Rotational Stability of a Spinal Pedicle Screw/Rod System

Pintar, Frank A.; Maiman, Dennis J.; Yoganandan, N; Droese, Karl; Hollowell, James P.; Woodard, Eric J.

doi:10.1097/00002517-199502000-00007

Cited by 28 publications

(23 citation statements)

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“…Further evidence of this change in load path was the significant reduction in response hysteresis of the torsional gauge located on the screw, and the increase in the symmetry of the response due to the reduction in the effect of spatial coupling between the screws and rods. The present results may explain the reported efficacy of such fixator elements in increasing the overall torsional stiffness (Pintar et al, 1985;Alkalay et al, 1999).…”

Section: Article In Presssupporting

confidence: 69%

A biomechanical analysis of an instrumented spinal fixator under torsional loads

Alkalay

Sharpe

Bader

2005

Journal of Biomechanics

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Section: Article In Presssupporting

confidence: 69%

A biomechanical analysis of an instrumented spinal fixator under torsional loads

Alkalay

Sharpe

Bader

2005

Journal of Biomechanics

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“…The rods were then secured to the screws with eyebolts and to each other with crosslinks to enhance rotational stability. [4,36,43,46,56] The transverse processes, other dorsal bone surfaces, and facet joints were decorticated with the drill. The bone graft, which had been obtained from the iliac crest, was combined with all bone obtained during the decompressive procedure and placed over the decorticated surfaces.…”

Section: Surgical Techniquementioning

confidence: 99%

“…[15,16,28,33,40] In such cases, laminar, transverse process, or pedicle hooks are used and attached to the pedicle screws in the lumbosacral spine. [4,13,28,31,43,46,56] Patients with spondylolisthesis were treated with decompression and fusion in situ. [8,47] Reduction of the spondylolisthesis was not necessary, as other authors have also reported.…”

Section: Patient Outcomesmentioning

confidence: 99%

“…[25,30,44,51,56,58] Nonetheless, an increasing number of spine surgeons are using this type of spinal fixation to treat a wide variety of conditions affecting the lumbar spine. Many articles have shown the superiority of pedicle screw fixation over other systems based on biomechanical properties, [2,13,17,20,29,31,34,36,39,43,46,59,61] involvement of fewer motion segments, [31,50] high rate of osseous union, [3,20,47,51,52,55,56] and versatility. [3,14,20,24,51,52,56,57,60] Other reports have stressed the importance of accurate knowledge of the vertebral anatomy and the relationships between the pedicle and surrounding neural structures, indicating the risks associated with this type of instrumentation.…”

mentioning

confidence: 99%

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Efficacy of pedicle screw fixation in the treatment of spinal instability and failed back surgery: a 5-year review

R¹,

Gómez²,

Karahalios³

et al. 1998

FOC

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Object The goal of this study was to review retrospectively the outcome of 95 patients with various disorders leading to instability of the thoracolumbar and lumbar spine who were treated consecutively via a posterior surgical approach with pedicle screw fixation in which the Texas Scottish Rite Hospital system was used. Methods All cases were managed according to the same protocol. Follow-up review averaged 29.6 months. Radiographic evidence of osseous union and the patient's current status were analyzed. Four screws were malpositioned, and there were two dural lacerations of a nerve root and one pedicle fracture. Deep wound infections developed in five patients (5.2%) and three patients had postoperative radicular pain. In one case, the rods disengaged from the screws; in four cases, hardware was removed but there were no broken screws. Neurological deficits improved in 85% of the patients and no patient was worse neurologically after surgery. The rate of osseous union was 96.8%. Three patients developed pseudarthrosis, one of whom was asymptomatic. Back pain improved in 80 patients (85%). A solid bone fusion, however, was not necessarily associated with decreased back pain. Conclusions These results support the use of pedicle screw fixation as an effective and safe procedure for fusion of the thoracolumbar and lumbar spine and support the finding that complications can be minimal when a meticulous surgical technique is used. The proper selection of patients for surgery is probably the most important factor associated with good outcomes.

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“…[32][33][34][35] Cross-links have also been shown to increase resistance of pedicle screw constructs to pullout failure; however, this effect was substantially diminished in osteoporotic spines. 36 Furthermore, the association between pseudarthrosis and cross-link use in adult patients undergoing primary correction of idiopathic scoliosis may negate the added construct rigidity that their use confers.…”

Section: Cross-linksmentioning

confidence: 99%

Surgical Management of Spinal Conditions in the Elderly Osteoporotic Spine

2015

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Osteoporosis, the most common form of metabolic bone disease, leads to alterations in bone structure and density that have been shown to compromise the strength of spinal instrumentation. In addition, osteoporosis may contribute to high rates of fracture and instrumentation failure after long posterior spinal fusions, resulting in proximal junctional kyphosis and recurrent spinal deformity. As increasing numbers of elderly patients present for surgical intervention for degenerative and traumatic spinal pathologies, current and future generations of spine surgeons will increasingly be faced with the challenge of obtaining adequate fixation in osteoporotic bone. The purpose of this review is to familiarize the reader with the impact of osteoporosis on spinal instrumentation, the broad variety of techniques that have been developed for addressing these issues, and the biomechanical and clinical evidence in support of the use of these techniques.

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Rotational Stability of a Spinal Pedicle Screw/Rod System

Cited by 28 publications

References 0 publications

A biomechanical analysis of an instrumented spinal fixator under torsional loads

A biomechanical analysis of an instrumented spinal fixator under torsional loads

Efficacy of pedicle screw fixation in the treatment of spinal instability and failed back surgery: a 5-year review

Surgical Management of Spinal Conditions in the Elderly Osteoporotic Spine

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