The Wiltse Pedicle Screw Fixation System

Horowitch, Alan; Peek, Richard D.; Thomas, James C.; Widell, Eric H.; Dimartino, Paul P.; Spencer, Curtis W.; Weinstein, J. N.; Wiltse, Leon L.

doi:10.1097/00007632-198904000-00025

Cited by 42 publications

(7 citation statements)

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“…The effect of constrained (rigid) systems in the lumbar spine has already been evaluated [7,34,50], whereas studies for the cervical spine are rare. The higher stability of pedicle screws in comparison with lateral mass screws [26,27] led to a frequent use in the lumbar spine [1,4,5,6,23,32,35] for various spinal disorders, including spondylolisthesis, scoliosis or degenerative conditions, and to a lesser degree in the cervical spine [2,3]. Acceptable complication rates were observed [18,57].…”

Section: Introductionmentioning

confidence: 99%

Effect of constrained posterior screw and rod systems for primary stability: Biomechanical in vitro comparison of various instrumentations in a single-level corpectomy model

et al. 2004

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Cervical corpectomy is a frequently used technique for a wide variety of spinal disorders. The most commonly used approach is anterior, either with or without plating. The results for single-level corpectomy are better than in multilevel procedures. Nevertheless, hardwareor graft-related complications are observed. In the past, constrained implant systems were developed and showed encouraging stability, especially for posterior screw and rod systems in the lumbar spine. In the cervical spine, few reports about the primary stability of constrained systems exist. Therefore, in the present study we evaluated the primary stability of posterior screw and rod systems, constrained and non-constrained, in comparison with anterior plating and circumferential instrumentations in a non-destructive set-up, by loading six human cadaver cervical spines with pure moments in a spine tester. Range of motion and neutral zone were measured for lateral bending, flexion/ extension and axial rotation.

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Section: Introductionmentioning

confidence: 99%

Effect of constrained posterior screw and rod systems for primary stability: Biomechanical in vitro comparison of various instrumentations in a single-level corpectomy model

et al. 2004

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“…As complicações relacionadas à cirurgia são, entre outras, infecção superficial ou profunda, tromboembolismo pulmonar, e várias outras complicações associadas às cirurgias de grande porte. As relacionadas a colocação do parafuso pedicular, relatada por vários autores (3,11,13,15,16,17,20,23,27,28) , são a colocação do parafuso fora do pedículo, podendo provocar lesão radicular, lesão da dura-máter, lesão vascular (26) , e fratura do pedículo. Além disso, pode ocorrer quebra do implante.…”

Section: Introductionunclassified

Anatomical study of lumbar vertebral pedicle and adjacent neural structures

Matuoka

Júnior

2002

Acta ortop. bras.

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RESUMOPara avaliação da morfometria do pedículo vertebral lombar e sua relação com as estruturas neurais, foram dissecados 14 cadáveres do sexo masculino, adultos, onde foram avaliados o tamanho do pedículo vertebral lombar, através da mensuração do seu diâmetro longitudinal e transversal. Os dados obtidos mostraram aumento do pedículo de L2 a L5, tanto no diâmetro longitudinal quanto transversal, sendo o primeiro maior. A relação do pedículo lombar com as estruturas neurais, foram avaliadas através da mensuração da distância da dura-máter à borda medial do pedículo, entre a região mais distal do pedículo à raiz nervosa que emerge abaixo deste e, de maneira indireta, a distância entre o ápice do pedículo à raiz nervosa que emerge acima deste. Os resultados obtidos mostraram que a distância entre a parte mais distal do pedículo e a raiz nervosa que emerge abaixo deste, e a distância entre a borda medial do pedículo à dura-máter, não aumentam de L2 a L5. Quanto à distância entre o ápice do pedículo à raiz nervosa que emerge acima, aumenta de L2 a L5. Localizamos também o gânglio espinhal em relação ao pedículo, sendo que 87% dos gânglios espinhais localizam-se na zona foraminal.Descritores: Cadáver; vértebras lombares; rede nervosa; duramáter; gânglios/espinhais INTRODUÇÃO O método de fixação pedicular da coluna lombar, vem sendo cada vez mais utilizado, nas últimas décadas, para o tratamento de diversas patologias. Esse método foi idealizado devido ao elevado índice de pseudoartrose após artrodese, sem fixação da coluna lombar. Vários autores (22,25) encontraram índices de 5 a 20% de pseudartrose após artrodese póstero-lateral. Thompson et al (24) , avaliaram vários pacientes submetidos a artrodese pela técnica de Hibbs, e encontraram um índice de pseudoartrose de 55%, quando realizadas de L4 a S1, e de 12%, quando de L5 a S1, SUMMARY

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“…Several rigid systems have been developed [5,8]. Compared to the semi-rigid systems, the general principle is that the longitudinal part of the implant is a rod rigidly connected to the pedicle screw.…”

Section: Introductionmentioning

confidence: 99%

Clinical outcome after spinal fusion with a rigid versus a semi-rigid pedicle screw system

et al. 1997

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Several biomechanical studies have evaluated the quality of fusion obtained with a rigid versus a semi-rigid pedicle screw implant. Some studies indicate that increased rigidity of the implant system results in an increased strength of the fusion mass. Other reports have underlined the risk of stress shielding due to rigid implant systems. Based on these findings some authors have recommended the use of a semi-rigid system. There are, however, few studies focusing on any possible difference in clinical outcome between the two different types of implant systems. Questionnaires were sent to 89 patients who had undergone primary spinal fusion with either a rigid or a semi-rigid pedicle-screw-based implant system. In every case the diagnosis was spondylolisthesis or degenerative lumbar disease. The questionnnaires were analysed using forward stepwise logistic regression analysis. Eighty (90%) of the questionnaires were returned. There was a mean follow-up of 4 years (range 2-8 years). It was not possible to demonstrate any difference in clinical outcome between patients undergoing lumbar fusion with a rigid implant system and those given a semirigid system. The overall patient satisfaction rate was 69%, with no difference between the two types of implant. No difference in clinical outcome between the two types of implant was found. Considering the fact that the primary goal of spinal fusion procedure is to obtain a solid fusion mass, biomechanical tests favour the used of a rigid pedicle screw system. This fact combined with the fact that early mobilisation is possible with rigid implants justifies the use of rigid implant systems, although no difference in clinical outcome could be demonstrated in this study.

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The Wiltse Pedicle Screw Fixation System

Cited by 42 publications

References 0 publications

Effect of constrained posterior screw and rod systems for primary stability: Biomechanical in vitro comparison of various instrumentations in a single-level corpectomy model

Effect of constrained posterior screw and rod systems for primary stability: Biomechanical in vitro comparison of various instrumentations in a single-level corpectomy model

Anatomical study of lumbar vertebral pedicle and adjacent neural structures

Clinical outcome after spinal fusion with a rigid versus a semi-rigid pedicle screw system

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