Biomechanical evaluation on the stability of anterior cervical pedicle screw fixation for osteoporosis

doi:10.3969/j.issn.2095-4344.2015.35.026

Abstract

Abstract:

BACKGROUND: Anterior cervical discectomy and bone graft fusion are effective method to treat cervical spondylosis. This method can provide firm fixation and the fusion rate is high. However, for cervical vertebra involved in more than two segments, the stability of fixator and bone graft is poor due to big bone graft span, which may easily cause fusion failure and pseudarthrosis, and impact curative effects.
OBJECTIVE: To investigate biomechanical stability of anterior cervical pedicle screw implantation for osteoporosis in the vertebra.
METHODS: A total of 12 human cervical vertebrae were collected, including 6 vertebrae with normal bone density and 6 vertebrae with osteoporosis. Data of 60 vertebra specimens were analyzed. 30 osteoporotic specimens
implanted in anterior cervical pedicle screw were set as anterior cervical pedicle screw group. 30 normal specimens implanted in anterior cervical pedicle screw were set as anterior vertebral screw group. According to bone density, 40 vertebrae were collected in above two groups, and were considered as normal bone mineral density group, instant osteoporosis group, fatigue normal bone mineral density group, and fatigue osteoporosis group (n=10). Bone mineral density of each vertebra was detected using dual-energy X-ray absorptiometry. Biomechanical index of two kinds of screws was detected using ElectroForce 3510 material testing machine.
RESULTS AND CONCLUSION: Bone mineral content, vertebral screw pull-out strength, vertebral screw pull-out stiffness, pedicle screw pull-out strength, and pedicle screw pull-out stiffness were significantly higher in the anterior cervical pedicle screw group than in the anterior vertebral screw group (P < 0.05). The maximum axial pull-out strength of normal bone mineral density group, instant osteoporosis group, fatigue normal bone mineral density group, and fatigue osteoporosis group was significantly higher than in the anterior vertebral screw group (P < 0.05). The results confirmed that osteoporotic vertebral biomechanical performance is more stable in anterior pedicle screws compared with the anterior vertebral screw.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Tissue Engineering, Intervertebral Disk, Cervical Spondylosis, Biomechanics

CLC Number:

R318

Li Zhen-wei, Xiang Yang-ming. Biomechanical evaluation on the stability of anterior cervical pedicle screw fixation for osteoporosis[J]. Chinese Journal of Tissue Engineering Research, 2015, 19(35): 5718-5722.

Figures/Tables 3

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