ArticlePloS one2019
Enhancing percutaneous pedicle screw fixation with hydroxyapatite granules: A biomechanical study using an osteoporotic bone model.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 18 citations in OpenAlex.
- Biomechanical comparison of posterior short-segment fixation with or without intermediate screws for thoracolumbar burst fractures under normal and osteoporotic conditions: a finite element analysis.Asian spine journal · 2026Article
- The Bony Density of the Pedicle Plays a More Significant Role in the Screw Anchorage Ability Than Other Regions of the Screw Trajectory.Orthopaedic surgery · 2025Article
- Impact of screw tip design on screw anchorage: mechanical testing and numerical simulation.Journal of orthopaedic surgery and research · 2024Article
- Incomplete insertion of pedicle screws triggers a higher biomechanical risk of screw loosening: mechanical tests and corresponding numerical simulations.Frontiers in bioengineering and biotechnology · 2023Article
- Innovation of Surgical Techniques for Screw Fixation in Patients with Osteoporotic Spine.Journal of clinical medicine · 2022Review
- Reinforcement of Percutaneous Pedicle Screw Fixation with Hydroxyapatite Granules in Patients with Osteoporotic Spine: Biomechanical Performance and Clinical Outcomes.Medicina (Kaunas, Lithuania) · 2022Review
- Hydroxyapatite Use in Spine Surgery-Molecular and Clinical Aspect.Materials (Basel, Switzerland) · 2022Review
- Predictors of adverse events after percutaneous pedicle screws fixation in patients with single-segment thoracolumbar burst fractures.BMC musculoskeletal disorders · 2022Article
- Novel augmentation technique of percutaneous pedicle screw fixation using hydroxyapatite granules in the osteoporotic lumbar spine: a cadaveric biomechanical analysis.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2021Article
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionPercutaneous pedicle screw (PPS) can provide internal fixation of the thoracolumbar spine through a minimally invasive surgical procedure. PPS fixation has been widely used to treat various spinal diseases. Rigid fixation of PPS is essential for managing osteoporotic spine in order to prevent the risks of screw loosening and implant failure. We recently developed a novel augmentation method using hydroxyapatite (HA) granules for PPS fixation. The aim of this study was to evaluate the strength and stiffness of PPS fixation augmented with HA granules using an osteoporotic bone model.
methodsScrews were inserted into uniform synthetic bone (sawbones) with and without augmentation. The uniaxial pullout strength and insertion torque of the screws were evaluated. In addition, each screw underwent cyclic toggling under incrementally increasing physiological loads until 2 mm of screwhead displacement occurred. The maximal pullout strength (N), maximal insertion torque (N·cm), number of toggle cycles and maximal load (N) required to achieve 2-mm screwhead displacement were compared between the screws with and without augmentation.
resultsThe maximal pullout strength was significantly stronger for screws with augmentation than for those without augmentation (302 ± 19 N vs. 254 ± 17 N, p < 0.05). In addition, the maximal insertion torque was significantly increased in screws with augmentation compared to those without augmentation (48 ± 4 N·cm vs. 26 ± 5 N·cm, p < 0.05). Furthermore, the number of toggle cycles and the maximal load required to reach 2 mm of displacement were significantly greater in screws with augmentation than in those without augmentation (106 ± 9 vs. 52 ± 10 cycles; 152 ± 4 N vs. 124 ± 5 N, p < 0.05).
conclusionsAugmentation using HA granules significantly enhanced the rigidity of PPS fixation in the osteoporotic bone model. The present study suggested that novel augmentation with HA granules may be a useful technique for PPS fixation in patients with osteoporotic spine.
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