May "Dubel" be a Solution for Pullout Problem of the Pedicle Screws at Osteoporotic Spine?
May "Dubel" be a Solution for Pullout Problem of the Pedicle Screws at Osteoporotic Spine?
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DOI：
10.5137/1019-5149.jtn.9718-13.1
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发表时间：
2014-09-01
影响因子：
0.8
通讯作者：
Baykal, Suleyman
中科院分区：
文献类型：
--
作者：
Cakir, Ertugrul;Eyuboglu, Eylem Eren;Baykal, Suleyman
目的：通过增加椎弓根螺钉的固定力来改善目前用于骨质疏松性脊柱骨折的稳定系统的强度。材料和方法：使用6具人体身体椎体。用双能X线骨密度仪测量标本的骨密度，以评估骨质疏松。所有椎体均被发现严重骨质疏松。左侧椎弓根采用标准椎弓根螺钉固定。右侧椎弓根采用Dubel固定塞加固的椎弓根螺钉。然后，将椎体植入丙烯酸铸型中，以防止骨质疏松性椎体可能发生骨折，并获得正确的垂直拔出矢量。在生物力学试验机上进行生物力学拔出试验。结果：在骨质疏松的人体身体椎弓根螺钉中，Dubel加强型椎弓根螺钉的强度是标准椎弓根螺钉的4倍。结论：Dubel加强型椎弓根螺钉有助于为需要手术的骨质疏松性胸腰椎骨折开发更好的稳定系统，并对以往脊柱融合手术的翻修有帮助。
AIM:To improve the strength of stabilization systems currently used in osteoporotic spinal fractures, essentially by increasing the fixation force of pedicle screws.MATERIAL and METHODS: Six human cadaveric vertebrae were used. Bone mineral densities of the specimens were measured with Dual Energy X-ray Absorptiometry in order to assess the osteoporosis. All vertebrae were found to be severely osteoporotic. Standard pedicle screws were applied to left pedicles of vertebrae. Pedicle screws reinforced by fixing plugs "Dubel" were applied to right pedicles of vertebrae. Afterwards the vertebrae were embedded in acrylic casts to prevent possible fracture of the osteoporotic vertebrae and to obtain a correct vertical pull-out vector. The biomechanical pullout tests were performed with biomechanical testing machine. Pullout forces in each group were recorded and compared with Mann-Whitney U test.RESULTS: The pedicle screws strengthened by "Dubel" were found to be four times stronger than the standard pedicle screws, in the osteoporotic human cadaveric vertebrae.CONCLUSION: "Dubel"-augmented pedicle screws may contribute to developing better stabilization systems for osteoporotic thoracolumbar fractures needing surgery and in the revision of the previous fusion surgeries of the spine.