PT - JOURNAL ARTICLE AU - Bernardo de Andrada Pereira AU - Luke K. O’Neill AU - Anna G.U. Sawa AU - James J. Zhou AU - Piyanat Wangsawatwong AU - Jennifer N. Lehrman AU - Jakub Godzik AU - Alton J. Oldham AU - Jay D. Turner AU - Brian P. Kelly AU - Juan S. Uribe ED - Harrop, James TI - Biomechanical Assessment of a Novel Sharp-Tipped Screw for 1-Step Minimally Invasive Pedicle Screw Placement Under Navigation AID - 10.14444/8470 DP - 2023 Apr 18 TA - International Journal of Spine Surgery PG - 8470 4099 - https://www.ijssurgery.com/content/early/2023/04/18/8470.short 4100 - https://www.ijssurgery.com/content/early/2023/04/18/8470.full AB - Background The objective of this study was to assess the pullout force of a novel sharp-tipped screw developed for single-step, minimally invasive pedicle screw placement guided by neuronavigation compared with the pullout force for traditional screws.Methods A total of 60 human cadaveric lumbar pedicles were studied. Three different screw insertion techniques were compared: (A) Jamshidi needle and Kirschner wire without tapping; (B) Jamshidi needle and Kirschner wire with tapping; and (C) sharp-tipped screw insertion. Pullout tests were performed at a displacement rate of 10 mm/min recorded at 20 Hz. Mean values of these parameters were compared using paired t tests (left vs right in the same specimen): A vs B, A vs C, and B vs C. Additionally, 3 L1-L5 spine models were used for timing each screw insertion technique for a total of 10 screw insertions for each technique. Insertion times were compared using 1-way analysis of variance.Results The mean pullout force for insertion technique A was 1462.3 (597.5) N; for technique B, it was 1693.5 (805.0) N; and for technique C, it was 1319.0 (735.7) N. There was no statistically significant difference in pullout force between techniques (P > 0.08). The average insertion time for condition C was significantly less than that for conditions A and B (P < 0.001).Conclusions The pullout force of the novel sharp-tipped screw placement technique is equivalent to that of traditional techniques. The sharp-tipped screw placement technique appears biomechanically viable and has the advantage of saving time during insertion.Clinical Relevance Single-step screw placement using high resolution 3-dimensional navigation has the potential to streamline workflow and reduce operative time.Level of Evidence 5.