ArticleAsian spine journal2021
Impact of Screw Diameter and Length on Pedicle Screw Fixation Strength in Osteoporotic Vertebrae: A Finite Element Analysis.
Article in Asian spine journal, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers.
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Who cites it
50 citing papers in PubMed, 75 citations in OpenAlex.
- Orthopedic Biomaterials in the Clinical Reconstruction of Osteoporotic Atlantoaxial Injuries: A Review.Bioengineering (Basel, Switzerland) · 2026Review
- Multimodal model predicts screw loosening at user-specified postoperative time points after single-level lumbar interbody fusion.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 · 2026Article
- Association between pedicle screw dimensions and pedicle morphometry in computed tomography scans.Journal of Taibah University Medical Sciences · 2026Article
- Agreement Between Automated Pedicle Screw Planning and Surgeon-Selected Implant Dimensions in Thoracic and Lumbar Spine Surgery: A Three-Year Single-Center Study.Journal of clinical medicine · 2026Article
- The Anterolateral Transpedicular Transverse Process Screw Technique: Surgical Techniques, Biomechanical study and Preliminary Outcomes.Orthopaedic surgery · 2026Article
- Minimally Invasive, CT Neuronavigated Posterolateral Pedicle Screw Placement in Upper Cervical Spine: A Retrospective Accuracy and Safety Analysis.Journal of clinical medicine · 2026Article
- Pedicle screw insertion technique into a previously cement-augmented vertebral body: a technical note with a case series.Asian spine journal · 2026Article
- Diagnostic Performance of CT-like Images for Lumbar Pedicle Screw Planning and Spinal Canal Area Measurement: A Comparative Study with Conventional CT and MRI.Tomography (Ann Arbor, Mich.) · 2026Article
- Article
- Power-drill fluoroscopy-controlled technique as an alternative to navigation-assisted pedicle screw placement: A propensity score-matched retrospective cohort study.Brain & spine · 2026Article
- Evaluation of Outcomes from Pedicle Screw Fixation Before and After Laminectomy : Short title: Outcomes of Pedicle Screw Fixation Before and After Laminectomy.Galen medical journal · 2026Article
- A novel UHMWPE anchor for improving the pullout resistance of pedicle screws.Frontiers in bioengineering and biotechnology · 2026Article
- Analysis of biomechanical load cases for the investigation of pedicle screws ASTM F1717 vs. Toggling.Frontiers in bioengineering and biotechnology · 2026Article
- Study on anatomical parameters of modified cortical bone trajectories in the lower lumbar vertebrae.BMC musculoskeletal disorders · 2025Article
- Biomechanical optimization of pedicle screw trajectories in osteoporotic lumbar fusion: finite element analysis and validation of robotic-assisted implementation.Journal of robotic surgery · 2025Article
- Risk factors for screw loosening following lumbar interbody fusion surgery in degenerative lumbar disease: a systematic review and meta-analysis.Asian spine journal · 2025Article
- Risk factors for pedicle screw loosening: a comprehensive review.Journal of orthopaedic surgery and research · 2025Review
- Clinical Outcomes of Transdiscal Screws for Thoracolumbar Spinal Fractures with Marked Anterior Distraction Gap Accompanied by Diffuse Idiopathic Skeletal Hyperostosis.Medicina (Kaunas, Lithuania) · 2025Article
- Article
- Insertional torque and pullout strength of reinserted screws for sacroiliac joint fusion: Effects of implant dimensions, bone density, and tapping.North American Spine Society journal · 2025Article
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
STUDY
designBiomechanical study. PURPOSE: To quantitatively investigate the effect of screw size on screw fixation in osteoporotic vertebrae with finite element analysis (FEA). OVERVIEW OF LITERATURE: Osteoporosis poses a challenge in spinal instrumentation; however, the selection of screw size is directly related to fixation and is closely dependent on each surgeon's experience and preference.
methodsTotal 1,200 nonlinear FEA with various screw diameters (4.5-7.5 mm) and lengths (30-50 mm) were performed on 25 patients (seven men and 18 women; mean age, 75.2±10.8 years) with osteoporosis. The axial pullout strength, and the vertebral fixation strength of a paired-screw construct against flexion, extension, lateral bending, and axial rotation were examined. Thereafter, we calculated the equivalent stress of the bone-screw interface during nondestructive loading. Then, using diameter parameters (screw diameter or screw fitness in the pedicle [%fill]), and length parameters (screw length or screw depth in the vertebral body [%length]), multiple regression analyses were performed in order to evaluate the factors affecting various fixations.
resultsLarger diameter and longer screws significantly increased the pullout strength and vertebral fixation strength; further, they decreased the equivalent stress around the screws. Multiple regression analyses showed that the actual screw diameter and %length were factors that had a stronger effect on the fixation strength than %fill and the actual screw length. Screw diameter had a greater effect on the resistance to screw pullout and flexion and extension loading (β =0.38-0.43, p <0.01); while the %length had a greater effect on resistance to lateral bending and axial rotation loading (β =0.25-0.36, p <0.01) as well as mechanical stress of the bone-screw interface (β =-0.42, p <0.01).
conclusionsThe screw size should be determined based on the biomechanical behavior of the screws, type of mechanical force applied on the corresponding vertebra, and anatomical limitations.
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