Biomechanische Studien zur Verankerung von Pedikelschrauben

Zusammenfassung

Dieser Übersichtsartikel befasst sich mit biomechanischen Testungen zur Verankerung von Pedikelschrauben an der thorakolumbalen Wirbelsäule. Es werden verschiedene Verfahren zu Testungen von Gesamtkonstruktionen sowie einzelner Pedikelschrauben erörtert. Im Weiteren werden Ergebnisse bereits durchgeführter Testungen zur Verankerung von Pedikelschrauben diskutiert, in welchen gezeigt werden konnte, dass Adaptionen von Augmentationstechniken und Verbesserungen des Pedikelschraubendesign einen vorteilhaften Einfluss auf die Schraubenverankerung haben. Biomechanische Studien stellen somit ein wichtiges Bindeglied zwischen Entwicklung und Klinik dar.

Abstract

This review article addresses biomechanical testing for pedicle screws anchorage of the thoracolumbar spine. Various methods for testing entire constructions as well as individual pedicle screws are discussed. In addition, results of previous tests on pedicle screws anchorage will be discussed, in which it was shown that adaptations of augmentation techniques and improvements in the pedicle screw design have a beneficial effect on screw anchoring. Biomechanical studies thus represent an important link between development and clinical practice.

Schlüsselwörter

thorakolumbale Wirbelsäule - Biomechanik - Schraubenverankerung

Keywords

thoracolumbar spine - Biomechanics - screw anchoring

Publication History

Article published online:
02 May 2023

• Literatur

• 1 Bostelmann R, Keiler A, Steiger HJ. et al. Effect of augmentation techniques on the failure of pedicle screws under cranio-caudal cyclic loading. Eur Spine J 2007; 26: 181-188 DOI: 10.1007/s00586-015-3904-3. (PMID: 25813011)
• 2 Viezens L, Sellenschloh K, Püschel K. et al. Impact of Screw Diameter on Pedicle Screw Fatigue Strength-A Biomechanical Evaluation. World Neurosurg 2021; 152: e369-e376 DOI: 10.1016/j.wneu.2021.05.108. (PMID: 34087457)
• 3 Frankel BM, Monroe T, Wang C. Percutaneous vertebral augmentation: an elevation in adjacent-level fracture risk in kyphoplasty as compared with vertebroplasty. The Spine Journal 2007; 7: 575-582 DOI: 10.1016/j.spinee.2006.10.020. (PMID: 17905320)
• 4 Wilke HJ, Geppert J, Kienle A. Biomechanical in vitro evaluation of the complete porcine spine in comparison with data of the human spine. Eur Spine J 2011; 20: 1859-1868 DOI: 10.1007/s00586-011-1822-6. (PMID: 21674213)
• 5 Riederer B, Bueno-López J. Anatomy, respect for the body and body donation. A guide for good practice. European Journal of Anatomy 2014; 18: 361-368
• 6 Wilke HJ, Krischak S, Claes LE. Formalin fixation strongly influences biomechanical properties of the spine. J Biomech 1996; 29: 1629-1631
• 7 Costi JJ, Ledet EH, O'Connell GD. Spine biomechanical testing methodologies: The controversy of consensus vs scientific evidence. JOR Spine 2021; 04: e1138 DOI: 10.1002/jsp2.1138. (PMID: 33778410)
• 8 Rohlmann A, Bergmann G, Graichen F. Loads on internal spinal fixators measured in different body positions. Eur Spine J 1999; 08: 354-359 DOI: 10.1007/s005860050187. (PMID: 10552317)
• 9 Rohlmann A, Graichen F, Weber U. et al. 2000 Volvo Award winner in biomechanical studies: Monitoring in vivo implant loads with a telemeterized internal spinal fixation device. Spine 2000; 25: 2981-2986
• 10 Schulze M, Gehweiler D, Riesenbeck O. et al. Biomechanical characteristics of pedicle screws in osteoporotic vertebrae-comparing a new cadaver corpectomy model and pure pull-out testing. J Orthop Res 35: 167-174
• 11 Spiegl UJ, Weidling M, Schleifenbaum S. et al. Comparison of Long Segmental Dorsal Stabilization with Complete Versus Restricted Pedicle Screw Cement Augmentation in Unstable Osteoporotic Midthoracic Vertebral Body Fractures: A Biomechanical Study. World Neurosurg 2020; 143: e541-e549
• 12 Wilke HJ, Kaiser D, Volkheimer D. et al. A pedicle screw system and a lamina hook system provide similar primary and long-term stability: a biomechanical in vitro study with quasi-static and dynamic loading conditions. Eur Spine J 2016; 25: 2919-2928
• 13 Weiser L, Huber G, Sellenschloh K. et al. Time to augment?! Impact of cement augmentation on pedicle screw fixation strength depending on bone mineral density. Eur Spine J 2018; 27: 1964-1971 DOI: 10.1007/s00586-018-5660-7. (PMID: 29948322)
• 14 Liebsch C, Zimmermann J, Graf N. et al. In vitro validation of a novel mechanical model for testing the anchorage capacity of pedicle screws using physiological load application. J Mech Behav Biomed Mater 2018; 77: 578-585 DOI: 10.1016/j.jmbbm.2017.10.030. (PMID: 29096123)
• 15 Schmoelz W, Keiler A, Konschake M. et al. Effect of pedicle screw augmentation with a self-curing elastomeric material under cranio-caudal cyclic loading-a cadaveric biomechanical study. J Orthop Surg Res 2018; 13: 251-257
• 16 Lindtner RA, Schmid R, Nydegger T. et al. Pedicle screw anchorage of carbon fiber-reinforced PEEK screws under cyclic loading. Eur Spine J 2018; 18: 102-110 DOI: 10.1007/s00586-018-5538-8. (PMID: 29497852)
• 17 Schmoelz W, Heinrichs CH, Schmidt S. et al. Timing of PMMA cement application for pedicle screw augmentation affects screw anchorage. Eur Spine J 2017; 26: 2883-2890 DOI: 10.1007/s00586-017-5053-3. (PMID: 28374330)
• 18 Weiser L, Huber G, Sellenschloh K. et al. Insufficient stability of pedicle screws in osteoporotic vertebrae: biomechanical correlation of bone mineral density and pedicle screw fixation strength. Eur Spine J 2017; 26: 2891-2897 DOI: 10.1007/s00586-017-5091-x. (PMID: 28391382)
• 19 Liu D, Zhang B, Xie QY. et al. Biomechanical comparison of pedicle screw augmented with different volumes of polymethylmethacrylate in osteoporotic and severely osteoporotic cadaveric lumbar vertebrae: an experimental study. Spine J 2016; 16: 1124-1132
• 20 Kiner SW, Wybo CD, Sterba W. et al. Biomechanical analysis of different techniques in revision spinal instrumentation: larger diameter screws versus cement augmentation. Spine 2008; 33: 2618-2622 DOI: 10.1097/BRS.0b013e3181882cac. (PMID: 19011543)