Effect of different angles of implanted screws on the stability of pedicle screw

doi:10.3969/j.issn.2095-4344.2015.48.010

Abstract

Abstract:

BACKGROUND: Some studies have showed that the accuracy and surgery outcome of the percutaneous pedicle screw implantation was superior to open surgery, but the relationship between the angle of pedicle screws and screw stability is still unclear in previous studies.
OBJECTIVE: To investigate the effect of different angles of implanted screws on the stability of pedicle screw.
METHODS: A total of 30 vertebral specimens of adult pigs were selected and screws were implanted respectively according to different coronal and sagittal angles. The maximum pull-out strength of screws from each specimen was tested by machine. Load-displacement curves were drew and statistically analyzed.
RESULTS AND CONCLUSION: The maximum pull-out strength and maximum energy of screw with 10° and 15° coronal and sagittal angles implantation were significantly better than those of 0° angle group (P < 0.05). When the stress exceeded the maximum pull-out strength, the pull-out strength of screw decreased gradually. The curves in coronal and sagittal 10° and 15° angle groups was similar, and the slope was better than 0° angle group (P < 0.05). These results confirm that the angle of the implanted screw provides effective assistance to the stability of percutaneous pedicle screw. After the looseness of the screws, the pullout strength shows a steady downward trend.

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

CLC Number:

R318

Pang Zhong-hui, Liu Miao, Zhang Ya-bin, Yao Yong-feng, Pei Shao-kun. Effect of different angles of implanted screws on the stability of pedicle screw[J]. Chinese Journal of Tissue Engineering Research, 2015, 19(48): 7765-7769.

Figures/Tables 2

References

[1] 王旭,李永民,谷守山.椎弓根钉置入内固定治疗胸腰椎骨折的应用进展[J].中国组织工程研究与临床康复,2010,(22): 4109-4112.

[2] 胡海刚,谭伦,林旭,等.经伤椎椎弓根植骨置钉后路复位内固定术治疗胸腰椎骨折[J].中国脊柱脊髓杂志,2011,(8):663-668.

[3] Vu TT, Morishita Y, Yugue I, et al. Radiological Outcome of Short Segment Posterior Instrumentation and Fusion for Thoracolumbar Burst Fractures. Asian Spine J. 2015;9(3): 427-432.

[4] Ökten A?, Gezercan Y, Özsoy KM, et al. Results of treatment of unstable thoracolumbar burst fractures using pedicle instrumentation with and without fracture-level screws. Acta Neurochirurgica. 2015;157(5):831-836.

[5] Robinson PJ, Phelan PD. Rendu-Osler-Weber syndrome in a 9 year old girl presenting with repeated haemoptysis. Aust Paediatr J. 1989;25(4):248-249.

[6] Charles YP, Pelletier H, Hydier P, et al. Pullout characteristics of percutaneous pedicle screws with different cement augmentation methods in elderly spines: an in vitro biomechanical study. Orthop Traumatol Surg Res. 2015; 101(3): 369-374.

[7] Proietti L, Scaramuzzo L, Schirò GR, et al. Degenerative facet joint changes in lumbar percutaneous pedicle screw fixation without fusion. Orthop Traumatol Surg Res. 2015;101(3): 375-379.

[8] Reynolds GJ. Stabilization and fixation of percutaneous central venous catheters. Aust Paediatr J. 1989;25(4): 250-251.

[9] 蔡斌.经皮椎弓根螺钉置入准确性的CT评价及临床疗效[D].苏州:苏州大学,2014.

[10] 聂锋锋,张英华,黄寿国,等.经皮微创椎弓根螺钉内固定与开放手术治疗胸腰椎骨折:Cobb’s角与椎体前缘高度恢复的比较[J].中国组织工程研究,2014,18(44):7094-7099.

[11] 杨博.肾形n-HA/PA66腰椎间融合器在猪腰椎TLIF手术的体外生物力学研究[D].重庆:重庆医科大学,2014.

[12] 寿建国,应大君,曾养志.猪-人异种椎间盘移植在生化和解剖中的可行性初步研究[J].颈腰痛杂志,2004,25(3):170-173.

[13] 寿建国,应大君,曾养志.猪腰椎-人颈椎异种椎间盘移植在组织结构和生物力学中的可行性初步研究[J].颈腰痛杂志,2004, 25(6):375-378.

[14] 付鑫,谭杰,宋纯理,等.椎体内单次注射辛伐他汀对骨质疏松小型猪腰椎椎体骨质和椎弓根螺钉内固定稳定性的影响[J].中国脊柱脊髓杂志,2015,25(5):448-455.

[15] 廖红荔.腰椎间关节MRI多序列成像实验性研究[D].长沙:中南大学,2009.

