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Prospective study of the effect of pedicle screw placement on development of the immature vertebra in an in vivo porcine model

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Abstract

Introduction

There is increasing awareness of the need for pedicle screw constructs in the treatment of spinal deformities in very young children. However, the long-term effects of pedicle screws on the immature spine are still unclear. We used a porcine model to analyze the morphological changes of the spinal canal and vertebral body in response to the placement of pedicle screws.

Methods

13 newborn pigs were operated on. Each pig received a single pedicle screw at the L2 level. After a tenfold increase in body weight (7 months later), the symmetry of the spinal canal and vertebral body was measured on CT scans of the investigational (L2) and control (L3) levels in terms of the angulations of the instrumented and non-instrumented halves of the vertebral body and spinal canal.

Results

After 7 months, the normalised vertebral body angle had reduced on the non-screw side and increased on the screw side, indicating asymmetry in vertebral body growth in the axial plane. The difference was significant (p = 0.009). However, there was no significant difference between the screw and non-screw sides for the spinal canal angles at the L2 level at either the intraoperative or 7-month follow-up assessment (each p > 0.05).

Conclusions

Pedicle screws in the immature porcine spine have a significant effect on the development of the vertebral body. However, in the present study, no corresponding alteration of the morphology of the spinal canal was observed. Our results provide further support for the existing arguments in favour of pedicle screws when weighing up the many factors to be considered in creating a treatment plan for early onset scoliosis.

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Acknowledgment

The authors would like to thank Dave O′Riordan and Jiri Dvorak for their help and support in preparing the manuscript.

Conflict of interest

None.

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Authors and Affiliations

  1. Spine Center, Schulthess Clinic, Zürich, Switzerland

    Tamás Fülöp Fekete, Frank S. Kleinstück & Dezső J. Jeszenszky

  2. Spine Center Division, Department of Research and Development, Schulthess Clinic, Zürich, Switzerland

    Anne F. Mannion

  3. Department and Clinic of Surgery and Ophthalmology, Faculty of Veterinary Science, Szent Istvan University, Budapest, Hungary

    Zsolt S. Kendik

Authors
  1. Tamás Fülöp Fekete
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  2. Frank S. Kleinstück
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  3. Anne F. Mannion
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  4. Zsolt S. Kendik
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  5. Dezső J. Jeszenszky
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Corresponding author

Correspondence to Tamás Fülöp Fekete.

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Fekete, T.F., Kleinstück, F.S., Mannion, A.F. et al. Prospective study of the effect of pedicle screw placement on development of the immature vertebra in an in vivo porcine model. Eur Spine J 20, 1892–1898 (2011). https://doi.org/10.1007/s00586-011-1889-0

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  • DOI: https://doi.org/10.1007/s00586-011-1889-0

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