Konik ve silindirik pedikül vidalarının sıyırma dirençleri ve direngenliklerinin karşılaştırmalı biyomekanik analizi
Abstract
Amaç: Transpediküler enstrümantasyonda konik
ve silindirik pedikül vidaları sık kullanılmaktadır. Vidaların mekanik
performansı kemik-vida yüzeyinin biyomekanik özellikleri ve vidanın fiziksel
yapısı ile ilişkilidir. Bu çalışmada, konik ve silindirik pedikül vidalarının
biyomekanik açıdan farklarının olup olmadığının araştırılması amaçlandı. Yöntem: İskelet maturasyonunu
tamamlamış, 400-600 kg ağırlığında 24–32 haftalık danalardan elde edilmiş taze lomber
vertebralar kullanıldı. Toplam 24
vertebranın her iki pedikülüne (48 pedikül) vida yerleştirilerek biyomekanik
testler uygulandı. Vidaların maksimum giriş tork değerleri analog tork metre kullanılarak
kaydedildi. Rijid
tespitin sağlanması için polimetilmetakrilat içeren metal kutuların içerisine
gömülü vertebradaki pedikül vidaları mekanik test makinasına bağlanarak sıyırma
direnci ölçüldü. Bulgular: Konik
vidaların sıyırma dirençlerinin ve direngenliklerinin ilk atım ve tekrarlayan
atımlarda silindirik vidalara göre yüksek olduğu, ancak aradaki farkın
istatistiksel olarak anlamlı olmadığı tespit edildi (p>0.05). Maksimum giriş
tork değeri ise konik vidalarda silindirik vidalara göre istatistiksel olarak
anlamlı düzeyde yüksek idi (p=0.04). Vidaların 180º ve 360°geri çekimli sıyırma
direnci ve direngenlik verileri arasında istatistiksel olarak anlamlı fark
olmadığı tespit edildi (p>0.05). Sonuç:
Konik vidaların silindirik vidalara göre daha dirençli tutunma verilerine
sahip olmalarının yanı sıra, aynı delikten yapılan çoklu vida atımlarında ya da
geri çekilme işlemi sonucunda vidalar arasında sıyrılma verileri açısından
belirgin bir fark izlenmemiş olması, konik vidaların gelecekte daha sık
kullanılacaklarını düşündürmektedir.
References
- 1- Abshire BB, McLain RF, Valdevit A, Kambic HE. Charecteristic of pullout failure in conical and cylindrical screws after full insertion and back-out. Spine J 2001;1(6):408-414.
- 2- Skinner R, Maybee J, Transfeldt E, Venter R, Chalmers W. Experimental pullout testing and comparison of variable in transpedicular screw fixation. Spine 1990;15:195-201.
- 3- Esses SI, Sachs BL, Dryzin V. Complications associated with the technice of pedicle screw fixation. A selected survey of ABS Members. Spine 1993;18(15):2231-2238. 4- Weinstein JN, Spratt KF, Spengler D, Brick C, Reid S. Spinal pedicle fixation: reliability and validity of roentgenogram-based assessment and surgical factors on succesfull screw placement. Spine 1988;13(19):1012-1018.
- 5- Kwok AWL, Finklestein JA, Woodside T, Hearn TC, Hu RW. İnsertional torque and pull-out strengths of conical and clindyrical pedicle screw in cadaveric bone. Spine 1996;21(21):2429-2434.
- 6- Ransom N, La Rocca SH, Thalgott J. The case for pedicle fixation of the lomber spine. Spine 1994;19(23):2702-2706.
- 7- Schwab FJ, Nazarian DG, Mahmut F, Michelsen CB. Effects of spinal esrumantation on fusion of the lumbsacral spine. Spine 1995;20(18):2023-2028.
- 8- Dicman CA, Fesler RG, Macmillan M, Haid RW. Transpedicular screw-rod fixation of the lumber spine:operative technice and outcome in 104 cases. J Neurosurgery 1992;77:860-870.9- McLain R, Sparling E, Benson D. Early failture of the short segment pedicle instrumantation for thoracolumbar fractures: a preliminary report. J Bone Joint Surg 1993;75A:162-167.
- 10- Pfeifer M, Hoffman H, Goel VK, Weinstein JN, Griss P. In vitro testing of a new transpedicular stablization technique. Eur Spine J 1997;6(4):249-255. 11- Davne SH, Myers SL. Complications of lumbar spinl fusion with transpedicular instrumantaton. Spine 1992;17(supp):S184-189.
- 12- McKinley TO, McLain RF Yerby SA, Sarıgül- Klijn N, Smith TS.The effect of pedicle morphometry on pedicle screw loading in unstable burst fractures: a synthetic model. Spine 1997;22(3):246-252.
- 13- Yerby SA, Ehteshami JR, McLain RF. Loading of pedicle screws within the vertebra. J Biomechanics 1997;30(9):951-954.
- 14- Yamagata M, Kitahara H, Minami S, etc and all. Mechanical stability of pedicle screw systems fort the lumbar spine. Spine 1992;17(supp):S51-54.
