Straight-Forward versus Bicortical Fixation Penetrating Endplate in Lumbosacral Fixation-A Biomechanical Study
10.3340/jkns.2017.0404.004
- Author:
Ahmet KARAKASLI
1
;
Nihat ACAR
;
Bora UZUN
Author Information
1. Department of Orthopaedics and Traumatology, Dokuz Eylul University, Faculty of Medicine, Izmir, Turkey.
- Publication Type:Original Article
- Keywords:
Endplate;
Pedicular screw;
Biomechanical study
- MeSH:
Humans;
Lumbar Vertebrae;
Methods;
Osteoporosis;
Spine;
Surgeons;
Traction
- From:Journal of Korean Neurosurgical Society
2018;61(2):180-185
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: Many lumbosacral fixation techniques have been described to offer a more screw-bone purchase. The forward anatomical fixation parallel to the endplate is still the most preferred method. Literature revealed little knowledge regarding the mechanical stability of lumbosacral trans-endplate fixation compared to the traditional trans-pedicular screw fixation method. The aim of this study is to assess the pull-out strength of lumbosacral screws penetrating the end plate and comparing it to the conventional trans-pedicular screw insertion method.METHODS: Eight lumbar and eight sacral vertebrae, with average age 69.4 years, Left pedicles of the 5th lumbar vertebrae were used for trans-endplate screw fixation, group 1A, right pedicles were used for anatomical trans-pedicular screw fixation, group 1B. In the sacral vertebrae, the right side S1 pedicles were used for trans-endplate fixation, group 2A, left side pedicles were used for anatomical trans-pedicular screw fixation, group 2B. The biomechanical tests were performed using the axial compression testing machine. All tests were applied using 2 mm/min traction speed.RESULTS: The average pull-out strength values of groups 1A and 1B were 403.78±11.71 N and 306.26±17.55 N, respectively. A statistical significance was detected with p=0.012. The average pull-out strength values of groups 2A and 2B were 388.73±17.03 N and 299.84±17.52 N, respectively. A statistical significance was detected with p=0.012.CONCLUSION: The trans-endplate lumbosacral fixation method is a trustable fixation method with a stronger screw-bone purchase and offer a good alternative for surgeons specially in patients with osteoporosis.
