Document Detail


Dynamic lumbar pedicle screw-rod stabilization: in vitro biomechanical comparison with standard rigid pedicle screw-rod stabilization.
MedLine Citation:
PMID:  20121354     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECT: It is unclear how the biomechanics of dynamic posterior lumbar stabilization systems and traditional rigid pedicle screw-rod systems differ. This study examined the biomechanical response of a hinged-dynamic pedicle screw compared with a standard rigid screw used in a 1-level pedicle screw-rod construct. METHODS: Unembalmed human cadaveric L3-S1 segments were tested intact, after L4-5 discectomy, after rigid pedicle screw-rod fixation, and after dynamic pedicle screw-rod fixation. Specimens were loaded using pure moments to induce flexion, extension, lateral bending, and axial rotation while recording motion optoelectronically. Specimens were then loaded in physiological flexion-extension while applying 400 N of compression. Moment and force across instrumentation were recorded from pairs of strain gauges mounted on the interconnecting rods. RESULTS: The hinged-dynamic screws allowed an average of 160% greater range of motion during flexion, extension, lateral bending, and axial rotation than standard rigid screws (p < 0.03) but 30% less motion than normal. When using standard screws, bending moments and axial loads on the rods were greater than the bending moments and axial loads on the rods when using dynamic screws during most loading modes (p < 0.05). The axis of rotation shifted significantly posteriorly more than 10 mm from its normal position with both devices. CONCLUSIONS: In a 1-level pedicle screw-rod construct, hinged-dynamic screws allowed a quantity of motion that was substantially closer to normal motion than that allowed by rigid pedicle screws. Both systems altered kinematics similarly. Less load was borne by the hinged screw construct, indicating that the hinged-dynamic screws allow less stress shielding than standard rigid screws.
Authors:
Hakan Bozku?; Mehmet Seno?lu; Seungwon Baek; Anna G U Sawa; Ali Fahir Ozer; Volker K H Sonntag; Neil R Crawford
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Publication Detail:
Type:  In Vitro; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of neurosurgery. Spine     Volume:  12     ISSN:  1547-5646     ISO Abbreviation:  J Neurosurg Spine     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-03     Completed Date:  2010-02-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101223545     Medline TA:  J Neurosurg Spine     Country:  United States    
Other Details:
Languages:  eng     Pagination:  183-9     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, VKV Amerikan Hastanesi, Istanbul, Turkey.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Biomechanics
Bone Screws*
Diskectomy
Female
Humans
Lumbar Vertebrae / physiology*,  surgery*
Male
Middle Aged
Motion
Orthopedic Procedures / methods*
Rotation
Sacrum / physiology,  surgery
Stress, Mechanical
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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