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Qian L, Jiang C, Sun P, Xu D, Wang Y, Fu M, Zhong S, Ouyang J. A comparison of the biomechanical stability of pedicle-lengthening screws and traditional pedicle screws: an in vitro instant and fatigue-resistant pull-out test. Bone Joint J 2018; 100-B:516-521. [PMID: 29629595 DOI: 10.1302/0301-620x.100b4.bjj-2017-0877.r1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Aims The aim of this study was to compare the peak pull-out force (PPF) of pedicle-lengthening screws (PLS) and traditional pedicle screws (TPS) using instant and cyclic fatigue testing. Materials and Methods A total of 60 lumbar vertebrae were divided into six groups: PLS submitted to instant pull-out and fatigue-resistance testing (groups A1 and A2, respectively), TPS submitted to instant pull-out and fatigue-resistance testing (groups B1 and B2, respectively) and PLS augmented with 2 ml polymethylmethacrylate, submitted to instant pull-out and fatigue-resistance testing (groups C1 and C2, respectively). The PPF and normalized PPF (PPFn) for bone mineral density (BMD) were compared within and between all groups. Results In all groups, BMD was significantly correlated with PPF (r = 0.83, p < 0.001). The PPFn in A1 was significantly less than in B1 (p = 0.006) and C1 (p = 0.002). The PPFn of A2 was significantly less than in B2 (p < 0.001) and C2 (p < 0.001). The PPFn in A1, B1, and C1 was significantly greater than in A2 (p = 0.002), B2 (p = 0.027), and C2 (p = 0.003). There were no significant differences in PPFn between B1 and C1, or between B2 and C2. Conclusion Pedicle lengthening screws with cement augmentation can provide the same fixation stability as traditional pedicle screws and may be a viable clinical option. Cite this article: Bone Joint J 2018;100-B:516-21.
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Affiliation(s)
- L Qian
- Department of Anatomy, Southern Medical University, Guangdong Provincial Key Laboratory of Medical Biomechanics, Shenzhen Digital Orthopedic Engineering Laboratory, Guangdong, 510515, China
| | - C Jiang
- Department of Anatomy, Southern Medical University, Guangdong Provincial Key Laboratory of Medical Biomechanics, Shenzhen Digital Orthopedic Engineering Laboratory, Guangdong, 510515, China
| | - P Sun
- Department of Anatomy, Southern Medical University, Guangdong Provincial Key Laboratory of Medical Biomechanics, Shenzhen Digital Orthopedic Engineering Laboratory, Guangdong, 510515, China
| | - D Xu
- Department of Orthopedics, Nanfang Hospital, Southern Medical University
| | - Y Wang
- Department of Anatomy, Southern Medical University, Guangdong Provincial Key Laboratory of Medical Biomechanics, Shenzhen Digital Orthopedic Engineering Laboratory, Guangdong, 510515, China
| | - M Fu
- Department of Anatomy, Southern Medical University, Guangdong Provincial Key Laboratory of Medical Biomechanics, Shenzhen Digital Orthopedic Engineering Laboratory, Guangdong, 510515, China
| | - S Zhong
- Department of Anatomy, Southern Medical University, Guangdong Provincial Key Laboratory of Medical Biomechanics, Shenzhen Digital Orthopedic Engineering Laboratory, Guangdong, 510515, China
| | - J Ouyang
- Department of Anatomy, Southern Medical University, Guangdong Provincial Key Laboratory of Medical Biomechanics, Shenzhen Digital Orthopedic Engineering Laboratory, Satai Road, Guangzhou, P.R.C, China, Guangzhou, China
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Gao M, Zou J, Zhang Z, Luo Z, Yang H. Evaluation of the influence of pedicle-lengthening osteotomy on lumbar stability. Am J Transl Res 2016; 8:2070-2078. [PMID: 27347315 PMCID: PMC4891420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2016] [Accepted: 05/09/2016] [Indexed: 06/06/2023]
Abstract
Pedicle-lengthening osteotomy (PLO) is a minimally invasive and effective surgical procedure for lumbar spinal stenosis syndrome. Compared with traditional surgery, PLO can effectively enlarge the spinal canal while minimizing the disruption of posterior anatomical structures of the lumbar vertebra, leading to reduced postoperative perineural scarring adhesion and good clinical outcomes using minimally invasive procedures. However, PLO is still in its early stages, and only a few relevant experimental and clinical studies have been reported. The present study was performed to investigate the influence of PLO on the stability of lumbar vertebrae. The results indicated that PLO can effectively enlarge the spinal canal, and no lumbar spondylolisthesis or other complications occurred in this study. Moreover, this procedure does not significantly affect the stability of the lumbar spine, suggesting a possible clinical application.
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Affiliation(s)
- Maofeng Gao
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University 188 Shizi St., Suzhou, China
| | - Jun Zou
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University 188 Shizi St., Suzhou, China
| | - Zhigang Zhang
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University 188 Shizi St., Suzhou, China
| | - Zongping Luo
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University 188 Shizi St., Suzhou, China
| | - Huilin Yang
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University 188 Shizi St., Suzhou, China
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