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Related Experiment Videos

Transpedicular screw fixation.

J M Moran1, W S Berg, J L Berry

  • 1Cleveland Research Institute, St. Vincent Charity Hospital, Cleveland, OH 44115.

Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society
|January 1, 1989
PubMed
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Transpedicular screws for spinal fixation are safe when implanted using blunt probes for pilot holes, which improve pullout strength. Careful implantation is crucial to prevent screw bending and ensure fatigue life.

Area of Science:

  • Orthopedic Surgery
  • Spinal Biomechanics

Background:

  • Transpedicular screw fixation is increasingly used in spinal surgery worldwide.
  • Lingering concerns exist regarding the safety and efficacy of transpedicular screws.

Purpose of the Study:

  • To evaluate the safety and efficacy of transpedicular screw fixation.
  • To assess vertebral pedicle morphology and bone stock for screw placement.
  • To compare pilot hole preparation methods and screw designs.

Main Methods:

  • Morphological analysis of vertebral pedicles at T2, T7, T12, and L1-L5.
  • Evaluation of pilot hole preparation using blunt probes versus drills.
  • Fatigue testing of different pedicle screw designs.

Main Results:

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  • Vertebral pedicles generally possess adequate bone stock (4-7 mm diameter range) with thick cortical walls.
  • Pilot holes prepared with a 3.4-mm blunt probe yielded higher pullout forces than 3.2-mm drilled holes.
  • Screw bending during implantation significantly reduces fatigue life by 50%.

Conclusions:

  • Transpedicular screw fixation is feasible in the evaluated spinal levels.
  • Blunt probes enhance pedicle screw pullout strength and control.
  • Careful surgical technique is essential to avoid screw bending and ensure device integrity.