Salvage of C2 pedicle and pars screws using the intralaminar technique: a biomechanical analysis

Spine
Ronald A LehmanK Daniel Riew

Abstract

Human cadaveric biomechanical analysis. The purpose of this study is to evaluate the ability of using 1 of the remaining 2 methods of instrumenting C2, should the initial method fail. Although 3 different methods of C2 fixation (pedicle, pars, and laminar screws) are possible, occasionally an attempt at screw insertion fails. In such cases, the surgeon needs a viable alternative to salvage/obtain fixation to obviate the need to instrument an additional motion segment. METHODS.: Eleven fresh-frozen cadaveric specimens (Occ-C4) were DEXA scanned for bone mineral density. On the left side, pedicle screws were first inserted, then pulled out. Then, "salvage" pars screws were inserted, then pulled-out, followed by laminar screws. On the right, a similar sequence was repeated, except that a pars screw was followed by a pedicle screw, then a laminar screw. All screws were placed by experienced cervical spine surgeons. Insertional torque (IT) was measured in Newton-meters (Nm). Tensile loading to failure was performed "in-line"with the screw axis at a rate of 0.25 mm/s using a MTS 858 MiniBionix II System with data recorded as peak pull-out strength (POS) in newtons "N". Pedicle screws generated statistically greater IT and POS than ot...Continue Reading

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Citations

Mar 2, 2010·Archives of Orthopaedic and Trauma Surgery·Fengjin ZhouZhuangchen Zhu
Jan 6, 2011·Archives of Orthopaedic and Trauma Surgery·Ping ZhenLi-Wei Yang
May 1, 2009·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Marco CrostelliElio Ascani
Feb 23, 2010·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Bin YueSeung-Ho Han
Aug 29, 2012·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Michael MayerHeiko Koller
Dec 23, 2008·Journal of Pediatric Orthopedics·Daniel Hedequist, Mark Proctor
Mar 5, 2010·Neurosurgery·Daniel S Yanni, Noel I Perin
Aug 1, 2013·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Sanjiv SinhaRahul Jain
Nov 19, 2013·Surgical and Radiologic Anatomy : SRA·Mourad Ould-SlimaneFabrice Duparc
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Jun 7, 2011·The Spine Journal : Official Journal of the North American Spine Society·Jason W SavageEldin E Karaikovic
Oct 6, 2015·Asian Spine Journal·Daniel MendelsohnMichael C Boyd
Jul 15, 2015·The Spine Journal : Official Journal of the North American Spine Society·Da-Geng HuangXiang-Yi Fang
Apr 23, 2015·Asian Spine Journal·Kriangsak Saetia, Anuchit Phankhongsab
Mar 5, 2015·HSS Journal : the Musculoskeletal Journal of Hospital for Special Surgery·Daniel Hedequist
Dec 27, 2011·Journal of Korean Neurosurgical Society·Kwang Ho LeeJin Myung Jung
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Jan 8, 2020·Asian Spine Journal·Gururaj SangondimathSuman Salimath
Jul 23, 2020·Orthopaedic Surgery·Yu-Cheng WangHai-Qing Mao
Nov 30, 2018·Journal of Neurosurgery. Spine·Chih-Chang ChangHenrich Cheng
Oct 31, 2018·Journal of Orthopaedic Surgery and Research·Hiroshi UeiMasafumi Maseda
Mar 21, 2019·Revista da Associação Médica Brasileira·Cleiton FormentinAndrei F Joaquim
Jul 29, 2017·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Jae Taek HongHoward S An
Jan 11, 2021·World Neurosurgery·John K HoutenGila R Weinstein

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