[16] 刘珺,王维,童琼娟,等.双能X线骨密度仪(DXA)与定量CT(QCT)测量骨密度的比较研究[J].临床放射学杂志,2007,21(5): 504-507.

[17] 李朦.骨质疏松相关激素与骨密度相关性研究[D].重庆:重庆医科大学,2013.

[18] 黄何平.骨密度的影响因素分析[J].中国临床康复,2006,10(40): 124-126.

[19] 刘振.经皮脊柱外固定器螺钉不同角度拔出的生物力学研究[D].衡阳:南华大学,2012.

[20] 段洪斌.不同水平角度置入椎弓根螺钉的拔钉生物力学研究[D].长春:吉林大学,2005.

[21] 付少锋.胸椎椎弓根和椎弓根-助骨复合体的应用解剖及相关内固定技术的生物力学研究与临床评价[D].重庆:重庆医科大学, 2014.

[22] 史可强,雷云霞,王海奎,等.不同矢状角度置入椎弓根螺钉的拔钉生物力学研究[J].中国骨与关节损伤杂志,2009,24(4):311-313.

[23] 张文志,尚希福,段丽群,等.微创经皮与传统开放椎弓根螺钉内固定治疗胸腰椎骨折的临床对比研究[J].中国骨与关节外科,2012, 5(2):109-114.

[24] 段丽群,张文志,尚希福,等.微创经皮椎弓根螺钉内固定术治疗胸腰椎骨折的临床疗效分析[J].颈腰痛杂志,2012,33(5):336-339.

[25] 夏天,董双海,王雷,等.胸腰椎经皮椎弓根螺钉置钉的准确性分析[J].中国脊柱脊髓杂志,2013,23(9):794-797.

[26] 唐康,张文志,段丽群,等.微创经皮椎弓根螺钉联合伤椎置钉治疗胸腰段脊椎骨折[J].临床骨科杂志,2014,17(3):253-257.

[27] 刘达.骨质疏松条件下膨胀式椎弓根螺钉与骨水泥强化螺钉的稳定性和钉道界面的比较研究[D].西安:第四军医大学,2011.

[28] 史定伟,干耀恺,梁栋科,等.生物型空心松质骨螺钉的力学强度研究[J].医用生物力学,2013,28(5):574-579.

[29] 田冲,张美超,欧阳钧.不同骨密度下松质骨螺钉生物力学性能的三维有限元分析[J].南方医科大学学报,2010,30(11): 2466-2471.

[30] Bianco RJ, Aubin CE, Mac-Thiong JM, et al. Pedicle Screw Fixation Under Non-Axial Loads: a Cadaveric Study. Spine (Phila Pa 1976). 2015.

[31] Mayer M, Stephan D, Resch H, et al. BIomechanical comparison of sacral fixation characteristics of standard s1-pedicle screw fixation vs a novel constrained s1-dual-screw anchorage in the s1-pedicle and s1-alar bone. Spine (Phila Pa 1976). 2015.

[32] Shui X, Ying X, Mao C, et al. Percutaneous Screw Fixation of Crescent Fracture-Dislocation of the Sacroiliac Joint. Orthopedics. 2015;38(11):e976-e982.

[33] Hu Y, Dong WX, Kepler CK, et al. A novel anterior odontoid screw plate for c1-c3 internal fixation: an in vitro biomechanical study. Spine (Phila Pa 1976). 2015.

[34] Akpolat YT, ?nceo?lu S, Kinne N, et al. Fatigue performance of cortical bone trajectory screw compared to standard trajectory pedicle screw. Spine (Phila Pa 1976). 2015.

[35] Grechenig S, Gueorguiev B, Berner A, et al. A novel locking screw hip stem to achieve immediate stability in total hip arthroplasty: A biomechanical study. Injury. 2015;46 Suppl 4:S83-S87.

[36] Loibl M, Korsun M, Reiss J, et al. Spinal fracture reduction with a minimal-invasive transpedicular Schanz Screw system: clinical and radiological one-year follow-up. Injury. 2015;46 Suppl 4:S75-S82.

[37] Grechenig S, Gänsslen A, Gueorguiev B, et al. PMMA-augmented SI screw: a biomechanical analysis of stiffness and pull-out force in a matched paired human cadaveric model. Injury. 2015;46 Suppl 4:S125-S128.

[38] Quinn JC, Patel NV, Tyagi R. Hybrid lateral mass screw sublaminar wire construct: a salvage technique for posterior cervical fixation in pediatric spine surgery. J Clin Neurosci. 2015.

[39] Saleh MF, Dhenge RM, Cartwright JJ, et al.Twin screw wet granulation: Effect of process and formulation variables on powder caking during production. Int J Pharm. 2015.