Application of Cortical Bone Trajectory Screws in Elderly Patients with Lumbar Spinal Tuberculosis

Shi, Shiyuan; Ying, Xiaozhang; Zheng, Qi; Zhu, Bo; Jin, Yanghui; Shen, Jian Ren; Zheng, Mingfeng; Hu, Shunping

doi:10.1016/j.wneu.2018.05.168

Cited by 13 publications

(14 citation statements)

References 33 publications

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“…[14,15] Furthermore, several clinical studies have compared outcomes and complications between 2 techniques. [11,16,17,18,19,20,21,22,23,24,25,26,27,28] However, there is no clear conclusion on which technique, CBT or PS, is better. Therefore, we performed a meta-analysis to evaluate the clinical results between CBT screw technique and PS technique in lumbar fusion surgery.…”

Section: Introductionmentioning

confidence: 99%

Comparison of cortical bone trajectory versus pedicle screw techniques in lumbar fusion surgery

Yang

et al. 2019

Medicine

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Background:Biomechanical studies have demonstrated that cortical bone trajectory (CBT) screw can provide a 30% increase in uniaxial yield pullout load than pedicle screw (PS). In addition, the insertion torque of CBT screw is 1.71 times higher than that of PS. A meta-analysis was conducted to evaluate clinical results between CBT screw technique and PS technique in lumbar fusion surgery.Methods:An extensive search of literature was performed in PubMed, Embase, the Cochrane library. The following outcomes were extracted: visual analog scale (VAS), Oswestry disabilities index (ODI), Japanese Orthopaedic Association (JOA) score, complications, fusion rates, hospital stay, incision length, blood loss, and operation time. Data analysis was conducted with RevMan 5.3 and STATA 12.0.Results:A total of 12 studies were included in the final analysis. The results indicated that CBT group with less blood loss [P < .01], less hospital stay [P < .01], and less incision length [P < .01] than PS group. There were no significant differences between 2 groups in other clinical parameters and outcomes.Conclusion:CBT technique provided similar clinical outcomes and fusion rates compared to PS technique in lumbar fusion surgery. However, CBT technique provided additional benefits of less blood loss, less hospital stay, and less incision length.

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Section: Introductionmentioning

confidence: 99%

Comparison of cortical bone trajectory versus pedicle screw techniques in lumbar fusion surgery

Yang

et al. 2019

Medicine

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“…When compared with the traditional pedicle screw, the CBT screw torque is increased by 1.7 times, and the axial pull-out stress is increased by 30% [9,20]. The advantages of CBT screws for spinal tuberculosis are as follows [10,21]. First, they simplify the surgical procedure, reduce back muscle exfoliation and intraoperative bleeding, and reduce soft tissue damage.…”

Section: Discussionmentioning

confidence: 99%

“…Finally, if necessary, two sets of screws (one conventional pedicle screw and one CBT screw) can be placed in the same pedicle area to improve the osteoporotic bone-screw holding force. It has been reported that the application of a CBT screw combined with a traditional pedicle screw for the treatment of lumbar tuberculosis has achieved ideal clinical results [10,11]. However, the above application does not fully exploit the advantages of the CBT screws used in the intervertebral fixation.…”

Section: Discussionmentioning

confidence: 99%

“…We put the end of the screw into the pre-bent rod and fixed the nut. An effective negative pressure drainage device was placed and sutured to the skin layer by layer [10]. The patient was then placed in a semi-recumbent position.…”

Section: Surgical Methodsmentioning

confidence: 99%

“…It was mainly located in the cortical bone, with its biomechanical strength being enhanced when compared with the traditional pedicle screw [8]. As reported, the application of a CBT screw combined with a traditional pedicle screw has achieved ideal clinical results in treating lumbar tuberculosis [10,11]. However, the above application does not fully exploit the advantages of CBT screws used for an intervertebral fixation.…”

Section: Introductionmentioning

confidence: 99%

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Lumbar Tuberculosis Treatment with Cortical Bone Trajectory Screw Fixation

Shi

Ying

Zheng

et al. 2019

Preprint

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Objective: This study aimed to investigate the clinical efficacy of a cortical bone trajectory (CBT) screw technique combined with an anterior small incision lesion removal and bone grafting for the treatment of single-segment lumbar spinal tuberculosis. Methods: A retrospective analysis of 42 patients with lumbar tuberculosis was performed. The patients were divided into two groups: intervertebral CBT screw fixation group (CBT group) and posterior pedicle screw fixation group (traditional group). Then the surgery time, bleeding volume, postoperative drainage volume, postoperative hospital stay, visual analogue scale (VAS) score, Cobb angle, neurological function (Frankel grading), and bone graft fusion time were compared between the two groups. Results: There were no significant differences between the two groups in terms of the operation times, bleeding volumes, drainage volumes, hospital stays, VAS scores, and Frankel grading. VAS scores, Cobb angles, and Frankel grading improved significantly after surgeries, without a significant difference between the two groups. At the final follow-up, no significant loss of the Cobb angle was found. All of the patients were followed up for 14 to 30 months, with a mean time of 20.8 months. The bone graft fusion time ranged from 3 to 8 months, with a mean time of 5.1 months. There were no serious complications. Conclusions: The CBT screw technique combined with an anterior small incision lesion removal and bone grafting is an effective and safe method for the treatment of lumbar tuberculosis.

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Post‐yielding fracture mechanics of 3D printed polymer‐based orthopedic cortical screws

et al. 2022

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The internal fixation of a fractured bone is generally achieved with bone screws during most orthopedic surgeries. Biodegradable screws have not received as much attention as they deserve. Biodegradable screws reduce the stress‐shielding effect, screw failure, complex, painful revision surgery for screw extraction. The vital focus of the present research is to fabricate cortical bone screws using polylactic acid (PLA) by fused deposition modeling technology. The PLA cortical screws were manufactured with different infill patterns (triangular, honeycomb, grid, and concentric), keeping other parameters constant using three‐dimensional printing. The mechanical behavior and fracture mechanism of different patterned cortical screws were observed based on compression testing and tensile testing of screws. Scanning electron microscopy (SEM) observed the surface topographical features, fracture behavior, and microstructure characterization of different patterned polymeric cortical screws were observed using SEM. Based on the SEM micrographs, mechanical characterization of compression and tensile testing shows the stress, fractures and fatigue cracks propagation at the bone screw interfaces by fractures copy. Moreover, it was observed that the fracture mechanism of ductile to brittle fracture was observed with variation in the infill pattern of the bone screw. The outcomes revealed that the cortical screw with honeycomb infill pattern has the highest compressive and tensile strength than other infill patterns. Honeycomb structured cortical screws have approximately 17% higher compressive strength and 30% higher tensile strength than the triangular patterned cortical screw due to higher bonding surface area at the intercalated layers.

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Application of Cortical Bone Trajectory Screws in Elderly Patients with Lumbar Spinal Tuberculosis

Cited by 13 publications

References 33 publications

Comparison of cortical bone trajectory versus pedicle screw techniques in lumbar fusion surgery

Comparison of cortical bone trajectory versus pedicle screw techniques in lumbar fusion surgery

Lumbar Tuberculosis Treatment with Cortical Bone Trajectory Screw Fixation

Post‐yielding fracture mechanics of 3D printed polymer‐based orthopedic cortical screws

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