Enhancement of pedicle screw fixation through washers
| Autor: | Jung Yoo, J. Michael Kabo, Michael F. Shepard, Rayshad Oshtory, Jeffrey C. Wang |
|---|---|
| Rok vydání: | 2002 |
| Předmět: |
musculoskeletal diseases
medicine.medical_specialty Washer Swine Arthrodesis medicine.medical_treatment Bone Screws Fixation (surgical) Medicine Animals Orthopedics and Sports Medicine Orthopedic Procedures Pedicle screw fixation Pedicle screw Orthodontics business.industry Significant difference Biomechanics General Medicine Initial stability musculoskeletal system equipment and supplies Surgery surgical procedures operative Torque business |
| Zdroj: | Clinical orthopaedics and related research. (395) |
| ISSN: | 0009-921X |
| Popis: | This study examined the effect of washer usage on initial pedicle screw fixation and on the salvage of replaced pedicle screws, and the effect of minor adjustments of pedicle screws on insertional torque. Titanium, nontapered pedicle screws (6.5-mm in diameter and 35-mm in length) from one manufacturer and custom-made 5-mm washers were used in the fixation of porcine lumbar spines. Insertional torque was measured with an electronic torque screwdriver and failure strength was determined by straight pullout of the screws using an MTS machine. Initial insertional torque values were significantly greater in pedicle screws placed with washers compared with screws placed without washers. When the screw placed without a washer was salvaged with the addition of a washer, a significant increase in insertional torque resulted. Pullout testing failed to show a significant difference between the screws that were placed with washers and the screws that were placed without washers. In the second part of the experiment, there was a significant decrease in insertional torque after backing out the screw as little as 90 degrees. This current study showed that (1) washers significantly increase the insertional torque of pedicle screws; (2) screws placed without a washer can be salvaged and replaced with a washer, which results in significantly increased insertional torque; and (3) backing out a pedicle screw 90 degrees significantly decreases its insertional torque. Washers can be used with pedicle screws to enhance the initial stability of the screw constructs, and to maximize insertional torque when screws need to be replaced, revised, or adjusted (backed out). |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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