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Related Experiment Videos

Posterior thoracic extrapedicular fixation: a biomechanical study.

Walter Morgenstern1, Stephen J Ferguson, Szilard Berey

  • 1Department of Orthopaedic Surgery, Kantonsspital St. Gallen, Switzerland.

Spine
|August 19, 2003
PubMed
Summary
This summary is machine-generated.

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Extrapedicular pedicle screw placement in the thoracic spine offers comparable stability to the intrapedicular technique. This method enhances surgical safety by increasing the distance to the spinal canal.

Area of Science:

  • Orthopedic surgery
  • Spinal biomechanics
  • Neurosurgery

Background:

  • Pedicle screws offer rigid fixation for spinal instabilities.
  • Thoracic spine pedicle screw placement is approached cautiously due to proximity to the spinal canal and neurological risks.
  • Extrapedicular fixation may offer a safer insertion trajectory.

Purpose of the Study:

  • To compare the mechanical stability of intrapedicular versus extrapedicular pedicle screw techniques in the thoracic spine.
  • To test the hypothesis that extrapedicular screw placement yields an equally rigid spinal construct.

Main Methods:

  • In vitro biomechanical testing of twelve human cadaveric thoracic spines.
  • Instrumentation using the USS system with computed tomography-based navigation for accurate screw placement.

Related Experiment Videos

  • Standardized three-dimensional spine flexibility protocol measuring range of motion (ROM) in flexion-extension, torsion, and lateral bending before and after construct implantation and fatigue testing.

    • Main Results:

    • Spine instrumentation significantly reduced the range of motion by over 50%.
    • No statistically significant difference in ROM reduction was observed between the intrapedicular and extrapedicular techniques.
    • Cyclic fatigue testing did not lead to a significant increase in ROM for either technique.

    Conclusions:

    • The extrapedicular technique provides biomechanical stability equivalent to the intrapedicular technique for thoracic spine fixation.
    • Extrapedicular screw placement offers a potentially safer surgical approach due to increased distance from the spinal canal.