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Stability of different wiring techniques in segmental spinal instrumentation. An experimental study
K D Heller1, A Prescher, T Schneider
1Orthopedic University Clinic, Medical Faculty, Technical University Aachen, Germany.
Archives of Orthopaedic and Trauma Surgery
|February 11, 1998
Summary
Sublaminar wires offer superior pull-out strength compared to transspinous wires for spinal instrumentation. Bone stability, not wire type, limits fixation strength in cadaveric spines.
Area of Science:
- Orthopedic Surgery
- Spinal Biomechanics
- Neurosurgery
Background:
- Segmental spinal instrumentation is crucial for stabilizing the spine.
- Various wiring techniques exist, including sublaminar and transspinous methods.
- Understanding the biomechanical properties of these techniques is essential for surgical success.
Purpose of the Study:
- To compare the pull-out force of sublaminar and transspinous wires used in spinal instrumentation.
- To evaluate the influence of different wiring configurations on spinal stability.
- To identify the limiting factors in segmental spinal stabilization.
Main Methods:
- Human cadaver spines were used for testing.
- Four types of wiring techniques were evaluated: single/double sublaminar wires and two button-wire variations.
- Pull-out forces were measured, and failure modes were analyzed.
Main Results:
- Bone integrity was the primary limiting factor; no wires failed.
- Transspinous techniques exhibited significantly lower pull-out strength (30-45%) than sublaminar techniques.
- Pull-out forces decreased in cranial spinal segments and were influenced by crimps in weaker bone.
Conclusions:
- Sublaminar wiring techniques provide superior fixation strength compared to transspinous methods.
- Bone quality, rather than the specific wiring technique, is the main determinant of fixation stability.
- Crimps enhance fixation in transspinous techniques, particularly in weaker bone structures.