Enhancing percutaneous pedicle screw fixation with hydroxyapatite granules: A biomechanical study using an osteoporotic bone model
Fig 2
Surgical procedures of augmentation of PPS fixation with HA granules.
A guidewire was inserted into the vertebra, and tapping was performed as a standard procedure of PPS insertion (A). The funnel-shaped external cylinder was placed at the screw hole along the guidewire. HA granules were inserted into the external cylinder (B). The granules were then pushed into the screw hole using the internal cylinder and slide hammer (C). Finally, the cannulated PPS was placed into the screw hole (D).