• 대한의용생체공학회:의공학회지
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• 제42권1호
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• pp.1-6
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• 2021

Recently, various types of pedicle screws have been developed considering the anatomical structure of the spine. The purpose of this study was to evaluate the pullout stiffness and strength of two types of commercial pedicle screws. The design of two type screws were single pitched thread (ST) pedicle screw and dual pitched thread (DT) pedicle screw, respectively. The tests were conducted in accordance with the ASTM standards using polyurethane (PU) test blocks which has anatomical structure of the spine. There was no significant difference in pullout stiffness between two types of screw. However, DT exhibited higher pullout strength than ST (p<0.05). Pedicle screw with dual pitched thread showed higher pullout strength without decrease in pullout stiffness compared to the standard pedicle screw. In conclusion, dual pitched thread design of the pedicle screw is considered to be more suitable than the single pitched thread for the anatomical structure of the spine.

• 한국지반공학회논문집
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• 제30권1호
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• pp.5-16
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• 2014

본 논문에서는 현장인발재하시험을 통한 스크류 앵커 파일의 인발 저항 특성에 관한 연구내용을 제시하였다. 현장시험에서는 동일한 피치를 가지나 샤프트나 스크류 직경이 다른 스크류 앵커 파일에 대해 다양한 시공조건을 도출하고 이에 대한 시험을 수행하였다. 실험결과 스크류 앵커 파일은 스크류가 없는 파일에 비해 현저히 큰 인발저항력을 발휘하는 것으로 검토되었으며 시간경과 효과와 그라우팅 여부에 따른 검토 결과 일반 파일과 유사하게 시간경과에 따라 인발저항력이 증가하는 셋업효과와 그라우팅시 인발저항력 상승효과를 기대할 수 있는 것으로 분석되었다. 이와 아울러 기존의 헬리컬 파일의 인발저항력 산정식을 스크류 앵커 파일의 인발저항력 평가에 있어서의 적용성을 검토하였으며 현장인발재하 시험결과를 다양한 측면에서의 상관관계를 파악할 수 있도록 제시하고 연구결과의 실무적 관점에서의 검토 내용을 기술하였다.

• Journal of Korean Neurosurgical Society
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• 제57권4호
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• pp.229-234
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• 2015

Objective : Pedicle screw fixation for spine arthrodesis is a useful procedure for the treatment of spinal disorders. However, instrument failure often occurs, and pedicle screw loosening is the initial step of a range of complications. The authors recently used a modified transpedicular polymethylmethacrylate (PMMA) screw augmentation technique to overcome pedicle screw loosening. Here, they report on the laboratory testing of pedicle screws inserted using this modified technique. Methods : To evaluate pullout strengths three cadaveric spinal columns were used. Three pedicle screw insertion methods were utilized to compare pullout strength; the three methods used were; control (C), traditional transpedicular PMMA augmentation technique (T), and the modified transpedicular augmentation technique (M). After control screws had been pulled out, loosening with instrument was made. Screw augmentations were executed and screw pullout strength was rechecked. Results : Pedicle screws augmented using the modified technique for pedicle screw loosening had higher pullout strengths than the control ($1106.2{\pm}458.0N$ vs. $741.2{\pm}269.5N$; p=0.001). Traditional transpedicular augmentation achieved a mean pullout strength similar to that of the control group ($657.5{\pm}172.3N$ vs. $724.5{\pm}234.4N$; p=0.537). The modified technique had higher strength than the traditional PMMA augmentation technique ($1070.8{\pm}358.6N$ vs. $652.2{\pm}185.5N$; p=0.023). Conclusion : The modified PMMA transpedicular screw augmentation technique is a straightforward, effective surgical procedure for treating pedicle screw loosening, and exhibits greater pullout strength than traditional PMMA transpedicular augmentation. However, long-term clinical evaluation is required.

• 대한의용생체공학회:의공학회지
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• 제39권3호
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• pp.134-139
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• 2018

One of the most common problems with pedicle screw system is pullout of the screw. This study was performed to evaluate the pullout strength and driving torque of newly designed pedicle screws. The design of three type screws were standard pedicle screw, which had single lead threaded and single pitched design (Type A), single pitched and dual lead threaded pedicle screw (Type B), dual pitched and dual lead threaded pedicle screw (Type C), respectively. The tests were performed in accordance with the ASTM standards using polyurethane (PU) foam blocks. There was no significant difference in pullout strength among three types of screw. Type B and Type C exhibited higher insertion torque and removal torque than Type A, respectively (p<0.05). Pedicle screws newly developed with dual pitched and dual lead threaded design showed higher driving torque without decrease in pullout strength compared to the standard pedicle screw and could be inserted more rapidly with the same number of revolutions.

