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Biomechanical comparison of alternative densities of pedicle screws for the treatment of adolescent idiopathic scoliosis

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Abstract

Purpose

The objective of this computational study was to compare the biomechanical effects of different implant densities in terms of curve reduction and the force levels at the implant–vertebra interface and on the intervertebral elements.

Methods

Eight cases were randomly picked among patients who have undergone a posterior spinal instrumentation for adolescent idiopathic scoliosis (AIS). For each case, two computer simulations were performed, one with the actual surgery implant pattern and another with the same fusion levels but an alternative implant pattern proposed by an experienced surgeon. The two implant patterns for each case were respectively put into higher and lower implant density group. The spinal correction and the force levels at bone–implant interface and on the intervertebral elements were analyzed and compared between the two groups.

Results

There were on average 13% more pedicle screws and 30% more bilaterally placed pedicle screws in the higher versus lower density group. The difference in the density of screws (92% vs. 79%) did not lead to significant difference in terms of the resulting main thoracic (MT) Cobb angle, and the MT apical axial vertebral rotation. The average and maximum implant-vertebra force levels were about 50 and 65%, respectively higher in the higher versus lower density group, but without consistent distribution patterns. The average intervertebral forces did not significantly differ between the two groups.

Conclusions

With the same fusion levels, lower density screws allowed achieving similar deformity correction and it was more likely to have lower screw–vertebra loads.

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Acknowledgments

This study was funded by the Natural Sciences and Engineering Research Council of Canada (Industrial Research Chair Program with Medtronic of Canada), and the Canada Research Chair Program.

Conflict of interest

None.

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Authors and Affiliations

  1. Department of Mechanical Engineering, Ecole Polytechnique de Montréal, P.O. Box 6079, Downtown Station, Montreal, QC, H3C 3A7, Canada

    Xiaoyu Wang, Carl-Eric Aubin & Isabelle Robitaille

  2. Research Center, Sainte-Justine University Hospital Center, 3175, Cote Sainte-Catherine Road, Montreal, QC, H3T 1C5, Canada

    Carl-Eric Aubin, Isabelle Robitaille & Hubert Labelle

Authors
  1. Xiaoyu Wang
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  2. Carl-Eric Aubin
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  3. Isabelle Robitaille
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  4. Hubert Labelle
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Corresponding author

Correspondence to Carl-Eric Aubin.

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Wang, X., Aubin, CE., Robitaille, I. et al. Biomechanical comparison of alternative densities of pedicle screws for the treatment of adolescent idiopathic scoliosis. Eur Spine J 21, 1082–1090 (2012). https://doi.org/10.1007/s00586-011-2089-7

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  • DOI: https://doi.org/10.1007/s00586-011-2089-7

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