- 15- Daftari DK, Horton WC, HuttoN WC. Correlations between screw hole preparation, torque of insertion, and pullout strength for spinal screws. J Spinal Disord 1994;7(2):139-145.
- 16- Pfeifer M, Gilbertson LG, Goel VK, et al. Effect of specimen fixation method on pull-out tests of pedicle screws. Spine 1996;21:1037-1044.
- 17- Kılınçer C, İnceoğlu S, Çaylı S, Zileli M, Ferara L. Biomehanical analysis of a Turkis-Made posterior spinal instrumantation system. Turkish Neurosurgery 2005;15(2):58-63.
- 18- İnceoğlu S, Ferrara L, Mclain RF. Pedicle screw fixation strenght: pullout versus insertional torque. Spine J 2004;4:513-518.
- 19- McLain RF, Fry MF, Moseley TA, Sharkey NA. Lumba pedicle screw salvage:pull-out testing of three different pedicle screw designs. J Spinal Disor 1995;8(1):62-68.
- 20- Ashman RB, Galpin RD, Corin JD, Johnston CE. Biomechanical analysis of pedicle screw instrumantation systems in a corpectomy model. Spine 1989;14:1398-1405.
- 21- Zindrick MR, Wiltse LL, Widel EH, Thomas JC, Holland WR, Field BT, Spencer CW. A biomechanical study of intrapedincular screw fixation in the lumbosacral spine. Clin Orthop Relat Res 1986;203:99-112.
- 22- Myers B, Belmont P, Richardson w, Yu J, Harper K, Nightingale R. The role of imaging and in situ biomechanical testing in assessing pedicle screw pullout strenght. Spine 1996;21:1962-1968.
- 23- Soshi S, Shiba R, Kondo H, Murato K. An experimental study on transpedicular screw fixation in relation to osteoporosis of the lumbar spine. Spine 1991;16(11):1335-1341.
- 24- Hirano T, Hasegava K, Takahashi HE, Uchiyama S, Hara T, Washio T, Sugiura T, Yokaichiya M, Ikeda M. Structurel characteristics of the pedicle and its role in screw stabilty. Spine 1997;22:2504-2509.
A comparative biomechanical analysis of pull-out resistance and stiffness of conical and cylindrical pedicle screws
Abstract
Aim:
Conical and cylindrical pedicle screws are frequently used
in transpedicular instrumentation. The mechanical performance of screws is
associated with the biomechanical properties of the bone–screw surface and the
physical structure of the screw. The purpose of this study was to investigate
whether conical and cylindrical pedicle screws differ in their biomechanical
properties. Methods: Fresh lumbar
vertebrae were obtained from 24–32-week-old calves that completed skeletal
maturation and weighed 400–600 kg. Screws were placed on both pedicles (48
pedicles) of total 24 vertebrae, and biomechanical tests were performed. The
maximum input torque values of the screws were recorded using an analog torque
meter. Pull-out resistance was measured by attaching pedicle screws in the
vertebra. The vertebral pedicle screws were embedded into metal boxes
containing polymethyl-methacrylate to provide rigid fixation to a mechanical
tester. Results: Pull-out resistance
and stiffness were higher in conical screws than in cylindrical screws in the
first and repetitive insertions; however, the difference was not statistically
significant (p>0.05). The maximum input torque was significantly higher
(p=0.04) in conical screws than in cylindrical screws. No significant
difference (p>0.05) was observed between pull-out resistance and stiffness
values of the screws with 180° and 360° back-outs. Conclusion: Conical screws had more resistant fixation data than
cylindrical screws, and there was no significant difference between the screws
in terms of pull-out resistance data due to multiple screw insertions performed
from the same hole or due to the back-out procedure; this indicates that
conical screws are likely be used more frequently in the future.
References
- 1- Abshire BB, McLain RF, Valdevit A, Kambic HE. Charecteristic of pullout failure in conical and cylindrical screws after full insertion and back-out. Spine J 2001;1(6):408-414.
- 2- Skinner R, Maybee J, Transfeldt E, Venter R, Chalmers W. Experimental pullout testing and comparison of variable in transpedicular screw fixation. Spine 1990;15:195-201.
- 3- Esses SI, Sachs BL, Dryzin V. Complications associated with the technice of pedicle screw fixation. A selected survey of ABS Members. Spine 1993;18(15):2231-2238. 4- Weinstein JN, Spratt KF, Spengler D, Brick C, Reid S. Spinal pedicle fixation: reliability and validity of roentgenogram-based assessment and surgical factors on succesfull screw placement. Spine 1988;13(19):1012-1018.
- 5- Kwok AWL, Finklestein JA, Woodside T, Hearn TC, Hu RW. İnsertional torque and pull-out strengths of conical and clindyrical pedicle screw in cadaveric bone. Spine 1996;21(21):2429-2434.
- 6- Ransom N, La Rocca SH, Thalgott J. The case for pedicle fixation of the lomber spine. Spine 1994;19(23):2702-2706.
- 7- Schwab FJ, Nazarian DG, Mahmut F, Michelsen CB. Effects of spinal esrumantation on fusion of the lumbsacral spine. Spine 1995;20(18):2023-2028.
