RT Journal Article
SR Electronic
T1 Comparing the Biomechanical Stability of Cortical Screw Trajectory Versus Standard Pedicle Screw Trajectory for Short- and Long-Segment Posterior Fixation in 3-Column Thoracic Spinal Injury
JF International Journal of Spine Surgery
JO Int J Spine Surg
FD International Society for the Advancement of Spine Surgery
SP 245
OP 251
DO 10.14444/6033
VO 13
IS 3
A1 AMEY R. SAVARDEKAR
A1 NESTOR G. RODRIGUEZ-MARTINEZ
A1 ANNA G.U.S. NEWCOMB
A1 PHILLIP M. REYES
A1 HECTOR SORIANO-BARON
A1 STEVE W. CHANG
A1 BRIAN P. KELLY
A1 NEIL R. CRAWFORD
YR 2019
UL http://ijssurgery.com//content/13/3/245.abstract
AB Background: Information on the performance of posterior fixation with cortical screw (CS) versus pedicle screw (PS) trajectories for stabilizing thoracolumbar burst fractures is limited. Therefore, we sought to analyze stability with CS versus PS in short- and long-segment fixations using a 3-column spinal injury model.Methods: Nondestructive flexibility tests: (1) intact, (2) intact + short fixation, (3) intact + long fixation, (4) after burst fracture, (5) short fixation + burst fracture, and (6) long fixation + burst fracture using thoracic spine segments (7 CS, 7 PS).Results: With CS, the range of motion (ROM) was significantly greater with short-segment than with long-segment fixation in all directions, with and without burst fracture (P ≤ .008). With PS and burst fracture, ROM was significantly greater with short fixation during lateral bending and axial rotation (P < .006), but not during flexion-extension (P = .10). Groups with CS versus PS were not significantly different after burst fracture during flexion-extension and axial rotation, with short (P ≥ .58) or long fixation (P ≥ .17). During lateral bending, ROM was significantly greater with CS versus PS, without burst fracture (long fixation, P = .02) and with burst fracture (short and long fixation, P ≤ .001).Conclusions: CS trajectory is a valid alternative to PS trajectory for thoracic spine fixation in 3-column spinal injuries, and long-segment fixation is superior to short-segment fixation with either.