Straight-Forward versus Bicortical Fixation Penetrating Endplate in Lumbosacral Fixation-A Biomechanical Study

Karakasli, Ahmet; Acar, Nihat; Uzun, Bora

Straight-Forward versus Bicortical Fixation Penetrating Endplate in Lumbosacral Fixation-A Biomechanical Study

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Type: Academic journal

Author: Karakasli, Ahmet (Department of Orthopaedics and Traumatology, Dokuz Eylul University, Faculty of Medicine) Acar, Nihat (Department of Orthopaedics and Traumatology, Catalca Ilyas Cokay Hospital) Uzun, Bora (Department of Biomechanics, Dokuz Eylul University, Health Science Institute)

Journal: 대한신경외과학회 대한신경외과학회지 대한신경외과학회지 제61권 제2호 SCOPUS

Published: 2018.1

Pages: 180 - 185 (6page)

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Straight-Forward versus Bicortical Fixation Penetrating Endplate in Lumbosacral Fixation-A Biomechanical Study

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Objective : Many lumbosacral fixation techniques have been described to offer a more screw-bone purchase. The forward anatomical fixation parallel to the endplate is still the most preferred method. Literature revealed little knowledge regarding the mechanical stability of lumbosacral trans-endplate fixation compared to the traditional trans-pedicular screw fixation method. The aim of this study is to assess the pull-out strength of lumbosacral screws penetrating the end plate and comparing it to the conventional trans-pedicular screw insertion method. Methods : Eight lumbar and eight sacral vertebrae, with average age 69.4 years, Left pedicles of the 5th lumbar vertebrae were used for trans-endplate screw fixation, group 1A, right pedicles were used for anatomical trans-pedicular screw fixation, group 1B. In the sacral vertebrae, the right side S1 pedicles were used for trans-endplate fixation, group 2A, left side pedicles were used for anatomical trans-pedicular screw fixation, group 2B. The biomechanical tests were performed using the axial compression testing machine. All tests were applied using 2 mm/min traction speed. Results : The average pull-out strength values of groups 1A and 1B were $403.78{\pm}11.71N$ and $306.26{\pm}17.55N$, respectively. A statistical significance was detected with p=0.012. The average pull-out strength values of groups 2A and 2B were $388.73{\pm}17.03N$ and $299.84{\pm}17.52N$, respectively. A statistical significance was detected with p=0.012. Conclusion : The trans-endplate lumbosacral fixation method is a trustable fixation method with a stronger screw-bone purchase and offer a good alternative for surgeons specially in patients with osteoporosis.

#Endplate #Pedicular screw #Biomechanical study

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Nihat Acar / 2016 / The Mechanical Effect of Rod Contouring on Rod-Screw System Strength in Spine Fixation / 대한신경외과학회지 59(5):425~429

Alkaly RN / 2016 / The effect of transpedicular screw design on its performance in vertebral bone under tensile loads: a parametric study / Clin Spine Surg 29:433~440

Balderston RA / 1986 / Fusion to the sacrum for nonparalytic scoliosis in the adult / Spine (Phila Pa 1976) 11:824~829

Carlson GD / 1992 / Screw fixation in the human sacrum. An in vitro study of the biomechanics of fixation / Spine (Phila Pa 1976) 17(6 Suppl):S196~S203

Cook SD / 2004 / Biomechanical study of pedicle screw fixation in severely osteoporotic bone / Spine J 4:402~408

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Karakasli, Ahmet

Affiliation Department of Orthopaedics and Traumatology, Dokuz Eylul University, Faculty of Medicine

Fields Medicine and Pharmacy > Clinical Medicine > Neurosurgery

Articles 2 Usage 0

Acar, Nihat

Affiliation Department of Orthopaedics and Traumatology, Catalca Ilyas Cokay Hospital

Fields Medicine and Pharmacy > Clinical Medicine > Neurosurgery

Articles 2 Usage 0

Uzun, Bora

Affiliation Department of Biomechanics, Dokuz Eylul University, Health Science Institute

Fields Medicine and Pharmacy > Clinical Medicine > Neurosurgery

Articles 1 Usage 0

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