Cargando…
Pullout strength of different pedicle screws after primary and revision insertion: an in vitro study on polyurethane foam
BACKGROUND: Surgeons are routinely required to remove loose or failed pedicle screws and insert a new screw in their place. However, inserting a new screw into an existing hole may compromise the holding capacity of the pedicle screw. The purpose of this study is to evaluate the pullout strength of...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10629141/ https://www.ncbi.nlm.nih.gov/pubmed/37932751 http://dx.doi.org/10.1186/s12891-023-07015-3 |
_version_ | 1785131902757240832 |
---|---|
author | Wu, Lien-Chen Hsieh, Yueh-Ying Tsuang, Fon-Yih Kuo, Yi-Jie Chen, Chia-Hsien Chiang, Chang-Jung |
author_facet | Wu, Lien-Chen Hsieh, Yueh-Ying Tsuang, Fon-Yih Kuo, Yi-Jie Chen, Chia-Hsien Chiang, Chang-Jung |
author_sort | Wu, Lien-Chen |
collection | PubMed |
description | BACKGROUND: Surgeons are routinely required to remove loose or failed pedicle screws and insert a new screw in their place. However, inserting a new screw into an existing hole may compromise the holding capacity of the pedicle screw. The purpose of this study is to evaluate the pullout strength of pedicle screws with different thread designs after the primary insertion and revision surgery in a synthetic bone model. METHODS: Four pedicle screws with different thread designs (single-lead-thread (SLT) screw, dual-lead-thread (DLT) screw, mixed-single-lead-thread (MSLT) screw, and proximal-unthreaded-dual-thread (PUDL) screw) were inserted into pre-drilled, untapped holes (ø 4.2 mm, length 35 mm) in Sawbone blocks of density 20 pcf. In the first sequence, a 6.0 mm screw was inserted into the predrilled foam block and the primary pullout strength of the screw was measured according to ASTM F543. In the second sequence, a 6.0 mm screw was inserted and removed, and then either a 6.5 mm screw of the same design or a different screw design was inserted into the same hole and the pullout strength recorded. RESULTS: In the first sequence, the mean pullout strength of the MSLT screw was significantly (p < 0.05) greater than all other screw designs. In the second sequence, when the MSLT screw was the primary screw, using a larger MSLT screw (6.5 mm) as the revision screw did not lead to a higher pullout strength than if a 6.0 mm diameter PUDL screw was used for the revision. Using a larger DLT screw (6.5 mm) as the revision screw resulted in a significantly (p < 0.05) greater pullout strength than a 6.0 mm STL, DLT, MSLT, or PUDL screw. CONCLUSIONS: Our results indicate that employing classic oversizing of the same screw design is a safe choice for maintaining screw purchase in the bone after revision. In cases where oversizing with the same screw design is not practical, opting for a PUDL screw with the same original diameter can provide enough purchase in the bone to maintain stability. |
format | Online Article Text |
id | pubmed-10629141 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-106291412023-11-08 Pullout strength of different pedicle screws after primary and revision insertion: an in vitro study on polyurethane foam Wu, Lien-Chen Hsieh, Yueh-Ying Tsuang, Fon-Yih Kuo, Yi-Jie Chen, Chia-Hsien Chiang, Chang-Jung BMC Musculoskelet Disord Research BACKGROUND: Surgeons are routinely required to remove loose or failed pedicle screws and insert a new screw in their place. However, inserting a new screw into an existing hole may compromise the holding capacity of the pedicle screw. The purpose of this study is to evaluate the pullout strength of pedicle screws with different thread designs after the primary insertion and revision surgery in a synthetic bone model. METHODS: Four pedicle screws with different thread designs (single-lead-thread (SLT) screw, dual-lead-thread (DLT) screw, mixed-single-lead-thread (MSLT) screw, and proximal-unthreaded-dual-thread (PUDL) screw) were inserted into pre-drilled, untapped holes (ø 4.2 mm, length 35 mm) in Sawbone blocks of density 20 pcf. In the first sequence, a 6.0 mm screw was inserted into the predrilled foam block and the primary pullout strength of the screw was measured according to ASTM F543. In the second sequence, a 6.0 mm screw was inserted and removed, and then either a 6.5 mm screw of the same design or a different screw design was inserted into the same hole and the pullout strength recorded. RESULTS: In the first sequence, the mean pullout strength of the MSLT screw was significantly (p < 0.05) greater than all other screw designs. In the second sequence, when the MSLT screw was the primary screw, using a larger MSLT screw (6.5 mm) as the revision screw did not lead to a higher pullout strength than if a 6.0 mm diameter PUDL screw was used for the revision. Using a larger DLT screw (6.5 mm) as the revision screw resulted in a significantly (p < 0.05) greater pullout strength than a 6.0 mm STL, DLT, MSLT, or PUDL screw. CONCLUSIONS: Our results indicate that employing classic oversizing of the same screw design is a safe choice for maintaining screw purchase in the bone after revision. In cases where oversizing with the same screw design is not practical, opting for a PUDL screw with the same original diameter can provide enough purchase in the bone to maintain stability. BioMed Central 2023-11-07 /pmc/articles/PMC10629141/ /pubmed/37932751 http://dx.doi.org/10.1186/s12891-023-07015-3 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Wu, Lien-Chen Hsieh, Yueh-Ying Tsuang, Fon-Yih Kuo, Yi-Jie Chen, Chia-Hsien Chiang, Chang-Jung Pullout strength of different pedicle screws after primary and revision insertion: an in vitro study on polyurethane foam |
title | Pullout strength of different pedicle screws after primary and revision insertion: an in vitro study on polyurethane foam |
title_full | Pullout strength of different pedicle screws after primary and revision insertion: an in vitro study on polyurethane foam |
title_fullStr | Pullout strength of different pedicle screws after primary and revision insertion: an in vitro study on polyurethane foam |
title_full_unstemmed | Pullout strength of different pedicle screws after primary and revision insertion: an in vitro study on polyurethane foam |
title_short | Pullout strength of different pedicle screws after primary and revision insertion: an in vitro study on polyurethane foam |
title_sort | pullout strength of different pedicle screws after primary and revision insertion: an in vitro study on polyurethane foam |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10629141/ https://www.ncbi.nlm.nih.gov/pubmed/37932751 http://dx.doi.org/10.1186/s12891-023-07015-3 |
work_keys_str_mv | AT wulienchen pulloutstrengthofdifferentpediclescrewsafterprimaryandrevisioninsertionaninvitrostudyonpolyurethanefoam AT hsiehyuehying pulloutstrengthofdifferentpediclescrewsafterprimaryandrevisioninsertionaninvitrostudyonpolyurethanefoam AT tsuangfonyih pulloutstrengthofdifferentpediclescrewsafterprimaryandrevisioninsertionaninvitrostudyonpolyurethanefoam AT kuoyijie pulloutstrengthofdifferentpediclescrewsafterprimaryandrevisioninsertionaninvitrostudyonpolyurethanefoam AT chenchiahsien pulloutstrengthofdifferentpediclescrewsafterprimaryandrevisioninsertionaninvitrostudyonpolyurethanefoam AT chiangchangjung pulloutstrengthofdifferentpediclescrewsafterprimaryandrevisioninsertionaninvitrostudyonpolyurethanefoam |