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Research ArticleBiomechanics

Biomechanical Assessment of a Novel Sharp-Tipped Screw for 1-Step Minimally Invasive Pedicle Screw Placement Under Navigation

Bernardo de Andrada Pereira, Luke K. O’Neill, Anna G.U. Sawa, James J. Zhou, Piyanat Wangsawatwong, Jennifer N. Lehrman, Jakub Godzik, Alton J. Oldham, Jay D. Turner, Brian P. Kelly, Juan S. Uribe and James Harrop
International Journal of Spine Surgery April 2023, 8470; DOI: https://doi.org/10.14444/8470
Bernardo de Andrada Pereira
1 Spinal Biomechanics Laboratory, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, Arizona, USA
MD
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Luke K. O’Neill
1 Spinal Biomechanics Laboratory, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, Arizona, USA
BS
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Anna G.U. Sawa
1 Spinal Biomechanics Laboratory, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, Arizona, USA
MS
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James J. Zhou
2 Department of Neurosurgery, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, Arizona, USA
MD
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Piyanat Wangsawatwong
1 Spinal Biomechanics Laboratory, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, Arizona, USA
MD
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Jennifer N. Lehrman
1 Spinal Biomechanics Laboratory, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, Arizona, USA
MS
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Jakub Godzik
2 Department of Neurosurgery, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, Arizona, USA
MD
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Alton J. Oldham
1 Spinal Biomechanics Laboratory, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, Arizona, USA
MS
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Jay D. Turner
1 Spinal Biomechanics Laboratory, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, Arizona, USA
MD, PHD
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Brian P. Kelly
1 Spinal Biomechanics Laboratory, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, Arizona, USA
PHD
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  • For correspondence: Neuropub@barrowneuro.org
Juan S. Uribe
2 Department of Neurosurgery, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, Arizona, USA
MD
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James Harrop
Jefferson University Hospitals: Thomas Jefferson University Hospital, 909 Walnut St #2 USA
MD
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  • Figure 1
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    Figure 1

    Images of sharp-tipped, self-tapping pedicle screw used for single-step, minimally invasive 3-dimensional navigation-guided pedicle screw placement (group C). Insets are enlarged to show detail. Used with permission from Barrow Neurological Institute, Phoenix, Arizona.

  • Figure 2
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    Figure 2

    Typical example of peak load at failure vs displacement curve. Used with permission from Barrow Neurological Institute, Phoenix, Arizona.

  • Figure 3
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    Figure 3

    Comparison for various biomechanical parameters between insertion groups. Mean (A) pullout force, (B) fixation stiffness, and (C) displacement of the screw to produce pullout for group A (insertion using the Jamshidi needle and a K-wire with no tapping), group B (insertion using the Jamshidi needle and a K-wire with tapping), and group C (sharp-tipped screw insertion without use of a Jamshidi needle, K-wire, or tapping). Whiskers show SDs. Abbreviation: PS, pedicle screw. Used with permission from Barrow Neurological Institute, Phoenix, Arizona.

  • Figure 4
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    Figure 4

    Linear correlations between (A) pullout force and (B) fixation stiffness vs bone mineral density (BMD). Abbreviation: PS, pedicle screw. Used with permission from Barrow Neurological Institute, Phoenix, Arizona.

Tables

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    Table

    Results for BMD, pullout force, stiffness, and mean displacement to achieve pullout for each pedicle of each specimen; P values are for the paired t test analysis (L vs R in same specimen and level): A vs B, A vs C, B vs C.

