In vitro biomechanical analysis of a new lumbar low-profile locking screw-plate construct versus a standard top-loading cantilevered pedicle screw-rod construct: technical report.

Abstract:

OBJECTIVE:A standard top-loading lumbar pedicle screw-rod system is compared with a pedicle screw-plate system with smaller-diameter screws, more medial entry, and lower profile to assess the relative stability, strength, and resistance to fatigue of the 2 systems. METHODS:Seven human cadaveric specimens were studied with each surgical construct. Nondestructive, nonconstraining pure moments were applied to specimens to induce flexion, extension, lateral bending, and axial rotation while recording L5-S1 motion optoelectronically. After initial tests, specimens were fatigued for 10,000 cycles and retested to assess early postoperative loosening. Specimens were then loaded to failure in hyperextension. RESULTS:The standard screw-rod construct reduced range of motion to a mean of 20% of normal, whereas the screw-plate construct reduced range of motion to 13% of normal. Differences between systems were not significant in any loading mode (P > 0.06). The 14% loosening of the screw-rod system with fatigue was not significantly different from the 10% loosening observed with the screw-plate system (P > 0.15). Mean failure loads of 30 Nm for screw-rod and 37 Nm for screw-plate were also not significantly different (P = 0.38). CONCLUSION:Posterior fixation at L5-S1 using the low-profile screw-plate system offers stability, resistance to fatigue, and resistance to failure equivalent to fixation using a standard cantilevered pedicle screw-rod system.

journal_name

Neurosurgery

journal_title

Neurosurgery

authors

Crawford NR,Doğan S,Yüksel KZ,Villasana-Ramos O,Soto-Barraza JC,Sawa AG,Porter RW,Marciano FF,Theodore N

doi

10.1227/01.NEU.0000363701.76835.BF

subject

Has Abstract

pub_date

2010-02-01 00:00:00

pages

E404-6; discussion E406

issue

2

eissn

0148-396X

issn

1524-4040

pii

00006123-201002000-00032

journal_volume

66

pub_type

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