P157. Biomechanics of Posterior Hybrid Constructs Using Laminar Hooks and Pedicle Screws in Short-segment Thoracic Fixation

2007 ◽  
Vol 7 (5) ◽  
pp. 155S ◽  
Author(s):  
Alexander Jones ◽  
Mark Kayanja ◽  
Ryan Milks ◽  
Isador Lieberman
Keyword(s):  
Pedicle Screws ◽  
Short Segment ◽  
Laminar Hooks

Biomechanical evaluation of pedicle screws versus pedicle and laminar hooks in the thoracic spine

2006 ◽  
Vol 6 (4) ◽  
pp. 444-449 ◽  
Author(s):  
Andrew Cordista ◽  
Bryan Conrad ◽  
MaryBeth Horodyski ◽  
Sheri Walters ◽  
Glenn Rechtine
Keyword(s):  
Thoracic Spine ◽  
Pedicle Screws ◽  
Biomechanical Evaluation ◽  
Laminar Hooks

scholarly journals Is It Necessary to Reduce Thoracolumbar Compression Fractures  with Intermediate Screws in the Fractured Vertebra?

2021 ◽  
Author(s):  
ZeJun Xing ◽  
Shuai Hao ◽  
XiaoFei Wu
Keyword(s):  
Blood Loss ◽  
Body Height ◽  
Pedicle Screws ◽  
Operation Time ◽  
Short Segment ◽  
Compression Fractures ◽  
Significant Difference ◽  
Before And After ◽  
Screw Group

Abstract PurposeTo compare the efficacy and safety of percutaneous short-segment pedicle screws fixation (PPSF) with or without intermediate screws (IS) for the treatment of thoracolumbar compression fractures.MethodsFrom January 2016 to March 2019, a retrospective study of 38 patients with thoracolumbar compression fractures conducted. The patients were divided into a 4-screw group (without IS) and a 6-screw group (with IS) according to whether pedicle screws were placed in the fractured vertebrae. Combined positional reduction effects with the technique of pre-contoured lordotic rods were used to reduce the fracture by lengthening the anterior column of the fractured vertebrae. The posterior structure of the fractured vertebrae was undertaken as the fulcrum point for both groups. The operation time, intra-operative blood loss, visual analogue scale (VAS), anterior vertebral body height (AVBH), segment kyphosis（SK）before and after operation and complications were recorded.ResultsAlthough the operation time and blood loss in the 6-screw group were higher than in the 4-screw group, difference was not significant (P＞0.05). There was no significant difference in VAS, AVBH and SK between the two groups (P＞0.05). Nevertheless, these results were significant differences between the preoperative and the immediate postoperative, between preoperative and follow-up groups (P < 0.001). No neurologic injury was observed in either groups. ConclusionsIn the treatment of thoracolumbar compression fractures, percutaneous short-segment pedicle screws fixation without intermediate screws in the 4-screw construct may obtain the same clinical effect as that in the 6-screw construct.

Crossed-screw fixation of the unstable thoracic and lumbar spine

1995 ◽  
Vol 82 (1) ◽  
pp. 11-16 ◽  
Author(s):  
Edward C. Benzel ◽  
Nevan G. Baldwin
Keyword(s):  
Vertebral Body ◽  
Screw Fixation ◽  
Three Dimensional ◽  
Deformity Correction ◽  
Pedicle Screws ◽  
Short Segment ◽  
Content Type ◽  
Thoracic And Lumbar Spine ◽  
Spinal Segments ◽  
Fine Print

✓ An ideal spinal construct should immobilize only the unstable spinal segments, and thus only the segments fused. Pedicle fixation techniques have provided operative stabilization with the instrumentation of a minimal number of spinal segments; however, some failures have been observed with pedicle instrumentation. These failures are primarily related to excessive preload forces and limitations caused by the size and orientation of the pedicles. To circumvent these problems, a new technique, the crossed-screw fixation method, was developed and is described in this report. This technique facilitates short-segment spinal fixation and uses a lateral extracavitary approach, which provides generous exposure for spinal decompression and interbody fusion. The technique employs two large transverse vertebral body screws (6.5 to 8.5 mm in diameter) to bear axial loads, and two unilateral pedicle screws (placed on the side of the exposure) to restrict flexion and extension deformation around the transverse screws and to provide three-dimensional deformity correction. The horizontal vertebral body and the pedicle screws are connected to rods and then to each other via rigid crosslinking. The transverse vertebral body screws are unloaded during insertion by placing the construct in a compression mode after the interbody bone graft is placed, thus optimizing the advantage gained by the significant “toe-in” configuration provided and further decreasing the chance for instrumentation failure. The initial results of this technique are reported in a series of 10 consecutively treated patients, in whom correction of the deformity was facilitated. Follow-up examination (average 10.1 months after surgery) demonstrated negligible angulation. Chronic pain was minimal. The crossed-screw fixation technique is biomechanically sound and offers a rapid and safe form of short-segment three-dimensional deformity correction and solid fixation when utilized in conjunction with the lateral extracavitary approach to the unstable thoracic and lumbar spine. This approach also facilitates the secure placement of an interbody bone graft.

The Use of Crosslinks with Posterior Pedicular Screw Fixation in Lumbar Spondylolisthesis

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Hossam El Huseiny ◽  
Ahmed El-Narsh ◽  
Amr El-Shehaby ◽  
Sherif Hashim ◽  
Mohamed M Mohasseb
Keyword(s):  
Pedicle Screw ◽  
Sagittal Alignment ◽  
Screw Fixation ◽  
Pedicle Screws ◽  
Slip Angle ◽  
Short Segment ◽  
Pedicular Screw ◽  
Significant Difference ◽  
Cross Links ◽  
Lumbar Spondylolisthesis

Abstract Background Pedicle screw instrumentation has gained wide popularity for stabilization of spinal fusions. The use of pedicle screw fixation has increased fusion rates. The placement of segmental pedicle screws and cross-links in short segment posterior pedicle screw constructs has been shown to increase the construct stiffness in some planes. Aim of the Work to evaluate addition of crosslinks to posterior pedicular screw fixation as a modality for surgical management of lumbar spondylolisthesis. Patients and Methods This study included 50 patients with lumbar spondylolisthesis divided into two groups according to the surgical approach used in treatment. One group with Posterolateral fixation by transpedicular screws and rods and the other Group had cross-links added to the posterior construct. Results There was no significant difference in postoperative JOA score between both groups, while comparing mean of preoperative and postoperative JOA scores in each group showed a significant rise of the score in each group after surgery. There was no significant difference in the variables of postoperative sagittal alignment between both groups, while comparing mean of preoperative and postoperative sagittal alignment variables in each group revealed a significant reduction of the disc height percent in both groups, and in slip angle and lumbar lordosis angle in group B. Regarding postoperative rate and degree of improvement in the studied groups, there was no significant difference in the rate and degree of improvement between both groups. Conclusion no appreciable benefit from using cross-links was found in short-segment fixation of lumbar spondylolisthesis, where there’s no or little torsional instability encountered.

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