Journal of Biomedical Engineering Research (대한의용생체공학회:의공학회지)

The Korean Society of Medical and Biological Engineering (대한의용생체공학회)
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Mechanical Performance Comparison of Pedicle Screw Based on Design Parameters: Dual Lead and Dual Pitch

척추경 나사못의 디자인이 고정력 및 구동 토크에 미치는 영향 분석: 이중 나사 및 이중 피치 나사

  • Choi, Sun-Gak (Department of Biomedical Engineering, Chungbuk National University) ;
  • Cha, Eun-Jong (Department of Biomedical Engineering, Chungbuk National University) ;
  • Kim, Kyung-Ah (Department of Biomedical Engineering, Chungbuk National University) ;
  • Ahn, Yoon-Ho (Department of Biomedical Engineering, Chungbuk National University)
  • 최선각 (충북대학교 의용생체공학과) ;
  • 차은종 (충북대학교 의용생체공학과) ;
  • 김경아 (충북대학교 의용생체공학과) ;
  • 안윤호 (충북대학교 의용생체공학과)
  • Received : 2018.04.10
  • Accepted : 2018.05.28
  • Published : 2018.06.30
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Abstract

One of the most common problems with pedicle screw system is pullout of the screw. This study was performed to evaluate the pullout strength and driving torque of newly designed pedicle screws. The design of three type screws were standard pedicle screw, which had single lead threaded and single pitched design (Type A), single pitched and dual lead threaded pedicle screw (Type B), dual pitched and dual lead threaded pedicle screw (Type C), respectively. The tests were performed in accordance with the ASTM standards using polyurethane (PU) foam blocks. There was no significant difference in pullout strength among three types of screw. Type B and Type C exhibited higher insertion torque and removal torque than Type A, respectively (p<0.05). Pedicle screws newly developed with dual pitched and dual lead threaded design showed higher driving torque without decrease in pullout strength compared to the standard pedicle screw and could be inserted more rapidly with the same number of revolutions.

