Jonathan M Vigdorchik1, Xin Jin2, Anil Sethi3, Darren T Herzog1, Bryant W Oliphant1, King H Yang2, Rahul Vaidya1. 1. Department of Orthopedic Surgery, Detroit Receiving Hospital, Detroit Medical Center, 4201 St. Antoine Blvd., Suite 4G, Detroit, MI 48201, United States. 2. Department of Biomedical Engineering, Wayne State University, 818 West Hancock, Detroit, MI 48201, United States. 3. Department of Orthopedic Surgery, Detroit Receiving Hospital, Detroit Medical Center, 4201 St. Antoine Blvd., Suite 4G, Detroit, MI 48201, United States. Electronic address: anilsethi09@gmail.com.
Abstract
OBJECTIVES: The purpose of this study was to biomechanically test a percutaneous pedicle screw construct for posterior pelvic stabilisation and compare it to standard fixation modalities. METHODS: Utilizing a sacral fracture and sacroiliac (SI) joint disruption model, we tested 4 constructs in single-leg stance: an S1 sacroiliac screw, S1 and S2 screws, the pedicle screw construct, and the pedicle screw construct+S1 screw. We recorded displacement at the pubic symphysis and SI joint using high-speed video. Axial stiffness was also calculated. Values were compared using a 2-way ANOVA with Bonferroni adjustment (p<0.05). RESULTS: In the sacral fracture model, the stiffness was greatest for the pedicle screw+S1 construct (p<0.001). There was no significant difference between the pedicle screw construct and S1 sacroiliac screw (p=1). For the SI joint model, the S1+S2 SI screws had the largest overall load and stiffness (p<0.001). The S1 screw was significantly stronger than pedicle screw construct (p=0.001). CONCLUSIONS: The pedicle screw construct biomechanically compares to currently accepted methods of fixation for sacral fractures when the fracture is uncompressible. It should not be used for SI joint disruptions as one SI or an S1+S2 are significantly stiffer and cheaper.
OBJECTIVES: The purpose of this study was to biomechanically test a percutaneous pedicle screw construct for posterior pelvic stabilisation and compare it to standard fixation modalities. METHODS: Utilizing a sacral fracture and sacroiliac (SI) joint disruption model, we tested 4 constructs in single-leg stance: an S1 sacroiliac screw, S1 and S2 screws, the pedicle screw construct, and the pedicle screw construct+S1 screw. We recorded displacement at the pubic symphysis and SI joint using high-speed video. Axial stiffness was also calculated. Values were compared using a 2-way ANOVA with Bonferroni adjustment (p<0.05). RESULTS: In the sacral fracture model, the stiffness was greatest for the pedicle screw+S1 construct (p<0.001). There was no significant difference between the pedicle screw construct and S1 sacroiliac screw (p=1). For the SI joint model, the S1+S2 SI screws had the largest overall load and stiffness (p<0.001). The S1 screw was significantly stronger than pedicle screw construct (p=0.001). CONCLUSIONS: The pedicle screw construct biomechanically compares to currently accepted methods of fixation for sacral fractures when the fracture is uncompressible. It should not be used for SI joint disruptions as one SI or an S1+S2 are significantly stiffer and cheaper.
Authors: Christopher Alexander Becker; Adrian Cavalcanti Kussmaul; Eduardo Manuel Suero; Markus Regauer; Matthias Woiczinski; Christian Braun; Wilhelm Flatz; Oliver Pieske; Christian Kammerlander; Wolfgang Boecker; Axel Greiner Journal: J Orthop Surg Res Date: 2019-12-27 Impact factor: 2.359
Authors: Jan Kubicek; Filip Tomanec; Martin Cerny; Dominik Vilimek; Martina Kalova; David Oczka Journal: Sensors (Basel) Date: 2019-11-27 Impact factor: 3.576