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Acta Orthopaedica et Traumatologica Turcica
Article . 2020 . Peer-reviewed
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Acta Orthopaedica et Traumatologica Turcica
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A biomechanical comparison of polymethylmethacrylatereinforced and expansive pedicle screws in pediclescrew revisions

Authors: Bostan, Bora; Esenkaya, Irfan; Gunes, Taner; Erdem, Mehmet; Asci, Murat; Kelestemur, M. Halidun; Sen, Cengiz;

A biomechanical comparison of polymethylmethacrylatereinforced and expansive pedicle screws in pediclescrew revisions

Abstract

Abstract Objectives: Different techniques and choices exist for revision of pedicle screws, two of which are pedicle screw combined with cement augmentation and expansive pedicle screw fixation. This biomechanical study was designed to compare the pullout strengths of two different revision techniques.\r\nMethods: Fourteen lumbar vertebrae obtained from four calves (mean age 15 months) were divided into two groups equal in number. Monoaxial 6.0-mm pedicle screws were inserted into the right pedicles, and axial pullout testing was performed at a rate of 10 mm/min and failure strengths were recorded. Revision was performed with the same-sized pedicle screws reinforced with polymethylmethacrylate in group 1, and with 7.0-mm expansive pedicle screws in group 2, and pullout testing was repeated to record maximum revision pullout strengths.\r\nResults: The mean pullout strengths recorded before and after revision were significantly different in both groups, being 2,162.9±718.5 N and 2,794.3±979.2 N in group 1 (p=0.041) and 2,605.0±487.6 N and 3,327.1±640.8 N in group 2 (p=0.012), respectively. However, the mean pullout strengths recorded before and after revision did not differ significantly between the two groups (p>0.05).\r\nConclusion: Our results showed that expansive pedicle screws 1 mm larger in diameter provide similar pullout strengths to those of same-sized, polymethylmethacrylate-reinforced screws in revision of pedicle screw fixation, suggesting that they can be preferred with the additional advantages of ease of application and avoiding risks for pedicle fracture and cement leakage. Özet Amaç: Pedikül vidalarının revizyonlarında çeşitli yöntemler ve seçenekler kullanılmaktadır. Bunlardan ikisi vidaların çimentoyla güçlendirilmesi ve ucu genişleyebilen pedikül vidalarının (UGPV) kullanılmasıdır. Bu biyomekanik çalışmada, pedikül vida revizyonlarında kullanılan iki farklı tekniğin sıyırma güçleri karşılaştırıldı.\r\nÇalışma planı: Ortalama 15 aylık dört adet dananın lomber omurgalarından, her biri yedi adet omur içeren iki grup oluşturuldu. Omurların sağ pediküllerine 6 mm çaplı monoaksiyel pedikül vidaları uygulandı ve 10 mm/dk hızında aksiyel sıyırma testi yapıldı, yetmezlik değerleri kaydedildi. Grup 1’deki pediküllerin revizyonu 6 mm’lik pedikül vidası ve polimetilmetakrilat güçlendirmesi ile yapıldı. Grup 2’deki pediküllerin revizyonu ise 7 mm’lik, uç kısımları genişleyebilen pedikül vidaları ile yapıldı. Revizyon sonrasında örneklere aynı hızda sıyırma testi uygulandı ve değerler kaydedildi.\r\nSonuçlar: Revizyon öncesi ve sonrası sıyırma güçleri her iki grupta da anlamlı farklılık gösterdi (grup 1’de sırasıyla 2162.9±718.5 N ve 2794.3±979.2 N, p=0.041; grup 2’de 2605.0±487.6 N ve 3327.1±640.8 N, p=0.012). İki grup arasında hem başlangıç sıyırma güçleri hem de revizyon sonrası sıyırma güçleri ortalamaları arasında anlamlı fark bulunmadı (p>0.05). \r\nÇıkarımlar: Pedikül vida revizyonlarında, 1 mm daha geniş UGPV’nin sıyırma gücünün, polimetilmetakrilatla güçlendirilmiş ve revizyon öncesiyle aynı çaptaki pedikül vidalarıyla benzer olduğu görüldü. Uç kısmı genişleyebilen pedikül vidaları, pedikül kırığı ve çimento sızma gibi riskleri taşımaması ve daha kolay uygulanabilmeleri nedeniyle revizyon cerrahisinde tercih edilebilir.

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Turkey
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Keywords

Lumbar Vertebrae, Compressive Strength, Bone Screws, Equipment Design, spinal fusion/instrumentation, spine/surgery, Radiography, bone screws, cattle, lumbar vertebrae/surgery, Animals, Humans, Polymethyl Methacrylate, Biomechanics, Cattle

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
15
Average
Top 10%
Top 10%
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gold