylolisthesis patients percutaneously [17] .…”

Section: Introductionmentioning

confidence: 99%

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Biomechanical properties of novel transpedicular transdiscal screw fixation with interbody arthrodesis technique in lumbar spine: A finite element study

Gao²,

Pan

et al. 2018

Journal of Orthopaedic Translation

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PurposeThe purpose of this study was to investigate finite element biomechanical properties of the novel transpedicular transdiscal (TPTD) screw fixation with interbody arthrodesis technique in lumbar spine.MethodsAn L4–L5 finite element model was established and validated. Then, two fixation models, TPTD screw system and bilateral pedicle screw system (BPSS), were established on the validated L4–L5 finite element model. The inferior surface of the L5 vertebra was set immobilised, and moment of 7.5 Nm was applied on the L4 vertebra to test the range of motion (ROM) and stress at flexion, extension, lateral bending and axial rotation.ResultsThe intact model was validated for prediction accuracy by comparing two previously published studies. Both of TPTD and BPSS fixation models displayed decreased motion at L4–L5. The ROMs of six moments of flexion, extension, left lateral bending, right lateral bending, left axial rotation and right axial rotation in TPTD model were 1.92, 2.12, 1.10, 1.11, 0.90 and 0.87°, respectively; in BPSS model, they were 1.48, 0.42, 0.35, 0.38, 0.74 and 0.75°, respectively. The screws' peak stress of above six moments in TPTD model was 182.58, 272.75, 133.01, 137.36, 155.48 and 150.50 MPa, respectively; and in BPSS model, it was 103.16, 129.74, 120.28, 134.62, 180.84 and 169.76 MPa, respectively.ConclusionBoth BPSS and TPTD can provide stable biomechanical properties for lumbar spine. The decreased ROM of flexion, extension and lateral bending was slightly more in BPSS model than in TPTD model, but TPTD model had similar ROM of axial rotation with BPSS model. The screws' peak stress of TPTD screw focused on the L4–L5 intervertebral space region, and more caution should be put at this site for the fatigue breakage.The translational potential of this articleOur finite element study provides the biomechanical properties of novel TPTD screw fixation, and promotes this novel transpedicular transdiscal screw fixation with interbody arthrodesis technique be used clinically.

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Section: Discussionmentioning

confidence: 71%

Section: Introductionmentioning

confidence: 99%

Biomechanical properties of novel transpedicular transdiscal screw fixation with interbody arthrodesis technique in lumbar spine: A finite element study

Gao²,

Pan

et al. 2018

Journal of Orthopaedic Translation

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“…9 For the last several years our group has been focused on transdiscal fusion constructs. 2 The most challenging part of the transdiscal stabilization is finding the optimal trajectory. We have previously shown the feasibility of transdiscal trajectory in the lumbar spine even in cases without spondylolisthesis.…”

Section: Discussionmentioning

confidence: 99%

Transdiscal mid- and upper thoracic vertebroplasty: first description of 2 exemplary cases

Filis

Aghayev

Schaller

et al. 2016

SPI

Self Cite

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Kyphoplasty and vertebroplasty are established treatment methods to reinforce fractured vertebral bodies. In cases of previous pedicle screw instrumentation, vertebral body cannulation may be challenging. The authors describe, for the first time, an approach through the adjacent inferior vertebra and disc space in the thoracic spine for cement augmentation. A 78-year-old woman underwent posterior fusion with pedicle screws after vertebrectomy and reconstruction with cement and Steinmann pins for a pathological T-7 fracture. Two months later she developed a compression fracture of the vertebral body at the lower part of the construct, and a vertebroplasty was performed. Because a standard transpedicular route was not available, an inferior transdiscal trajectory was used for the cement injection. A 73-year-old man with a history of rheumatoid arthritis underwent cervicothoracic fusion posteriorly for subluxation. He developed pain in the upper thoracic area, and the authors performed a transdiscal vertebroplasty at T-2. The standard transpedicular route was not possible. The vertebral body was satisfactorily filled up with cement. Clinically both patients benefited significantly in terms of back pain and showed an uneventful follow-up of 3 months. Transdiscal vertebroplasty can achieve good results in the mid- and upper thoracic spine when a standard transpedicular trajectory is not possible, and can therefore be a good alternative in select cases.

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“…Através dos raios X, foi identificado, de importante, a presença de listese e instabilidade dinâmica. [22][23][24][25][26][27][28] A tomografia teve seu valor na identificação do diâmetro do recesso lateral. 29,30 E a ressonância, na classificação da doença foraminal 31 e no sinal de sedimentação, [32][33][34][35][36] entre outros parâmetros.…”

Section: Cenário Radiológicounclassified

Uso da inteligência artificial como armamento no diagnóstico e condução clínica da estenose de canal lombar

Oppermann

Brasil

2015

Arq Bras Neurocir

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Resumo A estenose do canal vertebral lombar (ECL) ? uma patologia complexa, com alta incid?ncia entre pessoas acima de 65 anos de idade. No entanto, o diagn?stico correto ?, por vezes, dif?cil de ser confirmado. O uso de modelos de Intelig?ncia Artificial (IA) na medicina ?, em geral, desconhecida para a maioria da comunidade m?dica, mas tem sido usada h? d?cadas na assist?ncia em UTI, os m?todos de imagem e dispositivos de diagn?stico eletr?nico (ECG). Atrav?s de uma revis?o sistem?tica da literatura, com foco nos achados cl?nicos e radiol?gicos, juntamente com todas as modalidades de tratamento, foi poss?vel identificar o ambiente completo de pacientes LSS, para responder a quatro quest?es: (a) ?Com base no quadro cl?nico, o paciente tem um, cen?rio moderado ou grave??; (b) ?Com base nos dados radiol?gicos, o paciente pode ser classificado com um cen?rio leve, moderada ou grave??; (c) ?Qual ? a probabilidade, com base na anamnese, do paciente ter ECL??; (d) ?Qual ? o melhor tratamento a ser oferecido??.+Com o aux?lio de um software usando Sistema Especialista (Expert Sinta), uma linguagem de IA, alocamos todas as vari?veis e seus valores para orientar o software responder ?s quatro perguntas. Foi poss?vel identificar 657 artigos cient?ficos, no entanto apenas 63 poderia mencionar n?o apenas as vari?veis, mas a sua probabilidade de ocorr?ncia ou teve disponibilidade texto completo. Foi poss?vel classificar a intensidade do quadro cl?nico e radiol?gico, criar um ?ndice de probabilidade para LSS e oferecer o melhor tratamento. Recomendamos o uso, sob supervis?o m?dica, em de Neurocirurgia ou cl?nicas ortop?dicas como um conselheiro para os pacientes com ELA.

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Feasibility and biomechanical performance of a novel transdiscal screw system for one level in non-spondylolisthetic lumbar fusion: an in vitro investigation

Cited by 12 publications

References 26 publications

Biomechanical properties of novel transpedicular transdiscal screw fixation with interbody arthrodesis technique in lumbar spine: A finite element study

Biomechanical properties of novel transpedicular transdiscal screw fixation with interbody arthrodesis technique in lumbar spine: A finite element study

Transdiscal mid- and upper thoracic vertebroplasty: first description of 2 exemplary cases

Uso da inteligência artificial como armamento no diagnóstico e condução clínica da estenose de canal lombar

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