Evidence map›Paper›PMID 41932832›Full record

ArticleInternational journal of spine surgery2026

Dental Composite Offers Comparable or Greater Pullout and Shear Strength to Lateral Mass Screw Fixation in a Human Cadaveric Model.

Harsh Wadhwa, Javier Castro, Olivia Okoli, Calvin Chan, Somayeh H Ahmad, Anna Karnowska, Serena S Hu, Jayme C B Koltsov, Karl C Bruckman, James M Mok

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in International journal of spine surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Harsh WadhwaDepartment of Orthopaedic Surgery, Stanford University Medical Center, Stanford, CA, USA.
Javier CastroDepartment of Orthopaedic Surgery, Stanford University Medical Center, Stanford, CA, USA.
Olivia OkoliSchool of Medicine, Stanford University, Stanford, CA, USA.
Calvin ChanDepartment of Orthopaedic Surgery, Stanford University Medical Center, Stanford, CA, USA.
Somayeh H AhmadDepartment of Plastic and Reconstructive Surgery, Stanford University Medical Center, Stanford, CA, USA.
Anna KarnowskaDepartment of Plastic and Reconstructive Surgery, Stanford University Medical Center, Stanford, CA, USA.
Serena S HuDepartment of Orthopaedic Surgery, Stanford University Medical Center, Stanford, CA, USA.
Jayme C B KoltsovDepartment of Orthopaedic Surgery, Stanford University Medical Center, Stanford, CA, USA.
Karl C BruckmanDepartment of Plastic and Reconstructive Surgery, Stanford University Medical Center, Stanford, CA, USA.
James M MokDepartment of Orthopaedic Surgery, Stanford University Medical Center, Stanford, CA, USA jmok1@stanford.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLateral mass screw fixation is the common method of fixation for an instrumented posterior fusion of the subaxial cervical spine. While screws have established efficacy, adhesive material that can be applied to the bony surface may be a promising alternative strategy owing to ease of application, size, and avoidance of screw loosening, malposition, or fracture.

methodsEighteen fresh frozen human cadaveric subaxial cervical vertebrae were prepared for biomechanical testing. In each vertebra, 1 side underwent lateral mass screw fixation, and the contralateral side underwent composite fixation. On the screw side, a 12 × 3.5-mm lateral mass screw was inserted using a standard free-hand technique by a spine surgeon. For the dental composite side, the lamina was treated with etching acid solution and a dental bonding agent over a 10-mm diameter area before an orthodontic metal bracket was attached using dental composite. Nine specimens in each group were subjected to an axial load to failure (pullout) test, where the load was perpendicular to the vertebral surface. The remaining specimens were subjected to cyclical testing, where the load was applied cranially (shear) relative to each vertebra and gradually increased with each cycle until failure occurred. Differences were assessed with paired

resultsUnder axial load (pullout), the dental composite (203.4 ± 43.4 N) showed higher ultimate load than the screws (127.7 ± 21.2 N;

conclusionsDental composite displayed similar shear strength and greater pullout strength compared with lateral mass screws. CLINICAL RELEVANCE: An adhesion-based fixation strategy may serve as a viable alternative to traditional screws in specific clinical scenarios that are worthy of further investigation. LEVEL OF EVIDENCE: 3:

Indexed as

dental compositefixation failurelateral mass screwslooseningposterior cervical fusionpulloutrevision

Identifiers

PMID41932832
PMCPMC13670975

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.