Efficiency of Long Lateral Mass Screws

Watanabe, Seiya; Nakanishi, Kazuo; Misaki, Kosuke; Uchino, Kenji; Iba, Hideaki; Shimizu, Takachika

doi:10.3390/jcm11071953

Cited by 3 publications

(3 citation statements)

References 17 publications

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“…Here, we report a new trajectory and technique for the placement of a long lateral mass screw (LLMS) versus a Lateral mass screw (LMS) that should facilitate stronger posterior cervical spine fusion. [ 4 ] We report a short technical note of the insertion torque of LLMS.…”

Section: Introductionmentioning

confidence: 99%

Investigation of long lateral mass screw insertion torque

Watanabe,

Nakanishi,

Sugimoto

et al. 2024

Surgical Neurology International

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Background: Here, we assessed a new trajectory and insertion torque for the placement of a long lateral mass screw (LLMS) that offers stronger posterior fixation versus a shorter lateral mass screw (LMS) in the posterior cervical spine. We report a short technical note of the insertion torque of LLMS. Methods: The insertion trajectory/torque was evaluated in 30 patients (10 males and 20 females) undergoing posterior cervical LLMS fusions (2021–2023). Patients averaged 65 years of age. Pathology included eight cervical spine injuries, ten cord injuries, four dislocations/fractures, and eight other entities. Variables studied included the length of the LLMS inserted from C3–7, screw deviation rates, insertion torque, and adverse events. Results: A total of 146 screws were inserted: 11 pedicle screws (PSs) and 135 LLMS. The average insertion torque was 105.9 cNm for PS and 64.9 cNm for LLMS. As the screw lengthened by 1 mm, the insertion torque increased by approximately 4.4 cNm. Conclusion: Here, we documented that the insertion torque of LLMS was 66.1 cNm, greater than the 51.0 cNm for LMS, which should provide stronger posterior cervical fixation.

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Section: Introductionmentioning

confidence: 99%

Investigation of long lateral mass screw insertion torque

Watanabe,

Nakanishi,

Sugimoto

et al. 2024

Surgical Neurology International

Self Cite

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“…Numerous studies have confirmed that the LMS technique exhibited a lower risk of neurovascular injury and was more straightforward, safer, and more effective than other fixation techniques in posterior cervical surgery. 3,4 However, the advantages are highly dependent on the lateral mass bone quality of cervical vertebrae. Situations, such as LMS mal-positioning, screw loosening, and screw cutout, remain the major challenges spine surgeons face.…”

Section: Introductionmentioning

confidence: 99%

“…The screw fixation technique provides sufficient stability and allows the surgeon to place the screws under direct visualization. Numerous studies have confirmed that the LMS technique exhibited a lower risk of neurovascular injury and was more straightforward, safer, and more effective than other fixation techniques in posterior cervical surgery 3,4 …”

Section: Introductionmentioning

confidence: 99%

A Novel Semi‐Cannulated Screw Enhanced Bone Cement Augmentation and Pullout Strength in Posterior Cervical Lateral Mass Screw Fixations: An In Vitro Biomechanical and Morphological Study

Canyang,

Weidong,

Zhiping

et al. 2023

Orthopaedic Surgery

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ObjectiveTo develop a novel semi‐cannulated lateral mass screw (SC‐LMS) for cervical posterior fixations and compare the fixation stability and safety of SC‐LMS with regular solid lateral mass screw (S‐LMS) in bone cement augmentation and pullout strength using fresh cadaveric cervical vertebrae.MethodsThe conventional multiaxial screw for cervical lateral mass fixation was modified to a cannulated screw with two lateral holes, used for bone cement injection in situ. Eight fresh human cervical vertebrae (C3, C4, and C5) were collected and used. μCT scan was performed to evaluate the bone quality of the lateral masses, including bone mineral density (BMD), trabecular thickness (Tb.Th), and trabecular separation (Tb.Sp). SCLMS or S‐LMS were randomly inserted into the paired cervical vertebrae and pulled out as a screw loosening model. These screws were reinserted in with bone cement augmentation, scanned by μCT to obtain the bone cement distribution along the screws, and pulled out to test the screw purchase strength.ResultsFmax values exhibited strong positive correlations with the local BMD (𝑟 = 0.8640, p < 0.0001) and Tb.Th (𝑟 = 0.6795, p = 0.0038), whereas a negative correlation with Tb.Sp (𝑟 = −0.5567, p = 0.0251). A significant difference was observed between the Fmax before and after PMMA injection on the SC‐LMS side (p = 0.019). The SC‐LMS exhibited lower risk of cement leakage than S‐LMS after PMMA injection, and a positive correlation was observed between 𝐹max and the distribution volumes on the SC‐LMS side.ConclusionThe novel SC‐LMS provides more robust fixation stability and is safer than the S‐LMS for PMMA augmentation, which may be related to the cement‐screw‐cement‐bone complex formation.

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Efficiency of Long Lateral Mass Screw in Posterior Cervical Fusion

Watanabe,

Nakanishi,

Uchino

et al. 2024

Cureus

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Introduction: Long lateral mass screw (LLMS) technique for posterior cervical fusion has been performed in our hospital since 2019. In this study, the LLMS insertion technique, deviation rate, and insertion torque have been described. Moreover, several major concerns associated with LLMS have been adequately addressed. Methods: This study included 58 patients (43 men and 15 women) who had undergone LLMS surgery at our hospital during the four-year period from December 2019 to December 2023, and were evaluated using postoperative CT. The evaluation parameters included the screw length at each vertebral segment, screw angle in the sagittal section, distance between the screw heads, and complications. Results: The median screw length at C3 was 23.0 mm (22.0-24.0 mm), the screw angle was 36.1° (31.6-41.8°), and the distance between screw heads was 13.8 mm (11.6-17.2 mm). The median screw length at C4 was 22.0 mm (21.0-24.0 mm), the screw angle was 36.2° (28.7-40.7°), and the distance between screw heads was 15.9 mm (13.0-19.0 mm). The median screw length at C5 was 21.0 mm (20.0-22.0 mm), the screw angle was 35.6° (28.0-39.7°), and the distance between screw heads was 17.6 mm (15.1-20.4 mm). The median screw length for C6 was 20.0 mm (19.0-22.0 mm), the screw angle was 29.2° (25.2-36.8°), and the distance between screw heads was 20.4 mm (16.1-24.4 mm). Conclusion: The major limitations of the LLMS technique were inadequate screw angle, difficulty inserting long screws, inadequate decompression, and the inability to perform cervical laminoplasty. However, these limitations did not substantially affect the efficiency of LLMS. LLMS has fewer complications and can insert longer screws than LMS.

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Efficiency of Long Lateral Mass Screws

Cited by 3 publications

References 17 publications

Investigation of long lateral mass screw insertion torque

Investigation of long lateral mass screw insertion torque

A Novel Semi‐Cannulated Screw Enhanced Bone Cement Augmentation and Pullout Strength in Posterior Cervical Lateral Mass Screw Fixations: An In Vitro Biomechanical and Morphological Study

Efficiency of Long Lateral Mass Screw in Posterior Cervical Fusion

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