- 8- Dicman CA, Fesler RG, Macmillan M, Haid RW. Transpedicular screw-rod fixation of the lumber spine:operative technice and outcome in 104 cases. J Neurosurgery 1992;77:860-870.9- McLain R, Sparling E, Benson D. Early failture of the short segment pedicle instrumantation for thoracolumbar fractures: a preliminary report. J Bone Joint Surg 1993;75A:162-167.
- 10- Pfeifer M, Hoffman H, Goel VK, Weinstein JN, Griss P. In vitro testing of a new transpedicular stablization technique. Eur Spine J 1997;6(4):249-255. 11- Davne SH, Myers SL. Complications of lumbar spinl fusion with transpedicular instrumantaton. Spine 1992;17(supp):S184-189.
- 12- McKinley TO, McLain RF Yerby SA, Sarıgül- Klijn N, Smith TS.The effect of pedicle morphometry on pedicle screw loading in unstable burst fractures: a synthetic model. Spine 1997;22(3):246-252.
- 13- Yerby SA, Ehteshami JR, McLain RF. Loading of pedicle screws within the vertebra. J Biomechanics 1997;30(9):951-954.
- 14- Yamagata M, Kitahara H, Minami S, etc and all. Mechanical stability of pedicle screw systems fort the lumbar spine. Spine 1992;17(supp):S51-54.
- 15- Daftari DK, Horton WC, HuttoN WC. Correlations between screw hole preparation, torque of insertion, and pullout strength for spinal screws. J Spinal Disord 1994;7(2):139-145.
- 16- Pfeifer M, Gilbertson LG, Goel VK, et al. Effect of specimen fixation method on pull-out tests of pedicle screws. Spine 1996;21:1037-1044.
- 17- Kılınçer C, İnceoğlu S, Çaylı S, Zileli M, Ferara L. Biomehanical analysis of a Turkis-Made posterior spinal instrumantation system. Turkish Neurosurgery 2005;15(2):58-63.
- 18- İnceoğlu S, Ferrara L, Mclain RF. Pedicle screw fixation strenght: pullout versus insertional torque. Spine J 2004;4:513-518.
- 19- McLain RF, Fry MF, Moseley TA, Sharkey NA. Lumba pedicle screw salvage:pull-out testing of three different pedicle screw designs. J Spinal Disor 1995;8(1):62-68.
- 20- Ashman RB, Galpin RD, Corin JD, Johnston CE. Biomechanical analysis of pedicle screw instrumantation systems in a corpectomy model. Spine 1989;14:1398-1405.
- 21- Zindrick MR, Wiltse LL, Widel EH, Thomas JC, Holland WR, Field BT, Spencer CW. A biomechanical study of intrapedincular screw fixation in the lumbosacral spine. Clin Orthop Relat Res 1986;203:99-112.
- 22- Myers B, Belmont P, Richardson w, Yu J, Harper K, Nightingale R. The role of imaging and in situ biomechanical testing in assessing pedicle screw pullout strenght. Spine 1996;21:1962-1968.
- 23- Soshi S, Shiba R, Kondo H, Murato K. An experimental study on transpedicular screw fixation in relation to osteoporosis of the lumbar spine. Spine 1991;16(11):1335-1341.
- 24- Hirano T, Hasegava K, Takahashi HE, Uchiyama S, Hara T, Washio T, Sugiura T, Yokaichiya M, Ikeda M. Structurel characteristics of the pedicle and its role in screw stabilty. Spine 1997;22:2504-2509.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Articles |
| Authors | |
| Publication Date | December 31, 2019 |
| Submission Date | August 13, 2019 |
| Acceptance Date | September 18, 2019 |
| Published in Issue | Year 2019 Volume: 12 Issue: 3 |
Cite
MEU Journal of Health Sciences Assoc was began to the publishing process in 2008 under the supervision of Assoc. Prof. Gönül Aslan, Editor-in-Chief, and affiliated to Mersin University Institute of Health Sciences. In March 2015, Prof. Dr. Caferi Tayyar Şaşmaz undertook the Editor-in Chief position and since then he has been in charge.
Publishing in three issues per year (April - August - December), it is a multisectoral refereed scientific journal. In addition to research articles, scientific articles such as reviews, case reports and letters to the editor are published in the journal. Our journal, which has been published via e-mail since its inception, has been published both online and in print. Following the Participation Agreement signed with TÜBİTAK-ULAKBİM Dergi Park in April 2015, it has started to accept and evaluate online publications.
Mersin University Journal of Health Sciences have been indexed by Turkey Citation Index since November 16, 2011.
Mersin University Journal of Health Sciences have been indexed by ULAKBIM Medical Database from the first issue of 2016.
Mersin University Journal of Health Sciences have been indexed by DOAJ since October 02, 2019.
Article Publishing Charge Policy: Our journal has adopted an open access policy and there is no fee for article application, evaluation, and publication in our journal. All the articles published in our journal can be accessed from the Archive free of charge.
This work is licensed with Attribution-NonCommercial 4.0 International.