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Analysis of Pullout Strength and Pedicle Screw Loosening from Loading Rigid Rod Construct

机译:加载刚性杆构建体的拉出强度和椎弓根螺杆分析

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Introduction: Pedicle screws have been used for many different purposes in order to provide effective fixation between a metal interface like a rod or plate to a vertebral body. These screws generally fixate in a proper and secure manner in patients with normal bone density but in patients with osteoporosis, these screws can easily come out of the bone and lead to complications. Methods: Two pedicle screws each were applied in osteoporotic thoracic vertebral bodies from human cadavers. Three cc of Kyphplasty cement was injected through one screw and not through the other screw. Half were loaded in a cantilever setup to simulate the load as well as a 5 Nm moment to measure screw loosening that occurs. The other half had the screw heads were gripped in a self centering vice, secured in an aligning fixture, and subjected to pullout tests at a rate of 1 mm/sec on MTS 858 Minibionics until failure occurred and peak load is recorded. Results: For non-cemented screws, the angles increased for 5 of the 6 specimens and the translations increased for all 6 specimens tested. The average peak force recorded for the five vertebras tested is . 320.24±40.38N. When compared to the pullout forces of cemented pedicle screws inserted into the opposite pedicle of the same vertebral bodies, the average increases dramatically to 659.84±102.6N. The average percent increase in pullout strength is 109.75% (P < 0.003). Discussion: A t-test showed significantly more loosening (p<.05)of the non-cemented pedicle screw when compared to the cemented screw in the same vertebral body. In regard to pullout strength, the injection of cement the results show a significant increase in strength while using a small amount of bone cement compared to other forms of cement augmentation.
机译:简介:椎弓根螺钉已用于许多不同的目的,以便在金属界面之间提供有效的固定,如杆或板到椎体。这些螺钉通常以正常骨密度的患者以适当和安全的方式固定,但在骨质疏松症患者中,这些螺钉可以容易地从骨骼中出来并导致并发症。方法:两根椎弓根螺钉各自施用来自人尸体的骨质疏松胸椎椎体。通过一根螺钉注入三个基氏蛋白酶的kyphetty水泥,而不是通过另一个螺钉注入。一半装入悬臂设置中以模拟负载以及5 nm时刻来测量发生的螺杆松动。另一半使螺旋头夹住在自定心副中,固定在对准夹具中,并以1mm /秒的速率在MTS 858缩小的速率下进行拉出试验,直到记录发生故障并且记录峰值负荷。结果:对于非粘合的螺钉,6个标本中的5个角度增加,并且所有6个样本都会增加翻译。为五个测试的五个椎骨记录的平均峰值力是。 320.24±40.38N。与插入相同椎体的椎弓根螺钉的胶带螺钉的拉伸力相比,平均值显着增加至659.84±102.6N。拉出强度的平均百分比增加109.75%(P <0.003)。讨论:与在同一椎体中的粘合的螺钉相比,T检验显示出在非胶结椎弓根螺钉的宽松(P <.05)。关于拉出强度,水泥注射结果表明,与其他形式的水泥增强相比,使用少量骨水泥的强度显着增加。

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