• Title/Summary/Keyword: Screw stability

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Predictive Factors for a Kyphosis Recurrence Following Short-Segment Pedicle Screw Fixation Including Fractured Vertebral Body in Unstable Thoracolumbar Burst Fractures

  • Kim, Gun-Woo;Jang, Jae-Won;Hur, Hyuk;Lee, Jung-Kil;Kim, Jae-Hyoo;Kim, Soo-Han
    • Journal of Korean Neurosurgical Society
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    • v.56 no.3
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    • pp.230-236
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    • 2014
  • Objective : The technique of short segment pedicle screw fixation (SSPSF) has been widely used for stabilization in thoracolumbar burst fractures (TLBFs), but some studies reported high rate of kyphosis recurrence or hardware failure. This study was to evaluate the results of SSPSF including fractured level and to find the risk factors concerned with the kyphosis recurrence in TLBFs. Methods : This study included 42 patients, including 25 males and 17 females, who underwent SSPSF for stabilization of TLBFs between January 2003 and December 2010. For radiologic assessments, Cobb angle (CA), vertebral wedge angle (VWA), vertebral body compression ratio (VBCR), and difference between VWA and Cobb angle (DbVC) were measured. The relationships between kyphosis recurrence and radiologic parameters or demographic features were investigated. Frankel classification and low back outcome score (LBOS) were used for assessment of clinical outcomes. Results : The mean follow-up period was 38.6 months. CA, VWA, and VBCR were improved after SSPSF, and these parameters were well maintained at the final follow-up with minimal degree of correction loss. Kyphosis recurrence showed a significant increase in patients with Denis burst type A, load-sharing classification (LSC) score >6 or DbVC >6 (p<0.05). There were no patients who worsened to clinical outcome, and there was no significant correlation between kyphosis recurrence and clinical outcome in this series. Conclusion : SSPSF including the fractured vertebra is an effective surgical method for restoration and maintenance of vertebral column stability in TLBFs. However, kyphosis recurrence was significantly associated with Denis burst type A fracture, LSC score >6, or DbVC >6.

Comparison of the torque stability of Implant Torque Controllers

  • Kim, Dae-Gon;Cho, Lee-Ra;Park, Chan-Jin
    • Journal of Korean Dental Science
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    • v.2 no.1
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    • pp.19-27
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    • 2009
  • Tightening of the screws in implant restorations should be accurate and precise. If applied torque is too low, screw loosening would be occurred. With too high torque, the screw fracture might take place. Various torque generating devices are developed and employed to apply a proper torque. The purpose of this investigation was to determine and compare the accuracy of the torque controllers. In this study, 4 types of torque controllers were used; electronic torque controller, torque limiting device, torque indicating device and contra angle torque driver. Digital torque gauge was employed to measure the de-torque value. Thirty cycles of tightening and loosening were done with each torque controller. All implant torque controllers have shown slight errors and deviations. The torque liming device exhibited the most accurate data. No significant difference was found among the mean de-torque values of the electronic torque controller, torque indicating device and contra angle torque driver. In the limitation of this study, it would be recommended that the implant torque controllers should be checked whether uniformed and precise torque can be generated and a measuring error should be corrected.

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STABILITY OF TWO-JAW SURGERY FOR MANDIBULAR PROGNATHISM (하악전돌증 환자에 대한 양악 수술의 안정성)

  • Kwon, Tae-Geon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.23 no.4
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    • pp.348-356
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    • 2001
  • The factors related to relapse in 20 skeletal class III patients who performed two-jaw surgery with Le Fort I maxillary osteotomy and bilateral sagittal split ramus osteotomy was investigated. All patients were fixed with miniplate on the maxilla and three screws at each mandible. Cephalograms taken at preoperative, immediate postoperative and 8 months postoperative after surgery were traced and digitized. 1.The horizontal and vertical relapse of maxilla and mandibular chin points was within 1mm postoperatively. Compare to the preceding report concerning the mandibular set-back surgery only group, this reveals two-jaw surgery for mandibular prognathism using rigid fixation is more stable. 2.Although there was no significant relapse tendancy was observed at chin points, the screw tip land-marks moves anterio-superiorly and each side of the screws moved as a one unit. The screw tip points moved similar direction to the masticatory force and this movements might be influenced by the muscular tension to the distal segment of the mandible. 3.According to the regression analysis, the amount of horizontal and vertical movement of mandibular set-back influenced the mandibular relapse. However, direction and amount of maxillary surgical movement did not inf1uenced the maxillary and mandibular relapse.