    SpecimenBMD (g/cm2)Level, SideGroupPullout Force (N)a Fixation Stiffness (N/mm)b Displacement from Start (mm)c SpecimenLevel, SideGroupPullout Force (N)Fixation Stiffness (N/mm)Displacement From Start (mm)
    10430.883L1, LA23489294.61043L1, RB20635264.7
    10570.885L2, LA21513975.81057L2, RB18644035.7
    10880.810L3, LA14238792.01088L3, RB19008622.8
    10760.795L4, LA13356303.61076L4, RB17304434.8
    10760.795L5, LA7402584.41076L5, RB10013773.8
    11640.885L1, RA215310032.91164L1, LB305710504.0
    12430.644L2, RA14366103.51243L2, LB14827314.0
    12430.644L3, RA13647423.21243L3, LB11955713.9
    11640.885L4, RA26435686.01164L4, LB33439586.0
    10680.815L5, RA14527872.41068L5, LB10755542.1
    12410.585L1, LA19667864.61241L1, RC24117544.3
    10760.795L2, LA15616843.81076L2, RC15615422.7
    12460.651L3, LA9247912.21246L3, RC9067591.2
    10791.002L4, LA17277841.81079L4, RC215714233.0
    11211.137L5, LA13477572.81121L5, RC13283802.8
    12110.419L1, RA8808151.31211L1, LC6222592.6
    12110.419L2, RA6404761.81211L2, LC6123682.2
    11640.885L3, RA18276834.31164L3, LC26862659.1
    12110.419L4, RA5153192.41211L4, LC3022891.3
    10430.883L5, RA8135342.11043L5, LC7803832.0
    11130.713L1, LB210110623.11113L1, RC18847153.5
    10430.883L2, LB32015626.01043L2, RC24774505.6
    10760.795L3, LB13509443.11076L3, RC11399031.8
    10680.815L4, LB141311891.81068L4, RC168411492.0
    10570.885L5, LB14623824.21057L5, RC15526573.0
    12430.644L1, RB12194933.01243L1, LC6553802.3
    11640.885L2, RB22265507.71164L2, LC170254210.5
    12110.419L3, RB5003892.31211L3, LC3593211.2
    10430.883L4, RB12305583.61043L4, LC8733463.8
    12110.419L5, RB4583082.21211L5, LC6903772.4
    • Abbreviations: BMD, bone mineral density; L, left; R, right.

    • Note: Table arranged for paired t test analysis (L vs R in same specimen and level): A vs B, A vs C, B vs C.

    • ↵a The P value for pullout force between groups A and B was P = 0.27, between groups A and C was P = 0.32, and between groups B and C was P = 0.08.

    • ↵b The P value for stiffness between groups A and B was P = 0.66, between groups A and C was P = 0.27, and between groups B and C was P = 0.28.

    • ↵c The P value for displacement to achieve pullout between groups A and B was P = 0.11, between groups A and C was P = 0.50, and between groups B and C was P = 0.82.

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International Journal of Spine Surgery: 19 (S2)
International Journal of Spine Surgery
Vol. 19, Issue S2
1 Apr 2025
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Biomechanical Assessment of a Novel Sharp-Tipped Screw for 1-Step Minimally Invasive Pedicle Screw Placement Under Navigation
Bernardo de Andrada Pereira, Luke K. O’Neill, Anna G.U. Sawa, James J. Zhou, Piyanat Wangsawatwong, Jennifer N. Lehrman, Jakub Godzik, Alton J. Oldham, Jay D. Turner, Brian P. Kelly, Juan S. Uribe
International Journal of Spine Surgery Apr 2023, 8470; DOI: 10.14444/8470

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Biomechanical Assessment of a Novel Sharp-Tipped Screw for 1-Step Minimally Invasive Pedicle Screw Placement Under Navigation
Bernardo de Andrada Pereira, Luke K. O’Neill, Anna G.U. Sawa, James J. Zhou, Piyanat Wangsawatwong, Jennifer N. Lehrman, Jakub Godzik, Alton J. Oldham, Jay D. Turner, Brian P. Kelly, Juan S. Uribe
International Journal of Spine Surgery Apr 2023, 8470; DOI: 10.14444/8470
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Keywords

  • Biomechanics
  • insertion time
  • MIS
  • navigation
  • pullout
  • sharp-tipped screw

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