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Related Experiment Video

Updated: Jun 17, 2026

A Teleoperated Robotic System-Assisted Percutaneous Transiliac-Transsacral Screw Fixation Technique
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A Teleoperated Robotic System-Assisted Percutaneous Transiliac-Transsacral Screw Fixation Technique

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Pull-out strength of sacral implants using Cotrel-Dubousset fixation devices.

F de Peretti1, J Benoliel, I Hovorka

  • 1Service d'Orthopédie et Traumatologie de l'Hôpital Saint Roch, Nice, France.

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
|January 9, 2010
PubMed
Summary
This summary is machine-generated.

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This study identifies optimal sacral screw placement for spinal fusion. The corporopedicular screw in the first sacral vertebra (S1) demonstrated the highest pull-out strength for lumbosacral osteosynthesis.

Area of Science:

  • Orthopedic Surgery
  • Anatomy
  • Biomedical Engineering

Background:

  • Lumbosacral osteosynthesis requires precise screw placement for stability.
  • Understanding sacral bone structure is crucial for safe and effective screw insertion.

Purpose of the Study:

  • To determine the optimal location for lumbosacral screw insertion in the sacrum.
  • To evaluate the bone structure of the sacrum for surgical planning.

Main Methods:

  • Anatomical analysis of sacral bone structure using frozen and CT sections with 3D reconstruction.
  • Density assessment of sacral vertebrae (S1, S2) in Hounsfield units.
  • Experimental testing of 7-mm sacral screw pull-out strength using Cotrel-Dubousset instrumentation.

Main Results:

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  • The ala and lateral S1 contain yellow marrow, influencing screw purchase.
  • The corporopedicular screw in S1 and the caudal lateral oblique screw in S1 showed the best individual pull-out strength.
  • Paired screws including a corporopedicular screw in S1 provided the highest overall pull-out strength.

Conclusions:

  • The corporopedicular screw in the first sacral vertebra (S1) is recommended for optimal pull-out strength in lumbosacral osteosynthesis.
  • Sacral screw placement should consider the specific bone density and anatomical features of S1.