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SKELETAL RELAPSE AFTER SAGITTAL SPLIT RAMUS OSTEOTOMY AND SCREW FIXATION (하악전돌증에서 하악지 시상분할골절단 및 Screw고정후 골성회귀에 관한 연구)

  • Lee, Chang-Kug;Kim, Myung-Rae;Choi, Jang-Woo;Yun, Jung-Hoon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.18 no.4
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    • pp.563-569
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    • 1996
  • Skeletal and dental changes were examined in 38 patients of mandibular prognathism who been treated by a bilateral sagittal split osteotomy(SSRO) and internal fixation using titanium mini-screws. All patients were followed up for over 8 months after the surgeries, and postoperative cephalometric measurements were compared at 2 months and at 8 months. Linear measurements of the "Pog-most posterior screws" and angular measurementsts of "SN-Pog'were compared to figure out the change of bony fragments. The significancy of data were tested by unpaired T-test. The results were as follows : 1. The fixation screws were changed in cephalometric position as little as $0.32{\pm}2.51mm$ in SSRO and $0.15{\pm}1.00mm$ in SSRO & Le Fort I Osteotomy.(P<0.05) 2. Mandibular set-back over 5mm resulted in less stability of the fixation screws and higher relapse tendency. 3. The internal fixation using two screws along the inferior border and one on the superior ridge is considered to be very resistant to postoperative relapse of the repositioned bony segments.

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A Experimental Study on the Stability of Lumbar Interbody Fusion (추체간 유합술의 안정성에 관한 실험적 연구)

  • Kim H.S.;Park J.H.;Kim J.P.;Lee K.Y.;Lee M.J.
    • Proceedings of the Korean Society of Precision Engineering Conference
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    • 2005.10a
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    • pp.526-529
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    • 2005
  • The purpose of this study is to investigate a loosening process of screws through a fatigue test. Therefore, it is attempted to perform an interbody fusion on porsine lumbar spine using cage and screws. From the results, it is found that the combining force in both of the cylinder and the taper type screws located on the upper-left first start to decrease and then the combination between a rod and screw loosens. In addition, it is investigated that the life of taper type screw increases 5.5% and this fact is coincident with the previous results.

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A comparative study on the fit and screw joint stability of ready-made abutment and CAD-CAM custom-made abutment (기성 지대주와 맞춤형 CAD-CAM 지대주의 적합 및 나사 안정성 비교)

  • Kim, Jong-Wook;Heo, Yu-Ri;Kim, Hee-Jung;Chung, Chae-Heon
    • The Journal of Korean Academy of Prosthodontics
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    • v.51 no.4
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    • pp.276-283
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    • 2013
  • Purpose: The purpose of this study was to investigate the fit and screw joint stability between Ready-made abutment and CAD-CAM custom-made abutment. Materials and methods: Osstem implant system was used. Ready-made abutment (Transfer abutment, Osstem Implant Co. Ltd, Busan, Korea), CAD-CAM custom-made abutment (CustomFit abutment, Osstem Implant Co. Ltd, Busan, Korea) and domestically manufactured CAD-CAM custom-made abutment (Myplant, Raphabio Co., Seoul, Korea) were fabricated five each and screws were provided by each company. Fixture and abutments were tightening with 30Ncm according to the manufacturer's instruction and then preloding reverse torque values were measured 3 times repeatedly. Kruskal-Wallis test was used for statistical analysis of the preloading reverse torque values (${\alpha}=.05$). After specimens were embedded into epoxy resin, wet cutting and polishing was performed and FE-SEM imaging was performed, on the contact interface. Results: The pre-loading reverse torque values were $26.0{\pm}0.30Ncm$ (ready-made abutment; Transfer abutment) and $26.3{\pm}0.32Ncm$ (CAD-CAM custom-made abutment; CustomFit abutment) and $24.7{\pm}0.67Ncm$ (CAD-CAM custom-made abutment; Myplant). The domestically manufactured CAD-CAM custom-made abutment (Myplant abutment) presented lower pre-loading reverse torque value with statistically significant difference than that of the ready-made abutment (Transfer abutment) and CAD-CAM custom-made abutment (CustomFit abutment) manufactured from the same company (P=.027) and showed marginal gap in the fixture-abutment interface. Conclusion: Within the limitation of the present in-vitro study, in domestically manufactured CAD-CAM custom-made abutment (Myplant abutment) showed lower screw joint stability and fitness between fixture and abutment.

