The Selection of Wires for Sublaminar Fixation

A study of the mechanical stability of scoliosis constructs using variable numbers of sublaminar wires

“…In long fusion constructs, the wires at the proximal end are subjected to the highest loads, and are therefore the most likely sites for failure on repetitive loading [2]. This was demonstrated in our study by the fact that in all samples of construct B, the most proximal wire failed consistently on fatigue loading to 1.80 (±0.12) million cycles.…”

“…A handheld, Robinson Jet twister was used for application of symmetrical primary twist to the sublaminar wires. Fixation was further reinforced with the secondary twist [2].…”

Acute atlanto-axial post-operative subluxation following posterior C1/2 fusion

“…Recently the use of cables, initially stainless steel and more recently braided titanium (which has better imaging characteristics), has largely superseded wire for these fusions, although the principles remain the same. [67][68][69][70][71][72] Waddell and Reardon, in 1983, reported solid fusion in 15 of 16 cases of type II odontoid fracture treated with Gallie fusion and post-operative collar orthosis. 19 However Farey et al have reported failure of Gallie fusion in 42% of 27 cases in 1999.…”

Effect of Decortication on Laminar Strength During Sublaminar Wiring

“…Decortication is usually performed before the tightening of the wires to facilitate adequate cortical bone removal from the lamina, lest the hindering by rods and wires results in diminished decortication. Removal of cortical bone from the posterior aspect of a lamina during the decortication procedure may by itself lead to a laminar fracture, or it can result in such a fracture during sublaminar wiring by decreasing the strength of the lamina.There are many biomechanical studies about various aspects of sublaminar wiring, [8][9][10][11][12] and the only study that addresses the effect of decortication is that of Crawford et al, 13 which is actually about the mechanical properties of materials used for sublaminar fixation; but no study, to our knowledge, has been performed exclusively on the effect of decortication on laminar strength. The aim of this study was to investigate the effect of laminar decortication on the strength of the lamina during sublaminar wiring procedure in an ex vivo experimental sheep model.…”

“…There are many biomechanical studies about various aspects of sublaminar wiring, [8][9][10][11][12] and the only study that addresses the effect of decortication is that of Crawford et al, 13 which is actually about the mechanical properties of materials used for sublaminar fixation; but no study, to our knowledge, has been performed exclusively on the effect of decortication on laminar strength. The aim of this study was to investigate the effect of laminar decortication on the strength of the lamina during sublaminar wiring procedure in an ex vivo experimental sheep model.…”