Removal of broken locking bolts requires careful planning. The following tips facilitate the procedure and reduce operation time. Positioning the patient supine without traction allows optimal adduction. Early screw removal will leave the nail rotationally unstable; apply the jig beforehand. If direct palpation is not possible, access the end cap by a guided drill (Fig 1). Use screw holders (Fi...

STUDY DESIGN Cadaveric biomechanical study. OBJECTIVE To determine fatigue behavior of cortical bone trajectory (CBT) pedicle screws. SUMMARY OF BACKGROUND DATA Cortical bone trajectory screws have been becoming popular in spine surgery; however, the long-term fatigue behavior of the new CBT screws remains understudied and limitations not well defined. METHODS Twelve vertebrae from six ca...

BACKGROUND The wide use of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) surgery in the treatment of degenerative disc disease of lumbar spine in spinal surgery highlights the gradual decrease in the use of traditional pedicle screw insertion technology. This study aims to analyze the accuracy of the true anteroposterior view pedicle screw insertion technique in MIS-TLIF ...

Background: The purpose of this prospective study was to determine the accuracy of pedicular screw insertion withoutthe use of fluoroscopy.Methods: This study was conducted on patients with spinal diseases in need of pedicular screw fixation and fusion.The included patients suffered from such conditions as vertebral fracture, spinal stenosis, kyphosis, tumor, and pelvicf...

Introduction Pedicle screws are commonly used in posterior internal fixation systems to stabilise the spine for fusion procedures. Rigid fixation systems place high requirements on the load-carrying capacity at the screw-bone interface. Poor bone quality decreases the integrity of this interface, increasing screw micromotion and consequently reducing screw stability and possibly fusion success....

PURPOSE To biomechanically evaluate single screw and varying 2 screw fixations for an unstable slipped capital femoral epiphysis (SCFE) model using physiologically relevant loading. STUDY DESIGN In vitro biomechanical study. METHODS Twenty-four immature porcine proximal femurs were prepared to simulate a mild-to-moderate unstable SCFE. The femurs were randomized into 4 fixation groups: sing...

Expansive pedicle screws significantly improve fixation strength in osteoporotic spines. However, the previous literature does not adequately address the effects of the number of lengthwise slits and the extent of screw expansion on the strength of the bone/screw interface when expansive screws are used with or without cement augmentation. Herein, four designs for expansive pedicle screws with ...