Journal article
A Dual-Screw Technique for Vertebral Compression Fractures via Robotic Navigation in the Osteopenic Lumbar Spine: An In-Vitro Biomechanical Analysis
GLOBAL SPINE JOURNAL
15 Jan 2023
PMID: 36644787
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Study Design Biomechanical cadaveric study. Objectives Multi-rod constructs maximize posterior fixation, but most use a single pedicle screw (PS) anchor point to support multiple rods. Robotic navigation allows for insertion of PS and cortical screw (CS) within the same pedicle, providing 4 points of bony fixation per vertebra. Recent studies demonstrated radiographic feasibility for dual-screw constructs for posterior lumbar spinal fixation; however, biomechanical characterization of this technique is lacking. Methods Fourteen cadaveric lumbar specimens (L1-L5) were divided into 2 groups (n = 7): PS, and PS + CS. VCF was simulated at L3. Bilateral posterior screws were placed from L2-L4. Load control (+/- 7.5Nm) testing performed in flexion-extension (FE), lateral bending (LB), axial rotation (AR) to measure ROM of: (1) intact; (2) 2-rod construct; (3) 4-rod construct. Static compression testing of 4-rod construct performed at 5 mm/min to measure failure load, axial stiffness. Results Four-rod construct was more rigid than 2-rod in FE (P < .001), LB (P < .001), AR (P < .001). Screw technique had no significant effect on FE (P = .516), LB (P = .477), or AR (P = .452). PS + CS 4-rod construct was significantly more stable than PS group (P = .032). Stiffness of PS + CS group (445.8 +/- 79.3 N/mm) was significantly greater (P = .019) than PS (317.8 +/- 79.8 N/mm). Similarly, failure load of PS + CS group (1824.9 +/- 352.2 N) was significantly greater (P = .001) than PS (913.4 +/- 309.8 N). Conclusions Dual-screw, 4-rod construct may be more stable than traditional rod-to-rod connectors, especially in axial rotation. Axial stiffness and ultimate strength of 4-rod, dual-screw construct were significantly greater than rod-to-rod. In this study, 4-rod construct was found to have potential biomechanical benefits of increased strength, stiffness, stability.
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Details
- Title
- A Dual-Screw Technique for Vertebral Compression Fractures via Robotic Navigation in the Osteopenic Lumbar Spine: An In-Vitro Biomechanical Analysis
- Publication Details
- GLOBAL SPINE JOURNAL
- Publisher
- SAGE PUBLICATIONS LTD; LONDON
- Grant note
- The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was funded by Globus Medical, Inc.
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Drexel University
- Web of Science ID
- WOS:000914257000001
- Scopus ID
- 2-s2.0-85146355964
- Other Identifier
- 991021860735404721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Clinical Neurology
- Orthopedics