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首页> 外文期刊>Spine >A stronger bicortical sacral pedicle screw fixation through the s1 endplate: an in vitro cyclic loading and pull-out force evaluation.
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A stronger bicortical sacral pedicle screw fixation through the s1 endplate: an in vitro cyclic loading and pull-out force evaluation.

机译：通过s1终板更牢固的双cor骨椎弓根螺钉固定：体外循环载荷和拔出力评估。

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STUDY DESIGN: The insertion torque and pull-out force after cyclic loading of the bicortical sacral pedicle screw through the S1 endplate were tested using human cadaveric specimens. OBJECTIVES: The purpose of this study was to (1) evaluate the effect of cyclic loading on the pull-out force of two different techniques of bicortical sacral pedicle screw fixation and (2) to correlate the pull-out force after cyclic loading with the screw insertion torque. SUMMARY OF BACKGROUND DATA: Biomechanical studies using conventional sacral pedicle screw fixation techniques have demonstrated reduction in stiffness and strength after cyclic loading. Technical difficulties with anterior sacral cortex penetration and frequent screw loosening have been reported in clinical studies. In the authors' center, a new method of sacral pedicle screw fixation bicortically through the S1 endplate has been used successfully in the clinical setting. However, the mechanical stability of this new technique after undergoing cyclic loading has not been documented in the literature. METHODS: Seven-millimeter compact Cotrel-Dubousset sacral screws were randomly assigned by side (left vs. right) and inserted bicortically either anteromedially through the anterior sacral cortex or superiorly through the S1 endplate of 17 fresh frozen human sacrum. The tk;4maximum insertion torque for each screw was measured. Cyclic loading from 40 N to 400 N was applied to each screw at a frequency of 2 Hz for 20,000 cycles. Pull-out tests were conducted after completion of the cyclic tests. RESULTS: The mean maximum insertion torque and mean pull-out force following cyclic loading were significantly higher for bicortical fixation through the S1 endplate (mean 3.17 N.m and 1457 N) than bicortical fixation through the anterior sacral cortex (mean 1.98 N.m and 1122 N). Both S1 endplate and anterior cortical fixation techniques demonstrated significant correlations between insertion torque and pull-out force following cyclic loading. CONCLUSIONS: In sacral pedicle screw fixation, screw trajectory through the S1 endplate was significantly stronger than screws penetrating the anterior sacral cortex. Insertion torque was a good intraoperative indicator of screw pull-out force after cyclic loading.
机译：研究设计：使用人体尸体标本对双皮质骨椎弓根螺钉循环加载通过S1终板后的插入扭矩和拔出力进行了测试。目的：本研究的目的是（1）评估循环载荷对两种不同的双皮质骨椎弓根螺钉固定技术的拉拔力的影响，以及（2）将循环载荷后的拉拔力与螺丝插入扭矩。背景数据摘要：使用常规的椎椎弓根螺钉固定技术进行的生物力学研究表明，循环载荷后刚度和强度降低。临床研究中已报告了骨前皮质穿透和频繁螺钉松动的技术难题。在作者的中心，一种通过S1端板双侧骨椎弓根螺钉固定的新方法已在临床环境中成功使用。但是，这种新技术在承受周期性载荷后的机械稳定性尚未在文献中记载。方法：将7毫米紧凑型Cotrel-Dubousset ac骨螺钉从侧面随机分配（左与右），并从前骨皮膜远端穿过骨，或通过17个新鲜冷冻的人骨的S1终板向上插入。测量每个螺钉的tk; 4最大插入扭矩。从40 N到400 N的循环载荷以2 Hz的频率施加到每个螺杆上20,000个循环。循环测试完成后进行拉拔测试。结果：经循环载荷后，通过S1终板进行双皮质固定的平均最大插入扭矩和平均拔出力显着高于通过骨前皮质的双皮质固定（平均1.98 Nm和1122 N） 。 S1终板和前皮质固定技术均显示出周期性加载后插入扭矩和拔出力之间的显着相关性。结论：在椎椎弓根螺钉固定中，穿过S1终板的螺钉轨迹明显强于穿透骨前皮质的螺钉。插入扭矩是循环加载后螺钉拔出力的良好术中指标。

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