Pullout evaluation of sawbone experiment in different types of pedicle screws combined with bone cement augmentation for severe osteoporotic spine

• Autorzy: Yang S.-C. , Liu P.-H. , Tu Y.-K.

Identyfikatory

DOI

10.5277/ABB-01115-2018-02

• Języki publikacji: EN

Abstrakty

EN

Purpose: The conventional screw is unable to provide enough screw-bone interface strength for osteoporotic cencellous bone, and complications resulting from loosening or failure of the implants remain a significant clinical problem. Hence, the purpose of this study is to investigate pullout strength and energy in three types of the pedicle screws, including conventional solid pedicle screw, cannulated pedicle screw, and cannulated pedicle screw with a central pin, using osteoporotic sawbone test block with different bone cement volumes through pullout force testing. Methods: The control group (n = 15) of the osteoporotic sawbone test block includes groups A, B, and C to reflect three types of the pedicle screws without bone cement augmentation. The cemented group (n = 45) of the osteoporotic sawbone test block includes groups D1, D2, D3, E1, E2, E3, F1, F2, and F3 to reflect three types of the pedicle screws with PMMA bone cement of 2, 3, and 4 mL augmentation. Results: The results showed that the pullout strength and energy in the cemented group were significantly larger than that in the control group. Moreover, the best performances of the pullout strength and energy in the cemented group were evidenced obviously in the case of cannulated pedicle screw with a central pin with 4 mL bone cement augmentation. Conclusions: This study concludes that cement argumentation in the cannulated pedicle screw with a central pin can increase a pullout strength of pedicle screw for severe osteoporotic patients while bone cement of injective volume is limited.

Słowa kluczowe

EN

osteoporosis; bone cement augmentation; cannulated pedicle screw; sawbone; pullout strength

PL

osteoporoza; kości; wytrzymałość

• Wydawca: Oficyna Wydawnicza Politechniki Wrocławskiej
• Czasopismo: Acta of Bioengineering and Biomechanics
• Rocznik: 2018
• Tom: Vol. 20, no. 2
• Strony: 55--64
• Opis fizyczny: Bibliogr. 26 poz., rys., tab., wykr.

Twórcy

autor

Yang S.-C.

• Department of Orthopedic Surgery, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan

autor

Liu P.-H.

• Department of Biomedical Engineering, I-Shou University, Kaohsiung, Taiwan

autor

Tu Y.-K.

• Department of Orthopedic Surgery, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan

