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- W3008985787 abstract "Background Screw loosening is a major complication following spondylodesis. While several modifications increase screw stability, some, such as screw augmentation, are associated with potential complications; new techniques are needed to minimize the risk of screw loosening without increasing complication rates. Methods 13 fresh-frozen human lumbar vertebral bodies (L1 to L5) were dissected. In group 1 (n = 7), pedicle screws were implanted conventionally, while in group 2 (n = 6), the screws were positioned divergent in the sagittal pathway. Screw stability was tested under cyclic axial load; one testing-cycle included 1000 repetitions. The first cycle started with a load of 100 N while the load was increased by +20 N in each following cycle until failure. Failure was defined by either a >5 mm movement of the screw heads or triggering of the switch-off threshold. Findings Average number of cycles until failure was increased in group 2 compared with group 1 (12,046 vs 9761 cycles), as was the average load to failure (Fmax 313 N vs 260 N). Overall, in group 2, the number of cycles until screw loosening or failure increased by 23% (p = 0.28), while the required force increased by 20% (p = 0.3). Statistically significant correlation between BMD and increased number of cycles completed as well as with increased load (p < 0.01) could be observed. Interpretation The results demonstrate, that divergent screw-drift of pairs of screws in the sagittal plane tends to increase stability, especially in vertebral bodies with lower bone density. Moreover, we could demonstrate a correlation between BMD and stability of screw-fixation." @default.
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- W3008985787 date "2020-04-01" @default.
- W3008985787 modified "2023-10-16" @default.
- W3008985787 title "Impact of lumbar pedicle screw positioning on screw stability - A biomechanical investigation" @default.
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- W3008985787 doi "https://doi.org/10.1016/j.clinbiomech.2020.02.013" @default.
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