Abstract
Study DesignBiomechanical study.PurposeThis study investigates the benefits of supplemental hook fixation (SHF) on short-segment pedicle instrumentation (SSPI) in relation to anterior strut graft positioning. In addition, it seeks to determine whether the integrity of the posterior ligamentous complex (PLC) affects the stability of the spinal construct.Overview of LiteratureImplant and/or bone failure with progressive kyphotic deformity after SSPI is common. To prevent this, several approaches are available, including SHF, anterior strut grafting, use of longer spinal constructs, and extension of the fusion to additional adjacent segments.MethodsA total of eight calf spines were instrumented with SSPI (n=4) and SHF (n=4) with strain gauges on the implants. Strain measurements were performed under axial compression in the following order: intact spine, corpectomy, ventral positioned strut grafting, posterior positioned strut grafting, ventral positioned grafting with resected PLC, and corpectomy with resected PLC.ResultsThe SHF group showed slightly lower strain values than SSPI in instrumented corpectomy-only specimens, but there were no statistically significant differences between them (p >0.05). The SHF group was significantly more stable than SSPI when strut grafting is employed, regardless of the location of the grafts (p =0.000). In the SSPI group, ventral positioning of the graft contributed significantly to the stability (p =0.000). There was no statistically significant difference between the ventral or posterior positioning of the graft in the SHF group (p =0.187). In addition, the integrity of the PLC did not affect stability in either group (p >0.005).ConclusionsAlthough not statistically significant, our investigation demonstrated that the most stable method was the SHF along with ventral positioned strut graft. However, if the SSPI is the treatment of choice, ventral positioned strut graft support will be useful in minimizing the risk of implant failure and progressive kyphotic deformity.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.