Evidence map›Paper›PMID 42383468›Full record

ArticleGlobal spine journal2026

Influence of Lateral Perforation on the Biomechanical Stability of Thoracic Pedicle Screws.

Benno Bullert, Viktor Gupta, Mareike Schonhoff, Sebastian Jaeger, J Philippe Kretzer, Paul A Gruetzner, Sven Y Vetter, Jula Gierse

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In one paragraph

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

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Benno BullertDepartment for Orthopaedics and Trauma Surgery at Heidelberg University, BG Klinik Ludwigshafen, Ludwigshafen, Germany.ORCID 0009-0003-3539-4839
Viktor GuptaDepartment for Orthopaedics and Trauma Surgery at Heidelberg University, BG Klinik Ludwigshafen, Ludwigshafen, Germany.
Mareike SchonhoffResearch Center of Biomechanics and Implant Technology, Department of Orthopaedics, Heidelberg University Hospital, Heidelberg, Germany.
Sebastian JaegerResearch Center of Biomechanics and Implant Technology, Department of Orthopaedics, Heidelberg University Hospital, Heidelberg, Germany.
J Philippe KretzerResearch Center of Biomechanics and Implant Technology, Department of Orthopaedics, Heidelberg University Hospital, Heidelberg, Germany.
Paul A GruetznerDepartment for Orthopaedics and Trauma Surgery at Heidelberg University, BG Klinik Ludwigshafen, Ludwigshafen, Germany.
Sven Y VetterDepartment for Orthopaedics and Trauma Surgery at Heidelberg University, BG Klinik Ludwigshafen, Ludwigshafen, Germany.ORCID 0000-0001-8024-9276
Jula GierseDepartment for Orthopaedics and Trauma Surgery at Heidelberg University, BG Klinik Ludwigshafen, Ludwigshafen, Germany.ORCID 0000-0002-3955-0339

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Study DesignExperimental ex vivo biomechanical cadaver study.ObjectivesThoracic pedicle screws are essential for stabilizing spinal injuries, but misplacement remains a frequent complication. While many studies focus on neurovascular injuries, the impact of the degree of lateral misplacement (offset) on the biomechanical stability of thoracic pedicle screws has not been examined. Therefore, this study aimed to evaluate the influence of lateral offset on pullout force (POF) and peak insertion torque (PIT), and to analyse additional factors such as screw diameter, screw length, and bone quality.MethodsIn this ex vivo cadaveric study, 61 thoracic vertebrae (T1-T12) from seven human cadavers were instrumented using pedicle screws placed with predefined lateral offsets via 3D-printed templates. Each vertebra received one optimal and one offset screw for pairwise comparison. Biomechanical testing included cyclic loading followed by axial pullout testing. Linear mixed-effects models assessed the influence of offset, screw diameter, screw length, and bone density on POF and PIT.ResultsLateral offset significantly reduced POF and PIT. Each millimeter of offset decreased POF by 41.1 N (-9.2%;

Indexed as

biomechanicallateral breachpedicle screw malpositionpullout forcethoracic spine

Identifiers

PMID42383468
PMCPMC13323039

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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.