Biomechanical properties of bone cement injectable canulated pedicle screw / 中国组织工程研究

ABSTRACT

BACKGROUND:Bony and structural feature often cause pulout strength decrease of pedicle screw, which induces loosening and pulout, and finaly results in fixation failure. Thus, it is very important to elevate the stability of pedicle screw. OBJECTIVE:To detect the biomechanical stability of bone cement injectable canulated pedicle screw, and to provide reference for bone cement dosage. METHODS: We selected T11-L4 samples of seven fresh adult corpses, containing 40 vertebral bodies. They were randomly divided into bone cement injectable canulated pedicle screw group and DTPSTM pedicle screw group (n=20). After screw implantation, 1, 2, 3 and 5 mL bone cement was injected. The diffuse distribution of bone cement was observed by imaging. The maximum axial pulout strength was measured. RESULTS AND CONCLUSION:When the dose of bone cement was 1-3 mL, the average maximum axial pulout strength was significantly greater in the bone cement injectable canulated pedicle screw group than in the DTPSTM pedicle screw group (P 0.05). The regression equation was Y=25.269X+133.681 (R2=0.837) in the bone cement injectable canulated pedicle screw, and Y=32.039X+99.251 (R2=0.936) in the DTPSTM pedicle screw group. When the dosage of bone cement was 1-5 mL, the maximum axial pulout strength was highly positively correlated with bone cement dosage (|R| > 0.8). These results suggested that bone cement augmentation pedicle screw could apparently elevate the stability of the screw. The maximum axial pulout strength of the pedicle screw was positively correlated with bone cement dosage. After reaching the satisfactory fixation effects, the bone cement injectable canulated pedicle screw can reduce bone cement dosage, diminish the risk of bone cement leakage, and have more advantages than DTPSTM pedicle screw.