Biomechanical Analysis of a Pedicle Screw-Rod System with a Novel Cross-Link Configuration.
10.4184/asj.2016.10.6.993
- Author:
Yasuhiro NAKAJIMA
1
;
Masahito HARA
;
Daisuke UMEBAYASHI
;
Shoichi HAIMOTO
;
Yu YAMAMOTO
;
Yusuke NISHIMURA
;
Toshihiko WAKABAYASHI
Author Information
1. Department of Neurosurgery, Inazawa Municipal Hospital, Inazawa, Japan. y-nakajima@city.inazawa.aichi.jp
- Publication Type:Original Article
- Keywords:
Cross-link;
Spinous process;
Biomechanics;
Spinal fusion;
Pedicle screw-rod
- MeSH:
Lumbar Vertebrae;
Pedicle Screws;
Spinal Fusion;
Spine
- From:Asian Spine Journal
2016;10(6):993-999
- CountryRepublic of Korea
- Language:English
-
Abstract:
STUDY DESIGN: The strength effects of a pedicle screw-rod system supplemented with a novel cross-link configuration were biomechanically evaluated in porcine spines. PURPOSE: To assess the biomechanical differences between a conventional cross-link pedicle screw-rod system versus a novel cross-link instrumentation, and to determine the effect of the cross-links. OVERVIEW OF LITERATURE: Transverse cross-link systems affect torsional rigidity, but are thought to have little impact on the sagittal motion of spinal constructs. We tested the strength effects in pullout and flexion-compression tests of novel cross-link pedicle screw constructs using porcine thoracic and lumbar vertebrae. METHODS: Five matched thoracic and lumbar vertebral segments from 15 porcine spines were instrumented with 5.0-mm pedicle screws, which were then connected with 6.0-mm rods after partial corpectomy in the middle vertebral body. The forces required for construct failure in pullout and flexion-compression tests were examined in a randomized manner for three different cross-link configurations: un-cross-link control, conventional cross-link, and cross-link passing through the base of the spinous process. Statistical comparisons of strength data were analyzed using Student's t-tests. RESULTS: The spinous process group required a significantly greater pullout force for construct failure than the control group (p=0.036). No difference was found between the control and cross-link groups, or the cross-link and spinous process groups in pullout testing. In flexion-compression testing, the spinous processes group required significantly greater forces for construct failure than the control and cross-link groups (p<0.001 and p=0.003, respectively). However, there was no difference between the control and cross-link groups. CONCLUSIONS: A novel cross-link configuration that features cross-link devices passing through the base of the spinous processes increased the mechanical resistance in pullout and flexion-compression testing compared to un-cross-link constructs. This configuration provided more resistance to middle-column damage under flexion-compression testing than conventional cross-link configuration.
