Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Straight-Forward versus Bicortical Fixation Penetrating Endplate in Lumbosacral Fixation-A Biomechanical Study

  • Karakasli, Ahmet (Department of Orthopaedics and Traumatology, Dokuz Eylul University, Faculty of Medicine) ;
  • Acar, Nihat (Department of Orthopaedics and Traumatology, Catalca Ilyas Cokay Hospital) ;
  • Uzun, Bora (Department of Biomechanics, Dokuz Eylul University, Health Science Institute)
  • Received : 2017.04.07
  • Accepted : 2017.07.25
  • Published : 2018.03.01
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Abstract

Objective : Many lumbosacral fixation techniques have been described to offer a more screw-bone purchase. The forward anatomical fixation parallel to the endplate is still the most preferred method. Literature revealed little knowledge regarding the mechanical stability of lumbosacral trans-endplate fixation compared to the traditional trans-pedicular screw fixation method. The aim of this study is to assess the pull-out strength of lumbosacral screws penetrating the end plate and comparing it to the conventional trans-pedicular screw insertion method. Methods : Eight lumbar and eight sacral vertebrae, with average age 69.4 years, Left pedicles of the 5th lumbar vertebrae were used for trans-endplate screw fixation, group 1A, right pedicles were used for anatomical trans-pedicular screw fixation, group 1B. In the sacral vertebrae, the right side S1 pedicles were used for trans-endplate fixation, group 2A, left side pedicles were used for anatomical trans-pedicular screw fixation, group 2B. The biomechanical tests were performed using the axial compression testing machine. All tests were applied using 2 mm/min traction speed. Results : The average pull-out strength values of groups 1A and 1B were $403.78{\pm}11.71N$ and $306.26{\pm}17.55N$, respectively. A statistical significance was detected with p=0.012. The average pull-out strength values of groups 2A and 2B were $388.73{\pm}17.03N$ and $299.84{\pm}17.52N$, respectively. A statistical significance was detected with p=0.012. Conclusion : The trans-endplate lumbosacral fixation method is a trustable fixation method with a stronger screw-bone purchase and offer a good alternative for surgeons specially in patients with osteoporosis.

Keywords

References

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