Abstract
BACKGROUND CONTEXT: The pullout strength of a pedicle screw is dependent on several factors, including thread diameter, bone mineral density (BMD), cement augmentation of the screw tract, and triangulation of the screw trajectory. The use of laminar hooks is generally associated with lower pullout force and less dynamic stability than pedicle screws. However, when employed over a short (2 level) thoracic segment, a hybrid construct, which employs one screw and one hook at each level, may prove a reasonable and safe alternative to a construct which utilizes only pedicle screws.
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