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Is a cross-connector beneficial for single level traditional or cortical bone trajectory pedicle screw instrumentation?

The cortical bone trajectory (CBT) has been introduced with the aim of better screw hold, however, screw-rod constructs with this trajectory might provide less rigidity in lateral bending (LB) and axial rotation (AR) compared to the constructs with the traditional trajectory (TT). Therefore, the add...

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Autores principales: Cornaz, Frédéric, Widmer, Jonas, Fasser, Marie-Rosa, Snedeker, Jess Gerrit, Matsukawa, Keitaro, Spirig, José Miguel, Farshad, Mazda
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8195405/
https://www.ncbi.nlm.nih.gov/pubmed/34115816
http://dx.doi.org/10.1371/journal.pone.0253076
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author Cornaz, Frédéric
Widmer, Jonas
Fasser, Marie-Rosa
Snedeker, Jess Gerrit
Matsukawa, Keitaro
Spirig, José Miguel
Farshad, Mazda
author_facet Cornaz, Frédéric
Widmer, Jonas
Fasser, Marie-Rosa
Snedeker, Jess Gerrit
Matsukawa, Keitaro
Spirig, José Miguel
Farshad, Mazda
author_sort Cornaz, Frédéric
collection PubMed
description The cortical bone trajectory (CBT) has been introduced with the aim of better screw hold, however, screw-rod constructs with this trajectory might provide less rigidity in lateral bending (LB) and axial rotation (AR) compared to the constructs with the traditional trajectory (TT). Therefore, the addition of a horizontal cross-connector could be beneficial in counteracting this possible inferiority. The aim of this study was to compare the primary rigidity of TT with CBT screw-rod constructs and to quantify the effect of cross-connector-augmentation in both. Spines of four human cadavers (T9 –L5) were cropped into 15 functional spine units (FSU). Eight FSUs were instrumented with TT and seven FSUs with CBT pedicle screws. The segments were tested in six loading directions in three configurations: uninstrumented, instrumented with and without cross-connector. The motion between the cranial and caudal vertebra was recorded. The range of motion (ROM) between the CBT and the TT group did not differ significantly in either configuration. Cross-connector -augmentation did reduce the ROM in AR (16.3%, 0.27°, p = 0.02), LB (2.9%, 0.07°, p = 0.03) and flexion-extension FE (2.3%, 0.04°, p = 0.02) for the TT group and in AR (20.6%, 0.31°, p = 0.01) for the CBT-group. The primary rigidity of TT and CBT single level screw-rod constructs did not show significant difference. The minimal reduction of ROM due to cross-connector-augmentation seems clinically not relevant. Based on the findings of these study there is no increased necessity to use a cross-connector in a CBT-construct.
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spelling pubmed-81954052021-06-21 Is a cross-connector beneficial for single level traditional or cortical bone trajectory pedicle screw instrumentation? Cornaz, Frédéric Widmer, Jonas Fasser, Marie-Rosa Snedeker, Jess Gerrit Matsukawa, Keitaro Spirig, José Miguel Farshad, Mazda PLoS One Research Article The cortical bone trajectory (CBT) has been introduced with the aim of better screw hold, however, screw-rod constructs with this trajectory might provide less rigidity in lateral bending (LB) and axial rotation (AR) compared to the constructs with the traditional trajectory (TT). Therefore, the addition of a horizontal cross-connector could be beneficial in counteracting this possible inferiority. The aim of this study was to compare the primary rigidity of TT with CBT screw-rod constructs and to quantify the effect of cross-connector-augmentation in both. Spines of four human cadavers (T9 –L5) were cropped into 15 functional spine units (FSU). Eight FSUs were instrumented with TT and seven FSUs with CBT pedicle screws. The segments were tested in six loading directions in three configurations: uninstrumented, instrumented with and without cross-connector. The motion between the cranial and caudal vertebra was recorded. The range of motion (ROM) between the CBT and the TT group did not differ significantly in either configuration. Cross-connector -augmentation did reduce the ROM in AR (16.3%, 0.27°, p = 0.02), LB (2.9%, 0.07°, p = 0.03) and flexion-extension FE (2.3%, 0.04°, p = 0.02) for the TT group and in AR (20.6%, 0.31°, p = 0.01) for the CBT-group. The primary rigidity of TT and CBT single level screw-rod constructs did not show significant difference. The minimal reduction of ROM due to cross-connector-augmentation seems clinically not relevant. Based on the findings of these study there is no increased necessity to use a cross-connector in a CBT-construct. Public Library of Science 2021-06-11 /pmc/articles/PMC8195405/ /pubmed/34115816 http://dx.doi.org/10.1371/journal.pone.0253076 Text en © 2021 Cornaz et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Cornaz, Frédéric
Widmer, Jonas
Fasser, Marie-Rosa
Snedeker, Jess Gerrit
Matsukawa, Keitaro
Spirig, José Miguel
Farshad, Mazda
Is a cross-connector beneficial for single level traditional or cortical bone trajectory pedicle screw instrumentation?
title Is a cross-connector beneficial for single level traditional or cortical bone trajectory pedicle screw instrumentation?
title_full Is a cross-connector beneficial for single level traditional or cortical bone trajectory pedicle screw instrumentation?
title_fullStr Is a cross-connector beneficial for single level traditional or cortical bone trajectory pedicle screw instrumentation?
title_full_unstemmed Is a cross-connector beneficial for single level traditional or cortical bone trajectory pedicle screw instrumentation?
title_short Is a cross-connector beneficial for single level traditional or cortical bone trajectory pedicle screw instrumentation?
title_sort is a cross-connector beneficial for single level traditional or cortical bone trajectory pedicle screw instrumentation?
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8195405/
https://www.ncbi.nlm.nih.gov/pubmed/34115816
http://dx.doi.org/10.1371/journal.pone.0253076
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