The effect of screw insertion angle and thread type on the pullout strength of bone screws in normal and osteoporotic cancellous bone models

Medical Engineering and Physics

Volumn 32, Issue 8, 2010, Pages 822-828

  Patel, Purvi S D ^a   Shepherd, Duncan E T ^a   Hukins, David W L ^a  

^a UNIVERSITY OF BIRMINGHAM   (United Kingdom)

Author keywords

Bone screws; Osteoporosis; Pullout strength; Screw insertion angle

Indexed keywords

BONE MODELS; BONE SCREW; CANCELLOUS BONE; CANCELLOUS SCREWS; CORTICAL SCREWS; FOAM DENSITIES; FOAM MATERIAL; OSTEOPOROSIS; OSTEOPOROTIC; POLYURETHANE FOAMS; PULL-OUT FORCE; PULL-OUT STRENGTH; PULL-OUT TEST; SCREW FIXATION; SCREW INSERTION ANGLE; SCREW INSERTIONS;

BONE; FASTENERS; TITANIUM; TITANIUM ALLOYS;

SCREW THREADS;

POLYURETHAN; TITANIUM;

ARTICLE; BONE SCREW; CANCELLOUS BONE; COMPRESSION; CONTROLLED STUDY; CORTICAL BONE; FOAM; FORCE; OSTEOPOROSIS; PRIORITY JOURNAL; TENSILE STRENGTH;

BONE AND BONES; BONE DENSITY; BONE SCREWS; MECHANICAL PROCESSES; MODELS, BIOLOGICAL; ORTHOPEDIC PROCEDURES; OSTEOPOROSIS; POLYURETHANES;

EID: 77956412784     PISSN: 13504533     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.medengphy.2010.05.005     Document Type: Article

References (55)