• Journal of Korean Neurosurgical Society
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• 제30권2호
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• pp.131-136
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• 2001

목적 : 최근 척추 수술에 나사못을 사용하는 빈도와 범위가 넓어 지고 있는데 때로 수술 중 한번 삽입하였던 나사못을 다시 사용하는 경우가 있다. 인체 골과 타이타늄의 탄성계수가 크게 차이 나지만 반복 삽입 과정에서 나사못의 이가 손상될 가능성이 있다. 저자들은 나사못의 반복 삽입이 나사못의 인출 저항에 미치는 영향을 조사하였다. 방법 : 각각 6개의 세가지 다른 종류 cortical lateral mass screw, cancellous lateral mass screw and cervical vertebral body screw의 나사못을 시험하였다. 나사못을 인체의 골과 비슷한 밀도의 인공합성골에 삽입하였으며 삽입 중 삽입력을 측정하였고 그 후 Instron(Model TT-D, Canton, MA)을 이용하여 2.4mm의 속도로 인출하여 인장항력을 digital oscilloscope에 기록하였다. 위의 과정을 3회 반복하여 기록한 뒤 나사못을 광학 현미경으로 확대하여 관찰하였다. 결과 : cortical lateral mass screws의 평균 인장항력(1회인장 시험 $185.66N{\pm}42.60$, 2회 인장시험 $167.10N{\pm}27.01$, 3회인장 시험 $162.52N{\pm}23.83$ : p=0.03)과 cervical vertebral body screws ($386.0N{\pm}24.1$, $360.2N{\pm}17.5$ and $330.9N{\pm}16.7$ : p=0.0024)은 반복하여 삽입, 인장 검사 할 때 마다 감소하였으나 cancellous lateral mass screws의 평균 인장항력($194.00N{\pm}36.47$, $219.24N{\pm}26.58$ and $199.49N{\pm}36.63$ : p=0.24)은 감소하지 않았다. 전자현미경 소견에서 나사이의 끝이 무디어지고 표면이 문드러진 것을 관찰할 수 있었다. 결론 : 일부 나사못을 반복하여 삽입한 후 나사못의 인장항력이 감소되었으므로 수술중 여러번 삽입하였던 나사못은 최종 구조물에 사용되지 않아야 한다.

• 한국구조물진단유지관리공학회 논문집
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• 제25권6호
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• pp.84-89
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• 2021

2017년 경주지진은 블록이나 벽돌의 전도 및 탈락을 발생시켜 많은 인명피해 및 재산피해를 야기했다. 이에 칼블럭앵커나 치장벽 보강 나선앵커를 활용한 보강기법들이 제시되었지만 길이가 짧거나 시공오차에 대한 대응의 어려움 등 문제가 발생하였다. 따라서 본 연구는 기존의 칼블럭앵커을 개선한 긴 칼블럭앵커를 제안하고 뽑힘강도 평가 실험을 수행하였다. 실험 변수는 콘크리트 압축강도와 매입깊이로 설정하였다. 앵커 인발시험결과, 긴 칼블럭앵커의 뽑힘강도는 콘크리트 실험체의 압축강도가 증가함에 따라 증가하였으며, 긴 칼블럭앵커의 매입깊이는 큰 영향이 없었다. 오히려 나사산 길이가 뽑힘강도에 더 큰 영향이 있는 것으로 나타났다.

• 한국지반공학회논문집
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• 제28권1호
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• pp.5-15
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• 2012

본 논문에서는 지하굴착 혹은 절토사면에 적용할 수 있는 스크류 앵커 파일의 인발저항 특성에 관한 연구내용을 제시하였다. 이를 위해 스크류의 크기(직경) 및 피치길이 등 스크류 앵커 파일의 기하적 특성을 달리하는 모형 스크류 앵커 파일을 이용하여 모형실험을 수행하였다. 실험 결과 분석내용을 토대로 할 때 일정한 스크류 크기를 갖는 스크류 앵커 파일의 인발 저항력은 피치길이가 감소할수록 증가하는 것으로 검토 되었다. 또한 일정한 피치길이의 조건에서 스크류 앵커 파일의 인발저항력은 스크류 크기가 증가하면 일정 크기까지는 선형적으로 증가하나 일정 크기 이상에서는 증가량이 거의 일정해지는 것으로 검토 되었다. 본 논문에서는 실험결과를 스크류 앵커 파일의 다양한 제원과 인발저항 특성에 대한 상관관계를 파악할 수 있도록 제시하였으며 연구결과의 실무적 관점에서의 검토 내용을 기술하였다.