Quality Characteristics of Ginseng Seed Oil Obtained by Different Extraction Methods (추출방법에 따른 인삼씨유의 품질특성)

  • Kim, Ji-Eun;Lee, Seul;Yoo, Kyung-Mi;Lee, Kyoung-Hae;Kim, Kyung-Tack;Lee, Myung-Hee;Hwang, In-Kyeong
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.43 no.3
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    • pp.439-445
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    • 2014
  • This study aimed to determine the quality characteristics of ginseng seed oil as well as evaluate the efficacy of ginseng seed oil as a food resource. Ginseng seed oil was obtained by different extraction methods; from solvent extraction oil, supercritical fluid extraction oil, and screw pressed extraction oil. Total unsaturated fatty acids were present at 97.72~97.92%. Oleic acid (80.13~81.16%) was the highest, followed by linoleic acid (14.98~15.69%). The total phenol content (mg gallic acid equivalent/100 g oil) was higher in screw pressed extraction oil ($56.32{\pm}1.47$) compared to others. ${\gamma}$-Tocopherol was only present in ginseng seed oil and screw pressed extraction oil showed the highest levels of ${\gamma}$-tocopherol ($5.95{\pm}0.25$ mg/100g oil) among the tested samples. Screw pressed extraction oil showed the greatest oxidative stability with an induction time of 16.58 hours. Acid values and peroxide values of ginseng seed oil increased with increasing storage period. The total phenol and ${\gamma}$-tocopherol contents were higher in screw pressed extraction oil than in other ginseng seed oils, which suggests that screw pressed extraction oil has the greatest oxidative stability.

INFLUENCE OF IMPLANT-ABUTMENT INTERFACE DESIGN, IMPLANT DIAMETER AND PROSTHETIC TABLE WIDTH ON STRENGTH OF IMPLANT-ABUTMENT INTERFACE : THREE-DIMENSIONAL FINITE ELEMENT ANALYSIS (임플랜트의 지대주 연결방식, 임플랜트의 직경 및 지대주 연결부위의 직경 차이에 따른 응력분포에 관한 삼차원 유한요소분석)

  • Oh Se-Woong;Yang Jae-Ho;Lee Sun-Hyung;Han Jung-Suk
    • The Journal of Korean Academy of Prosthodontics
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    • v.41 no.4
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    • pp.393-404
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    • 2003
  • Statement of problem. Higher incidence of prosthetic complications such as screw loosening, screw fracture has been reported for posterior single tooth implant. So, there is ongoing research regarding stability of implant-abutment interface. One of those research is increasing the implant diameter and prosthetic table width to improve joint stability. In another part of this research, internal conical type implant-abutment interface was developed and reported joint strength is higher than traditional external hex interface. Purpose. The purpose of this study is to compare stress distribution in single molar implant between external hex butt joint implant and internal conical joint implant when increasing the implant diameter and prosthetic table width : 4mm diameter, 5mm diameter, 5mm diameter/6mm prosthetic table width. Material and method. Non-linear finite element models were created and the 3-dimensional finite element analysis was performed to see the distribution of stress when 300N static loading was applied to model at $0^{\circ},\;15^{\circ},\;30^{\circ}$ off-axis angle. Results. The following results were obtained : 1. Internal conical joint showed lower tensile stress value than that of external hex butt joint. 2. When off-axis loading was applied, internal conical joint showed more effective stress distribution than external hex butt joint. 3. External hex butt joint showed lower tensile stress value when the implant diameter was increased. 4. Internal conical joint showed lower tensile stress value than external hex butt joint when the implant diameter was increased. 5. Both of these joint mechanism showed lower tensile stress value when the prosthetic table width was increased. Conclusion. Internal conical joint showed more effective stress distribution than external hex joint. Increasing implant diameter showed more effective stress distribution than increasing prosthetic table width.