1. Silverthorn D.U. Human physiology: an integrated approach 2001, Prentice-Hall Inc., New Jersey.
2. Vaccaro A.R., Garfin S.R. Internal fixation (pedicle screw fixation) for fusions of the lumbar spine. Spine 1995, 20:S157-S165.
3. Thompson J.D., Benjamin J.B., Szivek J.A. Pullout strengths of cannulated and noncannulated cancellous bone screws. Clinical Orthopaedics and Related Research 1997, 341:241-249.
4. Hilibrand A.S., Moore D.C., Graziano G.P. The role of pediculolaminar fixation in compromised pedicle bone. Spine 1996, 21:445-451.
5. Lotz J.C., Hu S.S., Chiu D.F.M., Yu M., Colliou O., Poser R.D. Carbonated apatite cement augmentation of pedicle screw fixation in the lumbar spine. Spine 1997, 22:2716-2723.
6. Cordista A., Conrad B., Horodyski M., Walters S., Rechtine G. Biomechanical evaluation of pedicle screws versus pedicle and laminar hooks in the thoracic spine. Spine Journal 2006, 6:444-449.
7. Gausepohl T., Möhring R., Pennig D., Koebke J. Fine thread versus coarse thread: a comparison of the maximum holding power. Injury 2001, 32(Suppl. 4):1-7.
8. Inceoglu S., McLain R.F., Cayli S., Kilincer C., Ferrara L. Stress relaxation of bone significantly affects the pull-out behavior of pedicle screws. Journal of Orthopaedic Research 2004, 22:1243-1247.
9. Inceoglu S., Ehlert M., Akbay A., McLain R.F. Axial cyclic behavior of the bone-screw interface. Medical Engineering & Physics 2006, 28:888-893.
10. Hsu C.C., Chao C.K., Wang J.L., Hou S.M., Tsai Y.T., Lin J. Increase of pullout strength of spinal pedicle screws with conical core: biomechanical tests and finite element analyses. Journal of Orthopaedic Research 2005, 23:788-794.
11. Yi X.D., Wang Y., Lu H.L., Li C.D., Zhu T.Y. Augmentation of pedicle screw fixation strength using an injectable calcium sulfate cement: an in-vivo study. Spine 2008, 33:2503-2509.
12. Moore D.C., Maitra R.S., Farjo L.A., Graziano G.P., Goldstein S.A. Restoration of pedicle screw fixation with an in situ setting calcium phosphate cement. Spine 1997, 22:1696-1705.
13. Becker S., Chavanne A., Spitaler R., Kropik K., Aigner N., Ogon M., Redl H. Assessment of different screw augmentation techniques and screw designs in osteoporotic spines. European Spine Journal 2008, 17:1462-1469.
14. Burval D.J., McLain R.F., Milks R., Inceoglu S. Primary pedicle screw augmentation in osteoporotic lumbar vertebrae-biomechanical analysis of pedicle fixation strength. Spine 2007, 32:1077-1083.
15. Hashemi A., Bednar D., Ziada S. Pullout strength of pedicle screws augmented with particulate calcium phosphate: an experimental study. Spine Journal 2009, 9:404-410.
16. Cook S.D., Salkeld S.L., Stanley T., Faciane A., Miller S.D. Biomechanical study of pedicle screw fixation in severely osteoporotic bone. Spine Journal 2004, 4:402-408.
17. Soshi S., Shiba R., Kondo H., Murota K. An experimental study on transpedicular screw fixation in relation to osteoporosis of the lumbar spine. Spine 1991, 16:1335-1341.
18. Halvorson T.L., Kelley L.A., Thomas K.A., Whitecloud T.S., Cook S.D. Effects of bone mineral density on pedicle screw fixation. Spine 1994, 19:2415-2420.
19. Okuyama K., Sato K., Abe E., Inaba H., Shimada Y., Murai H. Stability of transpedicle screwing for the osteoporotic spine-an in-vitro study of the mechanical stability. Spine 1993, 18:2240-2245.
20. Dvorak M.F., Pitzen T., Zhu Q.G., Gordon J.D., Fisher C.G., Oxland T.R. Anterior cervical plate fixation: a biomechanical study to evaluate the effects of plate design, endplate preparation, and bone mineral density. Spine 2005, 30:294-301.
21. Coe J.D., Warden K.E., Herzig M.A., McAfee P.C. Influence of bone mineral density on the fixation of thoracolumbar implants-a comparative study of transpedicular screws, laminar hooks and spinous process wires. Spine 1990, 15:902-907.
22. Okuyama K., Abe E., Suzuki T., Tamura Y., Chiba M., Sato K. Influence of bone mineral density on pedicle screw fixation: a study of pedicle screw fixation augmenting posterior lumbar interbody fusion in elderly patients. Spine Journal 2001, 1:402-407.
23. Weinstein J.N., Rydevik B.L., Rauschning W. Anatomic and technical considerations of pedicle screw fixation. Clinical Orthopaedics and Related Research 1992, 284:34-46.
24. Hu S.S. Internal fixation in the osteoporotic spine. Spine 1997, 22:43S-48S.
25. Heini P.F. The current treatment-a survey of osteoporotic fracture treatment. Osteoporotic spine fractures: the spine surgeon's perspective. Osteoporosis International 2005, 16(Suppl. 2):S85-S92.
26. Wuisman P., Van Dijk M., Staal H., Van Royen B.J. Augmentation of (pedicle) screws with calcium apatite cement in patients with severe progressive osteoporotic spinal deformities: an innovative technique. European Spine Journal 2000, 9:528-533.
27. Li B., Aspden R.M. Composition and mechanical properties of cancellous bone from the femoral head of patients with osteoporosis or osteoarthritis. Journal of Bone and Mineral Research 1997, 12:641-651.
