ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2026
Bone density-optimized pedicle screw planning enhances mechanical stability.
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, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed.
- Development and Validation of a Computer-Assisted Screw Trajectory Planning Model Based on Iterative Closest Point Registration and Weighted K-Nearest Neighbors Algorithms for Cortical Bone and Pedicle Screw Techniques.Global spine journal · 2026Article
- Automated multi-objective pedicle screw planning.Journal of spine surgery (Hong Kong) · 2026Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThis study aimed to evaluate whether bone density-optimized (BDO) pedicle screw trajectories improve screw stability compared to standard trajectories in spinal fusion surgery. The central research question was whether preoperative planning based on bone mineral density (BMD) can enhance screw fixation strength and potentially reduce the risk of loosening.
methodsA biomechanical cadaveric study was conducted using thirty human vertebrae. Each vertebra was instrumented with one pedicle screw using a standard trajectory and another using a BDO trajectory. Two trajectory types were tested: traditional trajectory (TT) and cortical bone trajectory (CBT). Screw stability was assessed by mechanical pullout testing, measuring the ultimate force required to extract each screw.
resultsBDO trajectories significantly improved screw pullout strength in both trajectory types. For TT screws, the median increase in pullout force was 43.1% (interquartile range [IQR]: 10.1%, 108.3%; p = 0.004). For CBT screws, the median increase was 37.0% (IQR: -1.5%, 122.6%; p = 0.034).
conclusionBone density-optimized pedicle screw trajectories significantly enhance screw fixation strength in both traditional and cortical trajectories. These findings support the use of personalized, BMD-informed surgical planning to improve spinal fusion outcomes and reduce the incidence of screw loosening.
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Registered trials
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