The use of sublaminar cables to replace Luque wires

Area of Science:

• Spinal Surgery
• Biomedical Engineering
• Orthopedic Instrumentation

Background:

• Sublaminar wires are used for posterior spinal instrumentation.
• Traditional sublaminar wiring techniques have led to complications like neurologic injury, wire breakage, and dural tears.
• These issues have caused sublaminar wiring to fall into disfavor.

Purpose of the Study:

• To introduce a novel cable system designed to overcome the limitations of sublaminar wires.
• To evaluate the biomechanical properties and clinical efficacy of the new cable system.

Main Methods:

• A cable system with two 49-stranded stainless steel cables and a malleable leader was developed.
• Biomechanical testing included maximum yield strength and fatigue analysis comparing cables to wires.
• Preliminary clinical outcomes were assessed after a mean follow-up of 19 months in 245 patients.

Main Results:

• Stainless steel cables exhibited 2.85-2.94 times greater yield strength than double stainless steel wire loops.
• Fatigue tests showed stainless steel cables withstood 6-22 times more cycles to failure than wires.
• Clinical follow-up revealed no cable breakage or loosening, and no associated complications. Titanium cables showed initial failures due to crimp slipping.

Conclusions:

• The stainless steel cable system demonstrates superior biomechanical strength and fatigue resistance compared to traditional sublaminar wires.
• The flexibility of the cables may reduce neurologic complications by preventing spinal cord contusions during instrumentation.
• Preliminary clinical results are encouraging, suggesting the cable system is a safe and effective alternative for spinal stabilization.