RT Journal Article
SR Electronic
T1 Biomechanical Assessment of a Novel Sharp-Tipped Screw for 1-Step Minimally Invasive Pedicle Screw Placement Under Navigation
JF International Journal of Spine Surgery
JO Int J Spine Surg
FD International Society for the Advancement of Spine Surgery
SP 8470
DO 10.14444/8470
A1 Bernardo de Andrada Pereira
A1 Luke K. O’Neill
A1 Anna G.U. Sawa
A1 James J. Zhou
A1 Piyanat Wangsawatwong
A1 Jennifer N. Lehrman
A1 Jakub Godzik
A1 Alton J. Oldham
A1 Jay D. Turner
A1 Brian P. Kelly
A1 Juan S. Uribe
A2 James Harrop
YR 2023
UL https://www.ijssurgery.com/content/early/2023/04/18/8470.abstract
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.