Bibliografia

• [1] AYCAN M.F., TOLUNAY T., DEMIR T., YAMAN M.E., USTA Y., Pullout performance comparison of novel expandable pedicle screw with expandable poly-ether-ether-ketone shells and cementaugmented pedicle screws, J. Eng. Med., 2017, 231, 169–175.
• [2] BERNHARDT M., BRIDWELL K.H., Segmental analysis of the sagittal plane alignment of the normal thoracic and lumbar spines and thoracolumbar junction, Spine, 1989, 14, 717–721.
• [3] BURVAL D.J., MCLAIN R.F., MILKS R., INCEOGLU S., Primary pedicle screw augmentation in osteoporotic lumbar vertebrae: biomechanical analysis of pedicle fixation strength, Spine, 2007, 32, 1077–1083.
• [4] BAI B., KUMMER F.J., SPIVAK J., Augmentation of anterior vertebral body screw fixation by an injectable, biodegradable calcium phosphate bone substitute, Spine, 2001, 26, 2679–2683.
• [5] BURVAL D.J., MCLAIN R.F., MILKS R., INCEOGLU S., Primary Pedicle Screw Augmentation in Osteoporotic Lumbar Vertebrae: Biomechanical Analysis of Pedicle Fixation Strength, Spine, 2007, 32, 1077–1083.
• [6] BECKER S., CHAVANNE A., SPITALER R., KROPIK K., AIGNER N., OGON M., REDL H., Assessment of different screw augmentation techniques and screw designs in osteoporotic spines, Eur. Spine J., 2008, 17, 1462–1469.
• [7] CHANG M.C., LIU C.L., CHEN T.H., Polymethylmethacrylate augmentation of pedicle screw for osteoporotic spinal surgery: a novel technique, Spine, 2008, 33, 317–324.
• [8] CHEN L.H., TAI C.L., LAI P.L., LEE D.M., TSAI T.T., FU T.S., NIU C.C., CHEN W.J., Pullout strength for cannulated pedicle screws with bone cement augmentation in severely osteoporotic bone: Influences of radial hole and pilot hole tapping, Clin. Biomech., 2009, 24, 613–618.
• [9] GODA Y., HIGASHINO K., TOKI S., SUZUKI D., KOBAYASHI T., MATSUURA T., FUJIMIYA M., HUTTON W.C., FUKUI Y., SAIRYO K., The pullout strength of pedicle screws following redirection after lateral wall breach or end-plate breach, Spine, 2016, 41, 1218–1223.
• [10] HEINI P., BERLEMANN U., Bone substitutes in vertebroplasty, Eur. Spine J., 2001, 10, 205–213.
• [11] JOHNSON A.E., KELLER T.S., Mechanical properties of opencell foam synthetic thoracic vertebrae, J. Mater. Sci. Mater. Med., 2007, 19, 1317–1323.
• [12] KAYANJA M., EVANS K., MILKS R., LIEBERMAN I.H., The mechanics of polymethylmethacrylate augmentation, Clin. Orthop. Rel. Res., 2006, 443, 124–130.
• [13] MELTON L.J., LANE A.W., COOPER C., EASTELL R., O’FALLON W.M., RIGGS B.L., Prevalence and incidence of vertebral deformities, Osteoporosis Int., 1993, 3, 113– 119.
• [14] MCLAIN R.F., MCKINLEY T.O., YERBY S.A., SMITH T.S., SARIGUL-KLIJN N., The effect of bone quality on pedicle screw loading in axial instability, Spine, 1997, 22, 1454–1460.
• [15] MOSER J.E., KUNKEL K.A.R., GERARD P.D., Pullout strength of 2.0 mm cancellous and cortical screws in synthetic bone, Vet. Surg., 2017, 46, 1110–1115.
• [16] MCKOY B.E., AN Y.H., An injectable cementing screw for fixation in osteoporotic bone, J. Biomed. Mater. Res., 2000, 53, 216–220.
• [17] O’NEILL T.W., FELSENBERG D., VARLOW J., COOPER C., KANIS J.A., SILMAN A.J., The prevalence of vertebral deformity in european men and women: the European Vertebral Osteoporosis Study, J. Bone Miner. Res., 1996, 11, 1010–1018.
• [18] PEZOWICZ C., FILIPIAK J., Influence of loading history on the cervical screw pullout strength value, Acta Bioeng. Biomech., 2009, 11, 35–40.
• [19] ROHMILLER M.T., SCHWALM D., GLATTES R.C., ELALAYLI T.G., SPENGLER D.M., Evaluation of calcium sulfate paste for augmentation of lumbar pedicle screw pullout strength, Spine Journal, 2002, 2, 255–260.
• [20] RENNER S.M., LIM T.H., KIM W.J., KATOLIK L., AN H.S., ANDERSSON G.B., Augmentation of pedicle screw fixation strength using an injectable calcium phosphate cement as a function of injection timing and method, Spine, 2004, 29, 212–216.
• [21] TSUANG F.Y., CHEN C.H., WU L.C., KUO Y.J., LIN S.C., CHIANG C.J., Biomechanical arrangement of threaded and unthreaded portions providing holding power of transpedicular screw fixation, Clin. Biomech., 2016, 39, 71–76.
• [22] TSAI T.T., CHEN W.J., LAI P.L., CHEN L.H., NIU C.C., FU T.S., WONG C.B., Polymethylmethacrylate cement dislodgment following percutaneous vertebroplasty: a case report, Spine, 2003, 28, 457–460.
• [23] WU C.H., KAO Y.H., YANG S.C., FU T.S., LAI P.L., CHEN W.J., Supplementary pedicle screw fixation in spinal fusion for degenerative spondylolisthesis in patients aged 65 and over: outcome after a minimum of 2 years follow-up in 82 patients, Acta Orthop., 2008, 79, 67–73.
• [24] WITTENBERG R.H., LEE K.S., SHEA M., WHITE A.A., HAYES W.C., Effect of screw diameter, insertion technique, and bone cement augmentation of pedicular screw fixation strength, Clin. Orthop. Rel. Res., 1993, 22, 278–287.
• [25] WU Z.X., GAO M.X., SANG H.X., MA Z.S., CUI G., ZHANG Y., LEI W., Surgical treatment of osteoporotic thoracolumbar compressive fractures with open vertebral cement augmentation of expandable pedicle screw fixation: a biomechanical study and a 2-year follow-up of 20 patients, J. Surg. Res., 2012, 173, 91–98.
• [26] ZDERO R., SCHEMITSCH E.H., The Effect of Screw Pullout Rate on Screw Purchase in Synthetic Cancellous Bone, J. Biomech. Eng., 2008, 131, 024501–024501-5. DOI: 10.1115/1.3005344.

Uwagi

Opracowanie rekordu w ramach umowy 509/P-DUN/2018 ze środków MNiSW przeznaczonych na działalność upowszechniającą naukę (2019).