Skip to main content
SpringerLink
Log in

Stability of anterior vertebral body screws after kyphoplasty augmentation

An experimental study to compare anterior vertebral body screw fixation in soft and cured kyphoplasty cement

  • Original Paper
  • Published:
International Orthopaedics Aims and scope Submit manuscript

Abstract

The goal of this cadaver study was to compare the stability of anterior vertebral body screws after implantation in soft or cured kyphoplasty cement. Anterior vertebral body screws were inserted in a total of 30 thoracolumbar vertebrae of ten different human specimens: ten screws were implanted in non-augmented vertebrae (group 1), ten screws were placed in soft cement (group 2), and ten screws were placed in cured cement (group 3). The screws were then tested for biomechanical axial pullout resistance. Mean axial pullout strength was 192 N (range: 10–430 N) in group 1, 364 N (range: 65–875 N) in group 2, and 271 N (range: 35–625 N) in group 3. The paired Student’s t-test demonstrated a significant difference between pullout strength of groups 1 and 2 (p= 0.0475). No significant difference was seen between pullout strength of groups 1 and 3 (p= 0.2646) and between groups 2 and 3 (p= 0.3863). We achieved a 1.9 times higher pullout strength with kyphoplasty augmentation of osteoporotic vertebrae compared with the pullout strength of non-augmented vertebrae. Implantation of anterior vertebral body screws in cured cement is a satisfactory method. With this method we found a 1.4 times higher pullout strength than non-augmented vertebrae.

Résumé

Le but de cette étude est de comparer la stabilité de vis implantées dans le corps vertébral de sujets cadavériques avec ou sans kyphoplastie par ciment. Méthode : 30 vertèbres thoraciques et lombaires sur dix sujets ont été ainsi implantées, 10 vis dans des vertèbres non traitées. Groupe 1 : 10 vis ont été placées dans du ciment mou et 10 vis (groupe 2) et 10 vis (groupe 3) dans du ciment dur. Les vis ont été évaluées sur le plan bio-mécanique et sur la résistance à l’arrachage. Résultat : la résistance à l’arrachage a été de 192 N dans le groupe 1, 1 364 N dans le groupe 2 et 271 N dans le groupe 3. Le test de Student a démontré une différence significative entre groupes 1 et 2 et les groupes 1 et 3, par contre, entre les groupes 2 et 3 il n’a pas été observé de différences significatives. Conclusion : la Kyphoplastie multiplie 1,9 fois la résistance des vertèbres ostéoportiques. Cette technique par inclusion de vis dans le corps vertébral, des vertèbres ainsi traitées est une méthode expérimentale suffisante.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Bai Bo, Kummer J, Spivak J (2001) Augmentation of anterior vertebral body screw fixation by an injectable, biodegradable calcium phosphate bone substitute. Spine 26(24):2679–2683

    Article  PubMed  CAS  Google Scholar 

  2. Cohen JE, Lylyk P, Ceratto R, Kaplan L, Umanskyt F, Gomori JM (2004) Percutaneous vertebroplasty: technique and results in 192 procedures. Neurol Res 26(1):41–49

    Article  PubMed  Google Scholar 

  3. Cotten A, Boutry N, Cortet B (1998) Percutaneous vertebroplasty: state of the art. Radiographics 18:311–323

    PubMed  CAS  Google Scholar 

  4. Gangi A, Kastler BA, Dietemann JL (1994) Percutaneous vertebroplasty guided by a combination of CT and fluoroscopy. Am J Neuroradiol 15:83–86

    PubMed  CAS  Google Scholar 

  5. Garfin S, Hansen A, Reiley M (2001) New technologies in spine: kyphoplasty and vertebroplasty for the treatment of painful osteoporotic compression fractures. Spine 26:1511–1515

    Article  PubMed  CAS  Google Scholar 

  6. Gertzbein SD, Robbins SE (1990) Accuracy of pedicular screw placement in vivo. Spine 15:11–14

    Article  PubMed  CAS  Google Scholar 

  7. Jensen ME, Evans AJ, Mathis JM (1997) Percutaneous polymethylmethacrylate vertebroplasty in the treatment of osteoporotic vertebral body compression fractures: technical aspects. Am J Neuroradiol 18:1897–1904

    PubMed  CAS  Google Scholar 

  8. Kaneda K, Fujiya N, Satoh S (1986) Results with Zielke instrumentation for idiopathic thoracolumbar and lumbar scoliosis. Clin Orthop 205:195–203

    PubMed  Google Scholar 

  9. Kostuik JP, Carl A, Ferron S (1989) Anterior Zielke instrumentation for spinal deformity in adults. J Bone Joint Surg Am 71:898–912

    PubMed  CAS  Google Scholar 

  10. Kostuik JP, Errico TJ, Gleason TF (1986) Techniques of internal fixation for degenerative conditions of the lumbar spine. Clin Orthop 203:219–231

    PubMed  Google Scholar 

  11. Moe JH, Purcell GA, Bradford DS (1983) Zielke instrumentation (VDS) for the correction of spinal curvature: analysis of results in 66 patients. Clin Orthop 180:133–153

    PubMed  Google Scholar 

  12. Molloy S, Mathis JM, Belkoff SM (2003) The effect of vertebral body percentage fill on mechanical behavior during percutaneous vertebroplasty. Spine 28:1549–1554

    Article  PubMed  Google Scholar 

  13. Pfeifer BA, Krag MH, Johnson C (1994) Repair of failed transpedicular screw fixation: a biomechanical study comparing polymethylmethacrylate, milled bone, and matchstick bone reconstruction. Spine 19:350–353

    Article  PubMed  CAS  Google Scholar 

  14. Renner S, Lim T, Kim W, Katolik L, An H, Andersson G (2004) Augmentation of pedicle screw fixation strength using an injectable calcium phosphate cement as a function of injection timing and method. Spine 29(11):212–216

    Article  Google Scholar 

  15. Sarzier JS, Evans AJ, Cahill DW (2002) Increased pedicle screw pullout strength with vertebroplasty augmentation in osteoporotic spines. J Neurosurg Spine 96(3):309–312

    Article  Google Scholar 

  16. Tomita S, Molloy Sean M, Jasper L, Abe M, Belkoff S (2004) Biomechanical comparison of kyphoplasty with different bone cements. Spine 29(11):1203–1207

    Article  PubMed  Google Scholar 

  17. World Health Organisation Technical report (1994) Assessment of fracture risk and its application to screening for postmenopausal osteoporosis, series 843

Download references

Author information

Authors and Affiliations

  1. Orthopaedic Department of University Regensburg, Postfach 1134, D-93074, Bad Abbach, Regensburg, Germany

    O. Linhardt, C. Lüring, J. Matussek, C. Hamberger & J. Grifka

  2. Radiologic Department of University Regensburg, Regensburg, Germany

    T. Herold

  3. Orthopaedic Clinic of Ludwig-Maximilians-University Munich, Groβhadern Clinic, Munich, Germany

    W. Plitz

Authors
  1. O. Linhardt
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. C. Lüring
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J. Matussek
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. C. Hamberger
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. T. Herold
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. W. Plitz
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. J. Grifka
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to O. Linhardt.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Linhardt, O., Lüring, C., Matussek, J. et al. Stability of anterior vertebral body screws after kyphoplasty augmentation. International Orthopaedics (SICOT) 30, 366–370 (2006). https://doi.org/10.1007/s00264-006-0100-4

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-006-0100-4

Keywords

Search

Navigation