• Journal of Korean Neurosurgical Society
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• 제66권1호
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• pp.44-52
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• 2023

Objective : This study aimed to investigate the efficacy of transverse process (TP) hook system at the upper instrumented vertebra (UIV) for preventing screw pullout in adult spinal deformity surgery using the pedicle Hounsfield unit (HU) stratification based on K-means clustering. Methods : We retrospectively reviewed 74 patients who underwent deformity correction surgery between 2011 and 2020 and were followed up for >12 months. Pre- and post-operative data were used to determine the incidence of screw pullout, UIV TP hook implementation, vertebral body HU, pedicle HU, and patient outcomes. Data was then statistically analyzed for assessment of efficacy and risk prediction using stratified HU at UIV level alongside the effect of the TP hook system. Results : The screw pullout rate was 36.4% (27/74). Perioperative radiographic parameters were not significantly different between the pullout and non-pullout groups. The vertebral body HU and pedicle HU were significantly lower in the pullout group. K-means clustering stratified the vertebral body HU ≥205.3, <137.2, and pedicle HU ≥243.43, <156.03. The pullout rate significantly decreases in patients receiving the hook system when the pedicle HU was from ≥156.03 to < 243.43 (p<0.05), but the difference was not statistically significant in the vertebra HU stratified groups and when pedicle HU was ≥243.43 or <156.03. The postoperative clinical outcomes improved significantly with the implementation of the hook system. Conclusion : The UIV hook provides better clinical outcomes and can be considered a preventative strategy for screw-pullout in the certain pedicle HU range.

• 대한의용생체공학회:학술대회논문집
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• 대한의용생체공학회 1998년도 추계학술대회
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• pp.155-156
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• 1998

Screw loosening and subsequent pullout can be attributed to the reduction in bone mineral density in the vertebrae manifested by osteoporosis in which the decrease in fixation strength between the cancellous bone and screw threads are accelerated by repeated loads exerted by patients own weight and activities following the surgery. In this study, the change in pullout strength of the pedicle screws was investigated before and after repeated loads were imparted. For this purpose. Diapason pedicle screws $(6.7\times40mm)$ were inserted onto fresh porcine spine specimens (T1-L5) after bone mineral density was measured using a DEXA. With an MTS, an axial load was applied at a loading rate of 0.33mm/sec until failure to measure the maximum pullout strength. Flexion moment of 7.5N-m was then imparted at 0.5Hz for 2000 cycles. It was found that the maximum pullout strength was exponentially related to BMD regardless of load types ($107.71\;\times\;\exp^{(1.43{\times}BMD)}r^2=0.93$, P<0.0001 without repeated load; ($107.71\;\times\;\exp^{(2.19{\times}BMD)}r^2=0.78$, P<0.0001 with repeated load). The results suggest that the reduction in pullout strength for pedicle screws is far more prominent in osteoporotic spine than in normal spine especially as number of repeated load was increased. More importantly, it was demonstrated that the level of bone mineral density and the activity level of the patient should be evaluated in more detail for successful implementation of pedicle screw systems in spinal surgery.

• Geomechanics and Engineering
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• 제8권6호
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• pp.801-810
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• 2015

The ultimate pullout capacity under inclined dynamic loading is an important measure of the destruction degree of vertical screw piles (anchors) under dynamic actions. Based on the static and dynamic tests on two kinds of model screw piles, the ultimate bearing capacity was researched considering different distance-width ratio of blade (D/W) and preloading ratio. The results compared well with other experimental data available in the literature. This research reveals that D/W might determine the failure model of the piles (anchors), for example D/W = 3.14 or 5; a critical dynamic-static loading ratio (DSLR) existed in the experiments. The critical DSLR was reached under the conditions of 40%~60% preloading (D/W = 3.14) or 20%~40% preloading (D/W = 5), respectively.