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Title of Journal: Eur Spine J

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Abbravation: European Spine Journal

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Springer-Verlag

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10.1016/0022-4405(73)90057-5

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1432-0932

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A biomechanical analysis of the selfretaining ped

Authors: Wilbert van Laar Rinse J Meester Theo H Smit Barend J van Royen
Publish Date: 2007/01/03
Volume: 16, Issue: 8, Pages: 1209-1214
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Abstract

Regular hooks lack initial fixation to the spine during spinal deformity surgery This runs the risk of posterior hook dislodgement during manipulation and correction of the spinal deformity that may lead to loss of correction hook migration and postoperative junctional kyphosis To prevent hook dislodgement during surgery a selfretaining pedicle hook device SPHD is available that is made up of two counterpositioned hooks forming a monoblock posterior claw device The initial segmental posterior fixation strength of a SPHD however is unknown A biomechanical pullout study of posterior segmental spinal fixation in a cadaver vertebral model was designed to investigate the axial pullout strength for a SPHD and compared to the pullout strength of a pedicle screw Ten porcine lumbar vertebral bodies were instrumented in pairs with two different instrumentation constructs after measuring the bone mineral density of each individual vertebra The instrumentation constructs were extracted employing a material testing system using axial forces The maximum pullout forces were recorded at the time of the construct failure Failure of the SPHD appeared in rotation and lateral displacement without fracturing of the posterior structures The average pullout strength of the SPHD was 236 N versus 1047 N in the pedicle screws P  0001 The pullout strength of the pedicle screws showed greater correlation with the BMC compared to the SPHD P  0005 The SPHD showed to provide a significant inferior segmental fixation to the posterior spine in comparison to pedicle screw fixation Despite the beneficial characteristics of the monoblock claw construct in a SPHD that decreases the risk of posterior hook dislodgement during surgery compared to regular hooks the SPHD does not improve the pullout strength in such a way that it may provide a biomechanically solid alternative to pedicle screw fixation in the posterior spine

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