In-vitro Comparison of the Pullout Strength of 3 Different Thoracic Screw Fixation Techniques

Abstract

In-vitro pullout resistance of thoracic screw fixation does not differ significantly in intrapedicular and extrapedicular insertion techniques.

Redirecting pedicle screws: a revision spinal fusion strategy using three‐dimensional image guidance

“…Furderer et al . described an alternative insertion method in the thoracic spine, namely the ‘in‐out‐in’ technique, involving a more lateral insertion point with an oblique trajectory, allowing a more lateral insertion because of the sharper angulation, but risking the screw being directed toward the spinal canal . Rosner et al .…”

“…Rosner et al . compared this technique with standard insertion techniques and found that there is relatively good fixation strength associated with the pedicle‐rib technique compared with standard thoracic screw fixation . We used the in‐out‐in technique for five screw placements in cases with narrow pedicles.…”

“…Various intraoperative modalities are currently used as adjuncts to the free-hand technique; these include (13,14,20). We used the in-out-in technique for five screw placements in cases with narrow pedicles.…”

“…All patients underwent a postoperative CT scan, which also allowed for grading of the redirected pedicle screws by an independent radiologist using the system described by Mirza et al . (Figure (A)–(D)) .…”

“…Redirection of new screws down a different trajectory was accomplished with image-guided probes, taps, and screwdrivers ( Figure 1(A)-(B)). All patients underwent a postoperative CT scan, which also allowed for grading of the redirected pedicle screws by an independent radiologist using the system described by Mirza et al (Figure 2(A)-(D)) (13).…”