Biomechanical study of rotational micromovement of the pedicle screw

BACKGROUND In regard to the fixation using a pedicle screw (PS) and rod system, the mechanism from the onset of the clear zone up to the development of loosening of the pedicle screw is not completely clarified. The purpose of this study is to determine the cause of the pedicle screw loosening by performing a biomechanical study with three-dimensional movie analysis. METHODS Ten PS fixation model of the lumbar spines (L3-4) of boar cadavers were used. The rotational angles of the L3 and L4 vertebral body and the screw at the time of applying a ±5 Nm load in the left anterior and right posterior flexion directions respectively were calculated based on those at the time of applying no load. The absolute value of the difference in the rotational angles between each vertebral body with left anterior flexion and right posterior flexion and the inserted screws was defined as rotational micromovement. RESULTS In both the left anterior and right posterior flexion directions, there were significant differences (p < 0.05) in the rotational angles between the screw and the vertebral body for both the L3 and L4 vertebral bodies. CONCLUSION Our biomechanical results showed that rotational micromovement occurred between the PS and the vertebral body, and repeated rotational micromovement might cause loosening of the screw or pullout of PS fixation.