Clinical Significance of Radiological Stability in Reconstructed Thoracic and Lumbar Spine Following Vertebral Body Resection

  • Sung, Sang-Hyun;Chang, Ung-Kyu
    • Journal of Korean Neurosurgical Society
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    • v.56 no.4
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    • pp.323-329
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    • 2014
  • Objective : Vertebral body replacement following corpectomy in thoracic or lumbar spine is performed with titanium mesh cage (TMC) containing any grafts. Radiological changes often occur on follow-up. This study investigated the relationship between the radiological stability and clinical symptoms. Methods : The subjects of this study were 28 patients who underwent corpectomy on the thoracic or lumbar spine. Their medical records and radiological data were retrospectively analyzed. There were 23 cases of tumor, 2 cases of trauma, and 3 cases of infection. During operation, spinal reconstruction was done with TMC and additional screw fixation. We measured TMC settlement in sagittal plane and spinal angular change in coronal and sagittal plane at postoperative one month and last follow-up. Pain score was also checked. We investigated the correlation between radiologic change and pain status. Whether factors, such as the kind of graft material, surgical approach, and fusion can affect the radiological stability or not was analyzed as well. Results : Mean follow-up was 23.6 months. During follow-up, $2.08{\pm}1.65^{\circ}$ and $6.96{\pm}2.08^{\circ}$ of angular change was observed in coronal and sagittal plane, respectively. A mean of cage settlement was $4.02{\pm}2.83mm$. Pain aggravation was observed in 4 cases. However, no significant relationship was found between spinal angular change and pain status (p=0.518, 0.458). Cage settlement was seen not to be related with pain status, either (p=0.644). No factors were found to affect the radiological stability. Conclusion : TMC settlement and spinal angular change were often observed in reconstructed spine. However, these changes did not always cause postoperative axial pain.

The Change of Motion Ranges of Adjacent Vertebral Joints after Lumbar Fusion Operation (요추 고정수술 후 인접척추 운동범위의 변화)

  • Yeo, Sang-Jun;Park, Seung-Won;Kim, Young-Baeg;Hwang, Sung-Nam;Choi, Duck-Young;Suk, Jong-Sik;Chung, Dong-Kue;Min, Byung-Kook
    • Journal of Korean Neurosurgical Society
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    • v.29 no.11
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    • pp.1456-1460
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    • 2000
  • Objectives : Transpedicular screw fixation has become an important method for internal fixation in variety of disorders. However, acceleration of degeneration at the adjacent segment in any follow. The goal of this study is to review the change of motion ranges of vertebral joints adjacent to fused level in lumbar spine. Methods : This study consists of 22 patients with degenerative spinal instability. Treatment of spinal instability includes posterior fusion with transpedicular screw fixation or transpedicular screw fixation with posterior lumbar interbody fusion. The flexion-extension angle(FEA) was measured from dynamic views of lumbar spine taken both at preoperative and post operative period. Results : The FEA of upper vertebral joint adjacent(FEA-u) to a fused L4-5 level was increased(p=0.010). The FEA-u was increased in case of L5-S1 fusion(p=0.025). The change of FEA-u in case of L5-S1 fusion was greater than that in L4-5 fusion(p=0.013). Conclusion : After L4-5 fusion, there seems to be more meaningful increase in FEA of L3-4 than that of L5-S1. The reason may be due to the damage of L3-4 facet joints during the operation, the other possible explanation may be the anatomical stability of L5-S1 vertebral joint. The change of FEA-u of L5-S1 fusion is increased more than that of L4-5 fusion. Because there are compensations in the adjacent vertebrae both above and below the fused L4-5, the compensatory motion in FEA-u of L5-S1 fusion was greater than that of the L4-5 fusion.

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