ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2021
Cortical threaded pedicle screw improves fatigue strength in decreased bone quality.
Article in 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, 2021. 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, 20 citations in OpenAlex.
- Cortical Trajectory Fixation Versus Traditional Pedicle-Screw Fixation in the Treatment of Lumbar Degenerative Patients with Osteoporosis: A Prospective Randomized Controlled Trial.Clinical interventions in aging · 2022Trial
- Risk factors for pedicle screw loosening: a comprehensive review.Journal of orthopaedic surgery and research · 2025Review
- Measurement of Intraoperative Insertional Torque: Usefulness for Prediction of the Deviation of Pedicle Screw Insertion in Lumbar Degenerative Diseases.International journal of spine surgery · 2025Article
- Combined Rigid-Flexible Multibody Analysis Reveals Reduced Pedicle Screw Loads in Short-Segment Fixation for Decompressed Lumbar Spine Stabilization.Annals of biomedical engineering · 2025Article
- Article
- The predictive value of endplate morphology and pedicle screw bone quality score on screw loosening after single-level lumbar spinal fusion surgery.Journal of orthopaedic surgery and research · 2024Article
- Impact of screw tip design on screw anchorage: mechanical testing and numerical simulation.Journal of orthopaedic surgery and research · 2024Article
- [Osteoporotic vertebral fractures of the thoracic and lumbar spine].Unfallchirurgie (Heidelberg, Germany) · 2024Review
- Multi-rod fixation in spinal neuroarthropathy: a novel surgical technique.Journal of spine surgery (Hong Kong) · 2023Article
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeInadequate anchoring of pedicle screws in vertebrae with poor bone quality is a major problem in spine surgery. The aim was to evaluate whether a modified thread in the area of the pedicle could significantly improve the pedicle screw fatigue strength.
methodsFourteen human cadaveric vertebral bodies (L2 and L3) were used for in vitro testing. Bone density (BMD) was determined by quantitative computed tomography. Vertebral bodies were instrumented by standard pedicle screws with a constant double thread on the right pedicle and a partial doubling of the threads-quad thread-(cortical thread) in the area of the pedicle on the left pedicle. Pulsating sinusoidal, cyclic load (0.5 Hz) with increasing peak force (100 N + 0.1 N/cycles) was applied orthogonal to the screw axis. The baseline force remained constant (50 N). Fatigue test was terminated after exceeding 5.4-mm head displacement (~ 20° screw tilting).
resultsThe mean fatigue load at failure was 264.9 N (1682 cycles) for the standard screws and was increased significantly to 324.7 N (2285 cycles) by the use of cortical threaded screws (p = 0.014). This effect is particularly evident in reduced BMD (standard thread 241.2 N vs. cortical thread 328.4 N; p = 0.016), whereas in the group of vertebrae with normal BMD no significant difference could be detected (standard thread 296.5 N vs. cortical thread 319.8 N; p = 0.463).
conclusionsCompared to a conventional pedicle screw, the use of a cortical threaded pedicle screw promises superior fatigue load in vertebrae with reduced bone quality.
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