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2015 | Book

Introduction Read chapter Read first chapter

The Pullout Performance of Pedicle Screws

Authors: Teyfik Demir, Cemile Basgül

Publisher: Springer International Publishing

Book Series : SpringerBriefs in Applied Sciences and Technology

Part of: Springer Professional "Wirtschaft+Technik" , Springer Professional "Technik"

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About this book

This brief book systematically discusses all subjects that affect the pullout strength of pedicle screws. These screws are used in spinal surgeries to stabilize the spine. The holding strength of the pedicle screw is vital since loosening of the pedicle screws can cause revision surgeries. Once the pedicle screw is pulled out, it is harder to obtain same stabilization for the fused vertebrae. The book reviews the effect of screw designs, application techniques, cement augmentation, coating of the screw and test conditions on the pullout strength. The studies with finite element analysis were also included.

Table of Contents

Frontmatter
Chapter 1. Introduction
Abstract
The vertebrae and the soft tissues come together and constitute the spine. As the vertebra structure changes according to the region of the spine, the all vertebrae consists an anterior part namely vertebral body, which is durable for compressive and tensile loads and a posterior part (neural arch) consisting and protecting the spinal cord meanwhile allows movement of the spine. Intervertebral discs, which absorb the load applied to the vertebrae and regularize the load distribution as having a viscoelastic structure, are positioned between two adjacent vertebrae. The whole construction of the spine is tied together by ligaments and muscles.
Teyfik Demir, Cemile Başgül
Chapter 2. Effect of Screw Design
Abstract
Pullout strength of a pedicle screw is significantly correlated with the screw design. To increase the pullout strength of the screw many researches had already been completed. Pedicle screws with radial holes, different core geometries, thread designs, cannulated screws and expandable screws are different pedicle screw designs with different mechanical properties.
Teyfik Demir, Cemile Başgül
Chapter 3. Effect of Application Techniques
Abstract
As well as design, application technique of screw is also important for pullout strength. Surgeons should avoid application techniques which decrease the pullout strength. Many researches had already investigated tapping, hubbing, fixation techniques and insertional conditions of pedicle screws to increase the holding strength.
Teyfik Demir, Cemile Başgül
Chapter 4. Effect of Cement Augmentation
Abstract
It is difficult to stabilize the spine of patients with poor bone quality by normal pedicle screws. To increase the holding strength of screw, different designs and solutions had been found such as expandable and cannulated pedicle screws. Cement augmentation through the cannulated screws increase the pullout strength significantly.
Teyfik Demir, Cemile Başgül
Chapter 5. Effect of Coating
Abstract
Interface conditions affect the pullout strength of the screw. It is important to have a bonded surface rather than a contact surface between pedicle screw and the vertebrae. For this reason, pedicle screw can be coated with bounding materials to ensure this interface and avoid the screw failures. That explains why the screws are coated with bioresorbable materials to increase the holding strength of the pedicle screws.
Teyfik Demir, Cemile Başgül
Chapter 6. Effect of Test Conditions
Abstract
Pullout strength of a pedicle screw is also affected by test conditions. Pilot holes drilled before insertion and bone quality of test medium have all effects on holding strength of a pedicle screw. These effects on pullout strength of different pedicle screw types (Standard Pedicle Screw, Cannulated Pedicle Screw, and Expandable Pedicle Screw) are shown in Tables 6.1, 6.2 and 6.3, respectively. Tables are expected to help further researchers for their studies.
Teyfik Demir, Cemile Başgül
Chapter 7. Finite Element Modelling Studies
Abstract
Computer aided mechanical analysis is a common application for engineering problems. Conducting such analysis to newly developed systems can reduce the number of design variations without testing. Finite element modeling (FEM) gives the advantage of disabling the over usage of cadavers, synthetic materials, test equipment and so on.
Teyfik Demir, Cemile Başgül
Chapter 8. Conclusion
Teyfik Demir, Cemile Başgül
Metadata
Title
The Pullout Performance of Pedicle Screws
Authors
Teyfik Demir
Cemile Basgül
Copyright Year
2015
Electronic ISBN
978-3-319-16601-8
Print ISBN
978-3-319-16600-1
DOI
https://doi.org/10.1007/978-3-319-16601-8