Keywords

References

  1. O. Yaman, T. Demir, A.K. Arslan, M.A. Iyidiker, T. Tolunay, N. Camuscu, M. Ulutas, "The comparison of pullout strengths of various pedicle screw designs on synthetic foams and ovine vertebrae," Turk Neurosurg., vol. 25, no. 4, pp. 532-538, 2015.
  2. C.S. Chen, W.J. Chen, C.K. Cheng, et al., "Failure analysis of broken pedicle screws on spinal instrumentation," Medical Engineering and Physics, vol. 27, pp. 487-496, 2005. https://doi.org/10.1016/j.medengphy.2004.12.007
  3. S. Vishnubhotla, W.B. Mcgarry, A.T. Mahar, D.E. Gelb, "A titanium expandable pedicle screw improves initial pullout strength as compared with standard pedicle screws," Spine, vol. 11, pp. 777-781, 2011. https://doi.org/10.1016/j.spinee.2011.06.006
  4. S. Wan, W. Lei, Z. Wu, D. Liu, M. Gao, S. Fu, "Biomechanical and histological evaluation of an expandable pedicle screw in osteoporotic spine in sheep," Eur Spine, vol. 19, pp. 2122-2129, 2010. https://doi.org/10.1007/s00586-010-1489-4
  5. B.B. Abshire, R.F. McLain, A. Valdevit, H.E. Kambic, "Characteristics of pullout failure in conical and cylindrical pedicle screws after full insertion and back-out," Spine, vol. 1, pp. 408-414, 2001. https://doi.org/10.1016/S1529-9430(01)00119-X
  6. C.C. Hsu, C.K. Chao, J.L. Wang, S.M. Hou, Y.T. Tsai, J. Lin, "Increase of pullout strength of spinal pedicle screws with conical core: Biomechanical tests and finite element analyses," Orthopedic Research, vol. 23, pp. 788-794, 2005. https://doi.org/10.1016/j.orthres.2004.11.002
  7. C.A. Lill, E. Schneider, J. Goldhahn, A. Haslemann, F. Zeifang, "Mechanical performance of cylindrical and dual core pedicle screws in calf and human vertebrae," Arch Orthop Trauma Surg., vol. 126, pp. 686-694, 2006. https://doi.org/10.1007/s00402-006-0186-6
  8. V.M. Praveen, M.H. Sean, A.K.L. Michael, M.K. Tony, S.R. William, "Biomechanical evaluation of a double threaded pedicle screw in elderly vertebrae," Journal of spinal disorders& techniques, vol. 15, no. 1, pp.64-68, 2002. https://doi.org/10.1097/00024720-200202000-00012
  9. ASTM Standards, F543-17, Standard Specification and Test Methods for Metallic Medical Bone Screws, 2017.
  10. ASTM Standards, F1839-08(2016), Standard Specification for Rigid Polyurethane Foam for Use as a Standard Material for Testing Orthopaedic Devices and Instruments, 2016.
  11. B.S. Myers, P.J. Belmont, W.J. Richardson, J.R. Yu, K.D. Harper, R.W. Nightingale, "The role of imaging and in situ biomechaical testing in assessing pedicle screw pull-out strength," Spine, vol. 21, pp. 1962-1968, 1996. https://doi.org/10.1097/00007632-199609010-00004
  12. C.A. Dickman, R.G. Fessler, M. Macmillan, R.W. Haid, "Transpedicular screw-rod fixation of the lumbar spine: Operative technique and outcome in 104 cases," J. Neurosurg., vol. 77, pp. 860-870, 1992. https://doi.org/10.3171/jns.1992.77.6.0860
  13. K. Okuyama, E. Abe, T. Suzuki, Y. Tamura, M. Chiba, K. Sato, "Can insertional torque predict screw loosening and related failures? An in vivo study of pedicle screw fixation augmenting posterior lumbar interbody fusion," Spine, vol. 25, pp. 858-864, 2000. https://doi.org/10.1097/00007632-200004010-00015
  14. S.M. Renner, T.H. Lim, W.J. Kim, L. Katolik, H.S. An, G.B. Andersson, "Augmentation of pedicle screw fixation strength using an injectable calcium phosphate cement as a function of injection timing and method," Spine, vol. 29, no. 11, pp. 212-216, 2004. https://doi.org/10.1097/00007632-200406010-00020
  15. U. Talu, I. Kaya, F. Dikici, C. Sar, "Pedicle screw salvage: The effect of depth and diameter on pull-out strength: A biomechanical study," Acta Orthop Traumatol Turc, vol. 34, pp. 300-307, 2000.
  16. A.W.L. Kwok, J.A. Finkelstein, T. Woodside, T.C. Hearn, R.W. Hu, "Insertional torque and pull-out strengths of conical and cylindrical pedicle screws in cadaveric bone," Spine, vol. 21, pp. 2429-2434, 1996. https://doi.org/10.1097/00007632-199611010-00004
  17. L.B. Brasiliense, B.C. Lazaro, P.M. Reyes, A.G. Newcomb, J.L. Turner, D.G. Crandall, N. R. Crawford, "Characteristics of immediate and fatigue strength of a dual-threaded pedicle screw in cadaveric spine," Spine J, vol. 13, no. 8, pp. 947-956, 2013. https://doi.org/10.1016/j.spinee.2013.03.010
  18. S.L. Evans, C.M. Hunt, S. Ahuja, "Bone cement of bone substitute augmentation of pedicle screws improves pullout strength in posterior spinal fixation," Material Science, vol. 13, pp. 1143-1145, 2002.
  19. T. Suzuki, E. Abe, K. Okuyama, K. Sato, "Improving the pullout strength of pedicle screws by screw coupling," J Spinal Disord., vol. 14, pp. 399-403, 2001. https://doi.org/10.1097/00002517-200110000-00005
  20. A.W. Turner, R.M. Gillies, M.J. Svehla, M. Saito, W.R. Walsh, "Hydroxyapatite composite resin cement augmentation of pedicle screw fixation," Clin Orthop Relat Res., vol. 406, pp. 253-261, 2003. https://doi.org/10.1097/00003086-200301000-00036
  21. D.W. Polly Jr, J.R. Orchowski, R.G. Ellenbogen, "Revision pedicle screws: Bigger, longer shims-what is best?," Spine, vol. 23, pp. 1374-1379, 1998. https://doi.org/10.1097/00007632-199806150-00015
  22. R. Skinner, J. Maybee, E. Transfeldt, R. Venter, W. Chalmers, "Experimental pullout testing and comparison of variables in transpedicular screw fixation: A biomechanical study," Spine, vol. 15, pp. 195-201, 1990. https://doi.org/10.1097/00007632-199003000-00007
  23. Y.Y. Kim, W.S. Choi, K.W. Rhyu, "Assessment of pedicle screw pullout strength based on various screw designs and bone densities," Spine J, vol. 12, pp. 164-168, 2012. https://doi.org/10.1016/j.spinee.2012.01.014
  24. M.H. Krenn, W.P. Piotrowski, R. Penzkofer, "Influence of thread design on pedicle screw fixation," J Neurosurg Spine, vol. 9, pp. 90-95, 2008. https://doi.org/10.3171/SPI/2008/9/7/090
  25. T.K. Daftari, W.C. Horton, W.C. Hutton, "Correlations between screw hole preparation, torque of insertion, and pullout strength for spinal screws," J Spinal Disord., vol. 7, no. 2, pp. 139-145, 1994. https://doi.org/10.1097/00002517-199407020-00007
  26. K. Mizuno, K. Shinomiya, O. Nakai, S. Shindo, K. Otani, "Intraoperative insertion torque of lumbar pedicle screw and postoperative radiographic evaluation: short-term observation," J Orthop Sci., vol. 10, no. 2, pp. 137-144, 2005. https://doi.org/10.1007/s00776-004-0873-5