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Biomechanics of Posterior Instrumentation for Spinal Arthrodesis

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Abstract

The main purposes of spinal instrumentation are restoration of stability in an inherently unstable or surgically destabilized spine, and correction and maintenance of spinal deformities via forces effected by the instrumentation [1–6]. Spinal instrumentation may be, at large, divided into anterior instrumentation and posterior instrumentation by the element of the vertebral body utilized to fix the implant to the vertebral column. Those fixing the anterior column (usually the vertebra body proper) are considered anterior instrumentation while those fixing the structures of the posterior column (lamina, facets, pedicles) are considered posterior instrumentation.

Though there are many factors which may affect the choice of the instrumentation method for a specific spinal problem, the two most important factors seems to be the location of the pathology causing the instability or the deformity and the experience of the treating surgeon.

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References

  1. Abumi K, Panjabi MM, Duranceau J. Biomechanical evaluation of spinal fixation devices. Part III Stability provided by six spinal fixation devices and interbody bone graft. Spine. 1989;14:1249.

    Article  CAS  PubMed  Google Scholar 

  2. Ashman RB, Galpin RD, Corin JD, Johnston 2nd CE. Bio-mechanical analysis of pedicle screw instrumentation systems in a corpectomy model. Spine. 1989;14:l398.

    Article  Google Scholar 

  3. Cotrel Y, Dubousset J, Guillaumat M. New universal instrumentation in spinal surgery. Clin Orthop. 1988;227:10.

    CAS  PubMed  Google Scholar 

  4. Harrington PR. Treatment of scoliosis: correction and internal fixation by spine instrumentation. J Bone Joint Surg. 1962;44-A:591.

    CAS  PubMed  Google Scholar 

  5. Luque ER. The anatomic basis and development of seg-mental spinal instrumentation. Spine. 1982;7:256.

    Article  CAS  PubMed  Google Scholar 

  6. Suk SI, Lee CK, Kim WJ, Chung YJ, Park YB. Segmental pedicle serew fixation in the treatment of thoracic idio-pathic scoliosis. Spine. 1995;20:l399.

    Article  Google Scholar 

  7. Lenke LG. Posterior and posterolateral approaches to the spine. In: Bridwell KH, Dewald RL, editors. The textbook of spinal surgery. 2nd ed. Philadelphia: Lippincott-Raven; 1997. p. 193.

    Google Scholar 

  8. Benzel EC. Biomechanics of spine stabilization. New York: McGraw-Hill; 1995.

    Google Scholar 

  9. Rudisch A, Kremser C, Peer S, Kathrein A, Judmaier W, Daniaux H. Metallic artifacts in magnetic resonance imaging of patients with spinal fusion. A comparison of implant materials and imaging sequences. Spine. 1998;23:692.

    Article  CAS  PubMed  Google Scholar 

  10. Garfin SR. Spinal fusion: the use of bone screws in the vertebral pedicles. Summation. Spine. 1994;19:2300S.

    Article  CAS  PubMed  Google Scholar 

  11. Zuk SI, Kim WJ, Lee SM, Kim JH, Chung ER. Thoracic pedicle screw fixation in spinal deformities: are they really safe? Spine. 2001;26:2049.

    Article  Google Scholar 

  12. Nazarian SM, Louis RP. Posterior internal fixation with screw plates in traumatic lesions of the cervical spine. Spine. 1991;16:S64.

    Article  CAS  PubMed  Google Scholar 

  13. Licht NJ, Rowe DE, Ross LM. Pitfalls of pedicle screw fix-ation in the sacrum. A cadaver model. Spine. 1992;17:892.

    Article  CAS  PubMed  Google Scholar 

  14. Lonstein JE. The Galveston technique using Luque or Cotrel-Dubousset rods. Orthop Clin North Am. 1994;25:311.

    CAS  PubMed  Google Scholar 

  15. Suk SI, Lee CK, Min HJ, Cho KH, Oh JH. Comparison of Cotrel-Dubousset pedicle screws and hooks in the treatment of idiopathic scoliosis. Int Orthop. 1994;18:341.

    Article  CAS  PubMed  Google Scholar 

  16. Skinner R, Maybee J, Transfeldt E, Venter R, Chalmers W. Experimental pull-out testing and comparison of variables in transpedicular screw fixation. A biome-chanical study. Spine. 1990;15:195.

