Abstract
To determine whether a biodegradable calcium phosphate cement (CPC) provides significant augmentation of pedicle screw fixation or not, an in vitro biomechanical study was carried out to evaluate the biomechanical effect of CPC in the restoration and augmentation of pedicle screw fixation. Axial pullout test and cyclic bending resistance test were employed in the experiment, and polymethylmethacrylate (PMMA) was chosen as control. The results demonstrate that the pullout strengths following CPC restoration and augmentation are 74%greater on an average than those of the control group, but less than those of PMMA restoration group and augmentation group respectively (increased by 126%versus control). In cyclic bending resistance test, the CPC augmented screws are found to withstand a greater number of cycles or greater loading with less displacement before loosening, but the augmentation effect of PMMA is greater than that of CPC.
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References
Moore D C, Maitra R S, Farjo L A,et al. Restoration of Pedicle Screw Fixation within situ Setting Calcium Phospate Cement.Spine, 1997, 22: 1696–1705
Bai B, Kummer F J, Spivak J. Augmentation of Anterior Vertebral Body Screw Fixation by an Injectable, Biodegradable Calcium Phosphate Bone Substitute.Spine, 2001, 26: 2679–2683
Yang Shuhua, Hu Yong, Chen Zhonghai,et al. Biomechanical Study on Screws with Hollow Lateral Holes Infused with Polymethymethacrylate in Pedicle of Vertebral Arch.Chin. J. Traumatol, 2002, 18: 17–22
Soshi S, Shiba R, Kondo H,et al. An Experimental Study on Transpedicular Screw Fixation in Relation to Osteoporosis of the Lumbar Spine.Spine, 1991, 16: 1335–1341
Zindrick M R, Wilste L L, Widell EH,et al A Biomechanical Study of Intrapedicular Screw Fixation in the Lumbosacral Spine.Clin Orthop, 1986, 203: 99–112
Wittenberg R H, Lee KS, Shea M,et al. Effect of Screw Diameter, Insertion Technique, and Bone Cement Augmentation of Pedicular Screw Fixation Strength.Clin Orthop, 1993, 296: 278–287
Pfeifer B A, Krag M H, Johnson C. Repair of Failed Transpedicle Screw Fixation: A Biomechanical Study Comparing Polymethylmethacrylate, Milled Bone, and Matchstick Bone Reconstruction.Spine, 1994, 19: 350–353
Stankewich C J, Swiontkowski M F, Tencer A F,et al. Augmentation of Femoral Neck Fracture Fixation with an Injectable Calcium-phosphate Bone Mineral Cement.J. Orthop. Res., 1996, 145: 768–793
Allen M J, Park C K, Yuan P S,et al. Barrier Techniques for Preventing PMMA-induced Thermal Injury of the Spinal Cord, Proceedings of 44th Annual Meeting,Orthopaedic Research Society, 1998: 240
Konno S, Olmarker K, Byrod G,et al. The European Spine Society AcroMed Prize 1994: Acute Thermal Nerve Root Injury.Eur. Spine J., 1994, 3: 299–302
McAfee P C, Bohlman H H, Ducker T,etal. Failure of Stabilization of the Spine with Methylmethacrylate: A Retrospective Analysis of Twenty-four Cases.J. Bone Joint Surg. Am., 1986, 68: 1145–1157
Bartucci E J, Gonzalez M H, Cooperman D R,et al. The Effect of Adjunctive Methylmethacrylate on Failures of Fixation and Function in Patients with Intertrochanteric Fractures and Osteoporosis.J. Bone Joint Surg. Am., 1985, 67: 1094–1107
Brown W E, Chow L C.A New Calcium Phosphate, Water-setting Cement. In: Brown PW Ed, Cement Research Progress, Wasterville, Ohio: 1986. 352–379
Lotz J C, Hu S S, Chiu D F,et al. Carbonated Apatite Cement Augmentation of Pedicle Screw Fixation in the Lumber Spine.Spine, 1997, 22: 2716–2723
Mermelstein L E, Chow L C, Friedman C,et al. The Reinforcement of Cancellous Bone Screws with Calcium Phosphate Cement.J. Orthop Trauma., 1996, 10: 15–20
Moore D C, Frankenburg E P, Goulet J A,et al. Hip Screw Augmentation with anin situ-setting Calcium Phosphate Cement: Anin vitro Biomechanical Analysis.J. Orthop Trauma., 1997, 11: 577–583
SHAO Jingfan, Sarkar M R, Kinzl L,et al. Biomechanical Effect of Resorbable Calcium Phosphate Cement Augmentation of Pedicle Screw Fixation.Orthop J. Chin., 2001, 8: c896–899
Knaack D, Goad E B, Aiolova M,et al. Resorbable Calcium Phosphate Bone Substitute.J. Bone Miner. Res., 1998, 43: 399–409
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Yang, Sh., Fu, Dh., Li, J. et al. Augmentation of pedicle screw fixation with calcium phosphate cement. Journal of Wuhan University of Technology-Mater. Sci. Ed. 19, 20–23 (2004). https://doi.org/10.1007/BF03000160
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DOI: https://doi.org/10.1007/BF03000160