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
Biomechanical performance of bicortical versus pericortical bone trajectory (CBT) pedicle screws.
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 8 papers.
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Who cites it
8 citing papers in PubMed, 11 citations in OpenAlex.
- Clinical and radiological evaluation of cortical bone trajectory screw placement using patient-specific 3D templates: a multicentric prospective study.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
- BIOMECHANICAL STUDY OF PULLOUT RESISTANCE OF CORTICAL SCREWS IN SWINE LUMBAR VERTEBRAE.Acta ortopedica brasileira · 2026Article
- Comparison of midline lumbar interbody fusion and minimally invasive transforaminal lumbar interbody fusion for treatment of lumbar degeneration disease.Scientific reports · 2024Article
- The optimal introversion angle and length of pedicle screw to avoid L1-S1 vascular damage.BMC surgery · 2024Article
- Application of the cortical bone trajectory technique in posterior lumbar fixation.World journal of clinical cases · 2023Review
- Location of pedicle screw hold in relation to bone quality and loads.Frontiers in bioengineering and biotechnology · 2022Article
- Editorial: Innovations to improve screw fixation in traumatology and orthopedic surgery.Frontiers in bioengineering and biotechnology · 2022Article
- The treatment efficacy of cortical bone trajectory (CBT) pedicle screws for lumbar degenerative disease in the Chinese Han population.Frontiers in surgery · 2022Article
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe cortical bone trajectory (CBT) is an alternative to the traditional pedicle screw trajectory (TT) in posterior spinal instrumentation, enhancing screw contact with cortical bone and therefore increasing fixation strength. Additional to the trajectory, insertion depth (pericortical vs. bicortical placement) could be a relevant factor affecting the fixation strength. However, the potential biomechanical benefit of a bicortical placement of CBT screws is unknown. Therefore, the aim of this study was to quantify the fixation strength of pericortical- versus bicortical-CBT (pCBT versus bCBT) screws in a randomized cadaveric study.
methodsPedicle screws were either placed pericortical or bicortical with a CBT in 20 lumbar vertebrae (2 × 20 instrumented pedicles) from four human spine cadavers by using patient-specific templates. Instrumented specimens underwent physiological cyclic loading testing (1'800'000 cycles, 10 Hz), including shear and tension loads as well as bending moments. Translational and angular displacements of the screws were quantified and compared between the two techniques.
resultsThere was a slight decrease in translational (0.2 mm ± 0.09 vs. 0.24 mm ± 0.11) and angular displacements (0.06° ± 0.05 vs. 0.13° ± 0.11) of bCBT screws when compared with pCBT screws after 1'800'000 cycles. However, the results were non-significant (p > 0.05).
conclusionThe authors do not recommend placing CBT screws bicortically, as no relevant biomechanical advantage is gained while the potential risk for iatrogenic injury to structures anterior to the spine is increased.
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