    Article  CAS  PubMed  Google Scholar 

  17. Suk SI, Cha SI, Lee Ck, Kim WJ. A study on the pull-out strength of pedicle screws in relation to the size of drill 491 holes and inserted screws. Presented at the 30th annual meeting of the Scoliosis Research Society, Asheville, 13–16 Sept 1995.

    Google Scholar 

  18. Kwok AW, Finkelstein JA, Woodside T, Hearn TC, Hu RW. Insertional torque and pull-out strengths of conical and cylindrical pedicle screws in cadaveric bone. Spine. 1996;21:2429.

    Article  CAS  PubMed  Google Scholar 

  19. Yerby SA, Ehteshami JR, McLain RF. Loading of pedicle screws within the vertebra. J Biomech. 1997;30:951.

    Article  CAS  PubMed  Google Scholar 

  20. Schufflebarger HL. Moss Miami Instrumentation. In: Bridwell KH, Dewald RL, editors. The textbook of spinal surgery. 2nd ed. Philadelphia: Lippincott-Raven; 1997. p. 675.

    Google Scholar 

  21. Lim TH, Eck JC, An HS, Hong JH, Ahn JY, You JW. Bio-mechanics of transfixation in pedicle screw instrumen-tation. Spine. 1996;21:2224.

    Article  CAS  PubMed  Google Scholar 

  22. Ritterbusch JF, Ashman RB, Roach JW. Biomechanical comparison of spinal instrumentation systems. Orthop Trans. 1987;11:87.

    Google Scholar 

  23. Cunningham BW, Sefter JC, Shono Y, McAfee PC. Static and cyclical biomechanical analysis of pedicle screw spinal constructs. Spine. 1993;18:1677.

    Article  CAS  PubMed  Google Scholar 

  24. McCormack T, Karaikovic E, Gaines RW. The load-sharing classification of spine fractures. Spine. 1994;19:1741.

    Article  CAS  PubMed  Google Scholar 

  25. Zou D, Yoo JV, Edwards WT, Donovan DM, Chang KW, Bayley JC, et al. Mechanics of anatomic reduction of tho-racolumbar burst fractures. Comparison of distraction versus distraction plus lordosis in the anatomic reduc-tion of the thoracolumbar burst fracture. Spine. 1993;18:195.

    Article  CAS  PubMed  Google Scholar 

  26. Cotrel Y, Dubousset J. A new technique of spine fixation by a posterior approach in the treatment of scoliosis. Rev Chir Othop. 1987;70:489.

    Google Scholar 

  27. Denis F. Cotrel-Dubousset instrumentation in the treat-ment of idiopathic scoliosis. Orthop Clin North Am. 1988;19:291.

    CAS  PubMed  Google Scholar 

  28. Sanders JO, Sanders AE, More R, Ashman RB. A preliminary investigation of shape memory alloys in the surgical correction of scoliosis. Spine. 1993;18:1640.

    Article  CAS  PubMed  Google Scholar 

  29. Denis F. The three-column spine and its significance in the classification of acute thoracolumbar spinal injuries. Spine. 1983;8:817.

    Article  CAS  PubMed  Google Scholar 

  30. Denis F. Spinal instability as defined by the three-column spine concept in acute spinal trauma. Clin Orthop. 1984;189:65.

    PubMed  Google Scholar 

  31. Bradford DS, Tribus CB. Current concepts and manage-ment of patients with fixed decompensated spinal deformity. Clin Orthop. 1994;306:64.

    PubMed  Google Scholar 

  32. Suk SI, Kim JH, Kim WJ, Lee SM, Chung ER, Nah KH. Posterior vertebral column resection for severe spinal deformities. Spine. 2002;27:2374.

    Article  PubMed  Google Scholar 

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Correspondence to S. I. Suk MD, PhD .

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Suk, S.I., Kim, W.J. (2016). Biomechanics of Posterior Instrumentation for Spinal Arthrodesis. In: Poitout, D. (eds) Biomechanics and Biomaterials in Orthopedics. Springer, London. https://doi.org/10.1007/978-1-84882-664-9_35

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  • DOI: https://doi.org/10.1007/978-1-84882-664-9_35

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