28. Patel P.S.D., Shepherd D.E.T., Hukins D.W.L. Compressive properties of commercially available polyurethane foams as mechanical models for osteoporotic human cancellous bone. BMC Musculoskeletal Disorders 2008, 9:137.
29. Robert K.Q., Chandler R., Baratta R.V., Thomas K.A., Harris M.B. The effect of divergent screw placement on the initial strength of plate-to-bone fixation. Journal of Trauma-Injury Infection and Critical Care 2003, 55:1139-1144.
30. Ilahi O.A., Al-Fahl T., Bahrani H., Luo Z.P. Glenoid suture anchor fixation strength: effect of insertion angle. Arthroscopy-The Journal of Arthroscopic and Related Surgery 2004, 20:609-613.
31. Jomha N.M., Raso V.J., Leung P. Effect of varying angles on the pullout strength of interference screw fixation. Arthroscopy 1993, 9:580-583.
32. Barber J.W., Boden S.D., Ganey T., Hutton W.C. Biomechanical study of lumbar pedicle screws: does convergence affect axial pullout strength?. Journal of Spinal Disorders 1998, 11:215-220.
33. Kilincer C., Inceoglu S., Sohn M.J., Ferrara L.A., Benzel E.C. Effects of angle and laminectomy on triangulated pedicle screws. Journal of Clinical Neuroscience 2007, 14:1186-1191.
34. Sterba W., Kim D.G., Fyhrie D.P., Yeni Y.N., Vaidya R. Biomechanical analysis of differing pedicle screw insertion angles. Clinical Biomechanics 2007, 22:385-391.
35. Skinner R., Maybee J., Transfeldt E., Venter R., Chalmers W. Experimental pullout testing and comparison of variables in transpedicular screw fixation-a biomechanical study. Spine 1990, 15:195-201.
36. DiPaola C.P., Jacobson J.A., Awad H., Conrad B.P., Rechtine G.R. Screw orientation and plate type (variable- vs. fixed-angle) effect strength of fixation for in vitro biomechanical testing of the Synthes CSLP. Spine Journal 2008, 8:717-722.
37. Zehnder S., Bledsoe J.G., Puryear A. The effects of screw orientation in severely osteoporotic bone: a comparison with locked plating. Clinical Biomechanics 2009, 24:589-594.
38. ASTM F1839-01: Standard specification for rigid polyurethane foam for use as a standard material for testing orthopaedic devices and instruments 2001, American Society for Testing and Materials (ASTM) International, Pennsylvania.
39. BS 3531-5.3:1991; ISO 5835:1991. Implants for osteosynthesis - Part 5. Bone screws and auxiliary equipment - Section 5.3. Specification for the dimensions of screws having hexagonal drive connection, spherical under-surfaces and asymmetrical thread 1991, British Standards Institution, London.
40. Battula S., Schoenfeld A., Vrabec G., Njus G. Experimental evaluation of the holding power/stiffness of the self-tapping bone screws in normal and osteoporotic bone material. Clinical Biomechanics 2006, 21:533-537.
41. Gere J.M., Timoshenko S.P. Mechanics of materials 1997, PWS Publishing Company, Boston.
42. Sawbones® Europe AB, Malmö []. http://www.sawbones.com/products/bio/testblocks/rigidfoam.aspx.
43. Hibbeler R.C. Statics and mechanics of materials 2004, Pearson Prentice Hall, Upper Saddle River, NJ.
44. Peirce B. Criterion for the rejection of doubtful observations. The Astronomical Journal 1852, 2:161-163.
45. Ross S.M. Peirce's criterion for the elimination of suspect experimental data. Journal of Engineering Technology 2003, 20:38-41.
46. Hawkins D.M. Identification of outliers 1980, Chapman and Hall, London.
47. Bland M. An introduction to medical statistics 2000, Oxford University Press, Oxford.
48. Kuzhupilly R.R., Lieberman I.H., McLain R.F., Valdevit A., Kambic H., Richmond B.J. In vitro stability of FRA spacers with integrated crossed screws for anterior lumbar interbody fusion. Spine 2002, 27:923-928.
49. Asnis S.E., Ernberg J.J., Bostrom M.P.G., Wright T.M., Harrington R.M., Tencer A., Peterson M. Cancellous bone screw thread design and holding power. Journal of Orthopaedic Trauma 1996, 10:462-469.
50. DeCoster T.A., Heetderks D.B., Downey D.J., Ferries J.S., Jones W. Optimizing bone screw pullout force. Journal of Orthopaedic Trauma 1990, 4:169-174.
51. Krenn M.H., Piotrowski W.P., Penzkofer R., Augat P. Influence of thread design on pedicle screw fixation-laboratory investigation. Journal of Neurosurgery-Spine 2008, 9:90-95.
52. Chapman J.R., Harrington R.M., Lee K.M., Anderson P.A., Tencer A.F., Kowalski D. Factors affecting the pullout strength of cancellous bone screws. Journal of Biomechanical Engineering-Transactions of the ASME 1996, 118:391-398.
53. Iesaka K., Kummer F.J., Di Cesare P.E. Stress risers between two ipsilateral intramedullary stems-a finite-element and biomechanical analysis. Journal of Arthroplasty 2005, 20:386-391.
54. An Y.H. Internal fixation in osteoporotic bone 2002, Thieme Medical Publishers Inc., New York.
55. Oberg E., Jones F.D., Horton H.L., Ryffel H.H. Working strength of bolts. Machinery's handbook 1988, Industrial Press Inc., New York. R.E. Green (Ed.).