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ID 114709
Title Alternative
椎弓根スクリューの椎弓根外側、内側に誤挿入後再挿入した際の引き抜き強度
Pullout Strength of Pedicle Screws
Author
Manabe, Hiroaki Tokushima University
Hayashi, Fumio Tokushima University
Goda, Yuichiro Tokushima University
Keywords
larger screw
malpositioned screw
pedicle screw
pullout strength
redirection
thoracolumbar spine
Content Type
Thesis or Dissertation
Description
Study Design: A cadaveric biomechanical study designed to test the pullout strength of pedicle screws.
Objective: To evaluate the pullout strength of redirected pedicle screws with a larger diameter following lateral wall breach, redirected pedicle screws of the same diameter following medial wall breach, and redirected pedicle screws with a larger diameter following medial wall breach. Summary of Background Data: Screw malposition is one of the main pitfalls of inserting pedicle screws. Intraoperatively a malpositioned screw is re-directed and inserted along the correct axis.
Methods: Forty-seven vertebrae (T9–L5) were harvested from 8 fresh cadaveric spines. The 18 pedicle screws that breached the lateral wall were then removed and redirected using a pedicle screw of 1 mm larger in diameter. The 16 pedicle screws that had breached the medial wall were then removed and redirected using a pedicle screw of the same diameter. The other 13 pedicle screws that had breached the medial wall were then removed and redirected using a pedicle screw of 1 mm larger in diameter. The pullout strength was measured.
Results: Following lateral wall breach, mean pullout strength for the larger redirected screws was 46.9% greater than that of the correctly aligned screws. Following medial wall breach, mean pullout strength for the redirected screws of the same diameter was 20.6% less than that of the correctly aligned screws. Mean pullout strength for the larger pedicle screws following medial wall breach was 27.3% more than that of the correctly aligned screws.
Conclusion: Redirected pedicle screws of larger diameter after a lateral or medial pedicle breach show recovery of pullout strength. However, the pullout strength of redirected pedicle screws of the same diameter after a medial pedicle breach is significantly less than that of correctly aligned screws.
Description Alternative
Redirected pedicle screws of larger diameter after a lateral or medial pedicle breach show the recovery of pullout strength. However, the pullout strength of redirected pedicle screws of the same diameter after a medial pedicle breach is significantly less than that of correctly aligned screws.
Journal Title
Spine
ISSN
03622436
15281159
NCID
AA0084801X
AA12431865
Publisher
Lippincott Williams & Wilkins|Wolters Kluwer Health, Inc.
Volume
43
Issue
17
Start Page
E983
End Page
E989
Published Date
2018-09-01
Remark
内容要旨・審査要旨・論文本文の公開
本論文は,著者Toru Maedaの学位論文として提出され,学位審査・授与の対象となっている。
Rights
This the final peer-reviewed manuscript is made available under the CC-BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/)
EDB ID
DOI (Published Version)
URL ( Publisher's Version )
FullText File
language
eng
TextVersion
ETD
MEXT report number
甲第3372号
Diploma Number
甲医第1455号
Granted Date
2020-03-23
Degree Name
Doctor of Medical Science
Grantor
Tokushima University
departments
Medical Sciences
University Hospital