Pull-out strength of pedicle hooks with fixation screws: influence of screw length and angulation

Berlemann, U.; Cripton, Peter A.; Bincon, L.; Nolte, Lutz‐Peter; Schläpfer, F

doi:10.1007/bf00307831

Cited by 23 publications

(13 citation statements)

References 3 publications

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“…The use of the pedicle hook as a guide for the drilling of a small 3.2-mm fixation screw makes the insertion of the SPH safer than conventional pedicle screws [1,2]. By placing the SPH at the apex of the curve, we therefore achieved a strong segmental fixation which is close to the stability achieved with classic pedicle screws [5]. Another advantage SPH offer over classic hooks is that they will not displace during the correction maneuvers as they are solidly fixed to the vertebra.…”

Section: Discussionmentioning

confidence: 81%

Adolescent idiopathic thoracic scoliosis: apical correction with specialized pedicle hooks

Arlet

Papin

Marchesi

et al. 1999

European Spine Journal

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Section: Discussionmentioning

confidence: 81%

Adolescent idiopathic thoracic scoliosis: apical correction with specialized pedicle hooks

Arlet

Papin

Marchesi

et al. 1999

European Spine Journal

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“…Pedicular screw fixation allows for a transmission of the derotation force to the center of the vertebra and permits a true segmental scoliosis correction [1,92]. Due to the decreasing pedicle diameter in the upper thoracic spine [176], pedicle screws are combined with hooks or, as a further development, pedicle hooks with screw fixation [7]. A disturbing complication of Harrington instrumentation was the development of a flatback syndrome due to the reduction in thoracic kyphosis and lumbar lordosis by distraction [89,125].…”

Section: Scoliosismentioning

confidence: 99%

Pedicle screw fixation in spinal disorders: A European view

1997

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Continuing controversy over the use of pedicular fixation in the United States is promoted by the lack of governmental approval for the marketing of these devices due to safety and efficacy concerns. These implants have meanwhile become an invaluable part of spinal instrumentation in Europe. With regard to the North American view, there is a lack of comprehensive reviews that consider the historical evolution of pedicle screw systems, the rationales for their application, and the clinical outcome from a European perspective. This literature review suggests that pedicular fixation is a relatively safe procedure and is not associated with a significantly higher complication risk than non-pedicular instrumentation. Pedicle screw fixation provides short, rigid segmental stabilization that allows preservation of motion segments and stabilization of the spine in the absence of intact posterior elements, which is not possible with non-pedicular instrumentation. Fusion rates and clinical outcome in the treatment of thoracolumbar fractures appear to be superior to that achieved using other forms of treatment. For the correction of spinal deformity (i.e., scoliosis, kyphosis, spondylolisthesis, tumor), pedicular fixation provides the theoretical benefit of rigid segmental fixation and of facilitated deformity correction by a posterior approach, but the clinical relevance so far remains unknown. In low-back pain disorders, a literature analysis of 5,600 cases of lumbar fusion with different techniques reveals a trend that pedicle screw fixation enhances the fusion rate but not clinical outcome. The most striking finding in the literature is the large range in the radiological and clinical results. For every single fusion technique poor and excellent results have been described. This review argues that European spine surgeons should begin to back up the evident benefits of pedicle screw systems for specific spinal disorders by controlled prospective clinical trials. This may prevent forthcoming medical licensing authorities from restricting the use of pedicle screw devices and dictating the practice of spinal surgery in Europe in the near future.

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“…Pedicle screw-assisted instrumentation, however, provides more rigid fixation. 4,11,15,23,24,31,44 An understanding of pedicle screw biomechanics, bone quality, pedicle morphometry, complications, and salvage options is required when placing pedicle screw constructs.…”

Section: Thoracic Pedicle Screw Fixationmentioning

confidence: 99%

Thoracic pedicle screw fixation for spinal deformity

Rosner

Polly

Kuklo

et al. 2003

FOC

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Techniques to improve segmental fixation have advanced the ability to correct complex spinal deformity. The purpose of instrumentation is to correct spinal deformity or to stabilize the spine to enhance the long-term biological fusion. The ultimate goal of spinal deformity surgery is the creation of a stable, balanced, pain-free spine centered over the pelvis in the coronal and sagittal planes. The minimum number of segments should be fused. These concepts remain challenging in the setting of deformity and instability. Successful results can be obtained if the surgeon understands the technology available, its capabilities, biological limitations, and the desired solution. The authors prefer to use thoracic pedicle screws when treating patients with spinal deformity because they provide greater corrective forces for realignment. This allows shorter-segment constructs and the possibility of true derotation in correction. In this article the authors focus on the use of thoracic transpedicular screw fixation in the management of complex spinal disorders and deformity.

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Pull-out strength of pedicle hooks with fixation screws: influence of screw length and angulation

Cited by 23 publications

References 3 publications

Adolescent idiopathic thoracic scoliosis: apical correction with specialized pedicle hooks

Adolescent idiopathic thoracic scoliosis: apical correction with specialized pedicle hooks

Pedicle screw fixation in spinal disorders: A European view

Thoracic pedicle screw fixation for spinal deformity

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